Utilization Review Specialist - Behavioral Health, SUD Network

Utilization Review Specialist - Behavioral Health, SUD Network

Avenues Recovery Center is a nationwide network of drug and alcohol rehabilitation centers with eighteen locations across seven states. We provide highly individualized, evidence-based treatment in clean, modern settings across all levels of care including detox, residential, PHP, IOP, and outpatient services.

Our success is driven by our people and a strong clinical model that has helped transform thousands of lives. We are seeking a Utilization Review Specialist to join our corporate team in New Jersey and support authorization, clinical documentation integrity, and continued stay coordination across our network.

Position Overview

Location: Corporate office - New Jersey Schedule: Full-time

The Utilization Review Specialist ensures timely authorization of client services, supports appropriate level-of-care determinations, and partners closely with clinical and billing teams to maintain accurate documentation and continuity of care across facilities.

This role requires strong communication, attention to detail, and the ability to collaborate across clinical, administrative, and billing departments.

Key Responsibilities

Utilization Review & Authorization Management

• Field incoming calls, emails, and documentation requests related to client authorizations
• Ensure timely approval and continuation of services at the appropriate level of care
• Manage client caseloads and support authorization workflows across facilities
• Advocate for continued stay based on clinical documentation and treatment needs

Clinical & Billing Collaboration

• Work closely with billing and clinical teams to identify and resolve authorization issues
• Communicate with facility leadership regarding UR status and documentation needs
• Support coordination between treatment teams and administrative departments

Documentation & Compliance

• Maintain accurate electronic records of all UR activity and authorization communications
• Ensure documentation meets internal standards and payer requirements
• Assist in identifying gaps in charting and supporting improvements in documentation workflows

Systems & Process Improvement

• Assist in creating standardized templates and UR workflows across facilities
• Work with site leaders to ensure consistent implementation of processes
• Support improvement of internal UR systems and efficiency initiatives

Qualifications

Required / Preferred Education

• High school diploma or GED required
• Bachelor's degree preferred
• Nursing background, clinical background or healthcare knowledge strongly preferred

Experience

• Minimum 1 year of experience in behavioral health, healthcare, or treatment setting preferred
• Experience with utilization review, insurance authorization, or medical billing strongly preferred

Core Skills

• Strong communication (written and verbal)
• Excellent interpersonal and collaboration skills
• Strong attention to detail and documentation accuracy
• Ability to manage multiple cases and deadlines
• Sound judgment and critical thinking
• Flexible, team-oriented, and adaptable in a fast-paced environment

Why Join Avenues?

At Avenues, our people are our greatest strength. We foster a culture of support, collaboration, and purpose-driven work, where every team member is valued and empowered to make an impact.

We provide the tools, resources, and benefits needed to help you succeed both personally and professionally.

Comprehensive Benefits

• 401(k) with employer match
• Medical, Dental, and Vision Insurance
• Accident, Critical Illness, and Hospital Indemnity coverage
• Employer-paid Life and AD&D Insurance
• Short- and Long-Term Disability options
• Legal coverage and Identity Theft Protection
• Pet Insurance
• Employee Assistance Program (EAP)
• Flexible Spending Accounts (Medical & Dependent Care)

Join our growing team and discover the magic here at Avenues!

Apply today!