Utilization Review Specialist

Seeking an experienced and detail-driven Utilization Review Specialist, the full-time remote position will manage a caseload of 50-75 patients, conducting admission and continuing-stay reviews, coordinating authorizations, and serving as a liaison between clinical operations and managed care organizations. Key Responsibilities Manage a caseload of 50-75 patients, authorizing 15-25 cases daily while ensuring timely utilization reviews and appropriate level of care determinations Conduct admission and continuing-stay reviews to assess medical necessity and ensure compliance with treatment standards Verify insurance benefits, coordinate authorizations, and effectively communicate with external case managers and managed care organizations Required Qualifications High school diploma or equivalent Minimum one year of utilization review experience in a psychiatric or chemical dependency setting Strong organizational, documentation, and communication skills Ability to manage high caseloads with accuracy and efficiency Comfortable working independently in a remote environment