Utilization Review Specialist - Behavioral Health (Remote)

Employer Industry: Behavioral Healthcare Management Why consider this job opportunity Starting pay up to $50,000 per year, based on experience Free Teladoc access and visits for employees and eligible dependents Comprehensive benefits beginning on the 1st day of the month following the date of hire Matching HSA contributions of up to $1,500 per year Employee Referral Bonus of up to $4,000 Opportunity to make a tangible difference in the lives of patients and their families What to Expect (Job Responsibilities) Complete pre-authorizations, concurrent reviews, and internal utilization review assessments Consult with the multidisciplinary treatment team to gather necessary information for concurrent reviews Schedule peer-to-peer reviews and coordinate urgent/expedited appeals Staff individual cases with medical doctors as required Maintain compliance with all standard utilization review policies and procedures What is Required (Qualifications) Bachelor’s degree in a health or behavioral health-related field required; graduate degree preferred High School diploma or equivalent and a state license (e.g., Registered Nurse, Licensed Practical Nurse, LCSW, LMHC) preferred Minimum of three years’ experience in a psychiatric or chemical dependency setting Minimum of three years’ utilization review experience preferred State licensure preferred (Registered Nurse, Licensed Practical Nurse, Licensed Clinical Social Worker, Licensed Mental Health Counselor) How to Stand Out (Preferred Qualifications) Experience in behavioral health management or addiction treatment settings Familiarity with ASAM criteria and utilization review processes Strong organizational skills and ability to manage multiple tasks under pressure Excellent communication skills with managed care companies Proactive problem-solving skills in a healthcare environment

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