Licensed Utilization Review Specialist

To support a growing behavioral healthcare team, the remote Licensed Utilization Review Specialist will ensure clinically appropriate care and cost-effective utilization of services, managing the review process from patient admission through discharge while collaborating with multidisciplinary teams. Key responsibilities: Apply utilization criteria to monitor admissions and continued stay reviews Communicate with third-party payers for clinical reviews and document interactions with care team members Review patient charts to confirm ongoing medical necessity and prepare appeals for denied cases as needed Required qualifications: Master's Degree in Social Sciences or equivalent experience Active substance abuse or mental health licensure in the relevant state Minimum of 1 year of experience in a relevant field Ability to exercise discretion and maintain confidentiality in client interactions Knowledge of medical terminology, ASAM dimensions, and utilization review processes Virtual Vocations Inc