Utilization Review Specialist - Behavioral Health, SUD Network

Utilization Review Specialist 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. 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 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) #J-18808-Ljbffr AVENUES RECOVERY CENTER