Behavioral Health Utilization & Access Specialist

Row Partners; Sandy (UT); Hybrid; USD 65,000 - 85,000; Full time

Benefits offered by this job

Health, dental, vision benefits

Paid time off

Holidays & sick leave

Growth & training

Team-first culture

Job summary

Row Partners in Utah is seeking a Behavioral Health Utilization Management Specialist to bridge clinical care and insurance coverage. Based in Sandy with hybrid/remote options, you will review records, determine medical necessity, and collaborate with clinicians, payers, and patients to ensure timely access to services.

You’ll conduct clinical reviews across inpatient, outpatient, and residential settings, applying evidence-based criteria, and staying current with industry standards and

Qualifications

• 2+ years in utilization management, case management, or behavioral health services.
• Familiarity with mental health and substance use disorder diagnoses.
• Understanding of insurance coding, billing, and behavioral health authorization procedures.

Responsibilities

• Review medical records to determine medical necessity and appropriateness of behavioral health services.
• Collaborate with clinicians, staff, and insurers to ensure timely access to services.
• Conduct clinical reviews for inpatient, outpatient, and residential behavioral health services.
• Review treatment and discharge plans and progress toward goals.
• Apply clinical criteria and guidelines to approve needed care.
• Stay updated on industry standards, insurance requirements, and protocols.
• Facilitate communication between providers, patients, and payers to resolve barriers.
• Document utilization reviews, audits, and compliance needs.

Skills

Behavioral health knowledge

Evidence-based practices

Communication skills

Multitasking

EHR proficiency

Tools

ASAM

MCG

InterQual

Job description

Row Partners in Utah is seeking a Behavioral Health Utilization Management Specialist to bridge clinical care and insurance coverage. Based in Sandy with hybrid/remote options, you will review records, determine medical necessity, and collaborate with clinicians, payers, and patients to ensure timely access to services.

You’ll conduct clinical reviews across inpatient, outpatient, and residential settings, applying evidence-based criteria, and staying current with industry standards and