Behavioral Health Utilization & Authorization Specialist

Tcn Behavioral Health Services; Xenia (OH); On-site; USD 52,000 - 78,000; Full time

Job summary

TCN Behavioral Health Services in Xenia, OH is seeking a full-time Behavioral Health Utilization Analyst to manage prior authorizations, utilization review, and reporting. You will review clinical documentation, coordinate with clinical staff, and track authorizations across payer portals to ensure timely service delivery.

The role involves data analysis, creating dashboards, and collaborating with MIS, billing, and leadership to improve processes and outcomes for behavioral health services.

Qualifications

• Associate degree required; bachelor’s preferred in healthcare/admin fields.
• Experience with Medicaid, managed care, payer portals, and prior authorization.
• Experience with data reporting, dashboards, and quality improvement is preferred.

Responsibilities

• Completes prior authorization, reauthorization, continued-stay requests for mental health and SUD services.
• Reviews clinical docs to confirm medical necessity and payer requirements.
• Maintains centralized tracking of authorizations, units, and deadlines.
• Creates reports and dashboards for utilization, denials, and program performance.
• Collaborates with MIS, billing, and leadership to improve data integrity and workflow.

Education

Associate degree

Bachelor’s degree in healthcare administration, human services, behavioral health, business administration, data analytics, or related field

Tools

SQL reporting

Dashboards

Electronic health records (EHR)

Job description

TCN Behavioral Health Services in Xenia, OH is seeking a full-time Behavioral Health Utilization Analyst to manage prior authorizations, utilization review, and reporting. You will review clinical documentation, coordinate with clinical staff, and track authorizations across payer portals to ensure timely service delivery.

The role involves data analysis, creating dashboards, and collaborating with MIS, billing, and leadership to improve processes and outcomes for behavioral health services.