Behavioral Health Utilization Management Specialist

Ampian HR; Draper (UT); Hybrid; USD 60,000 - 90,000; Full time

Benefits offered by this job

Competitive salary

Comprehensive benefits

Growth opportunities

Job summary

Row Partners is seeking a Behavioral Health Utilization Management Specialist in Utah to bridge clinical care and insurance coverage and ensure timely access to services for patients.

You will review records, collaborate with clinicians and payers, and conduct clinical reviews across inpatient, outpatient, and residential settings while staying current with industry standards and regulatory guidelines. The role requires attention to detail, strong communication, and a patient-centered approach.

Qualifications

• Experience reviewing medical records to determine medical necessity and appropriateness.
• Collaborate with clinicians, medical staff, and insurance providers to ensure timely access to services.
• Understanding of behavioral health diagnoses and treatment criteria.

Responsibilities

• Champion patient care by reviewing records to determine medical necessity and appropriateness of behavioral health services.
• Collaborate with clinicians and insurance providers to ensure timely access to services.
• Conduct clinical reviews for inpatient, outpatient, and residential behavioral health services.
• Ensure quality of care by reviewing treatment plans and discharge plans.
• Support evidence-based treatment by applying clinical criteria and guidelines to approve and recommend necessary care.
• Stay ahead of industry standards, insurance requirements, and treatment protocols.
• Advocate for patients by facilitating communication between providers, patients, and payers.
• Document with precision for utilization reviews, audits, and compliance needs.

Skills

Utilization management

Behavioral health

Medical records review

Insurance coordination

EHR proficiency

Tools

ASAM

MCG

InterQual

Job description

Behavioral Health Utilization Management Specialist

Location: Utah (Hybrid & Remote Options Available)

Job Type: Full-time

Department: Behavioral Health / Utilization Management

Who We Are

At Row Partners, we’re more than a healthcare support organization — we’re a passionate team dedicated to empowering behavioral health facilities and their patients. We believe that compassionate, accessible, and high-quality care starts with the right people on our team.

Our Behavioral Health division is growing, and we’re looking for a Behavioral Health Utilization Management Specialist who shares our commitment to improving access, ensuring appropriate care, and supporting patient success stories every day.

If you’re driven by purpose, thrive in a collaborative environment, and want your work to make a real difference, this role is for you.

The Role

As a Behavioral Health Utilization Management Specialist, you will be the bridge between clinical care and insurance coverage — ensuring patients receive the right services, at the right time, for the right reasons. Your expertise will help providers, patients, and payers work together toward the shared goal of better behavioral health outcomes.

What You'll Do

• Champion patient care by reviewing medical records and clinical documentation to determine medical necessity and appropriateness of behavioral health services.
• Collaborate and connect with clinicians, medical staff, and insurance providers to make sure patients get timely access to the services they need.
• Conduct clinical reviews for inpatient, outpatient, and residential behavioral health services.
• Ensure quality of care by reviewing treatment plans, discharge plans, and progress toward goals.
• Support evidence-based treatment by applying clinical criteria and guidelines to approve and recommend necessary care.
• Stay ahead of industry standards, insurance requirements, and treatment protocols.
• Advocate for patients by facilitating communication and resolving barriers between providers, patients, and payers.
• Document with precision for utilization reviews, audits, and compliance needs.

What You Bring

Proven Success

• A history of professional growth, creative problem-solving, and a commitment to excellence.
• Integrity, accountability, and a collaborative spirit that uplifts your team and patients alike.

Preferred Experience

• 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.

Preferred Skills

• Strong knowledge of Behavioral Health diagnosis, Treatments, and evidence-based practices.
• Comfort with utilization management tools (ASAM, MCG, InterQual).
• Excellent communication and relationship-building skills.
• Ability to multitask in a fast-paced environment.
• EHR system proficiency.

(If you don’t have all the experience listed, but have the passion and potential to succeed, we’re willing to train the right candidate.)

Work Location

• Based in Sandy, Utah — remote work available for those living more than 50 miles from the office.

Why You’ll Love Working With Us

• Competitive salary & comprehensive benefits (health, dental, vision).
• Paid time off, sick leave, and paid holidays.
• Opportunities for growth, training, and continuing education.
• Supportive, team-first culture where your contributions matter.
• The chance to impact lives and improve care outcomes every single day.

If you’re ready to use your skills to make a lasting difference in behavioral health care, we’d love to hear from you. Apply today and join a team thats shaping the future of patient care.