Behavioral Health Utilization Review Specialist

Aspire Health Partners, Inc.; Orlando (FL); On-site; USD 52,000 - 68,000; Full time

Job summary

Aspire Health Partners in Orlando, FL is seeking a Utilization Review Specialist to coordinate insurance utilization review for hospitalized clients, support treatment planning, and ensure timely authorizations.

You will work with clinical teams, insurance reviewers, and internal departments to optimize patient outcomes while maintaining confidentiality and compliance with organizational policies.

Qualifications

• High School Diploma or equivalent
• Level II Background clearance- All Aspire Health Partners Internships and Careers require Level 2 clearance, with Aspire covering fingerprinting costs.
• Valid driver’s license with an acceptable driving record per organizational guidelines

Responsibilities

• Partner daily with the Access Center and/or Crisis Response Center (CRC) to identify clients needing utilization review
• Communicate clinical information to insurance reviewers to secure authorizations and extended lengths of stay
• Collaborate with attending psychiatrists on clinical assessments and treatment recommendations
• Participate in interdisciplinary treatment team meetings to support care for managed care clients
• Provide constructive clinical feedback to enhance service delivery and patient care
• Ensure accurate authorization details are submitted to Patient Accounts for billing
• Review client charts for potential denial issues and support appeal processes when needed
• Maintain strict adherence to ethical standards, confidentiality, and organizational policies

Job description

Aspire Health Partners in Orlando, FL is seeking a Utilization Review Specialist to coordinate insurance utilization review for hospitalized clients, support treatment planning, and ensure timely authorizations.

You will work with clinical teams, insurance reviewers, and internal departments to optimize patient outcomes while maintaining confidentiality and compliance with organizational policies.