Behavioral Health Utilization Specialist

Jackalope Digital LLC; DeKalb (IL); Hybrid; USD 60,000 - 95,000; Full time

Benefits offered by this job

Tuition reimbursement

Loan forgiveness

401(k) matching

Lifecycle benefits

Job summary

Northwestern Medicine Ben Gordon Center in DeKalb, IL, is seeking an Utilization Reviewer for Behavioral Health Programs. The role conducts concurrent, prospective, and retrospective reviews to ensure compliance across Medicaid, grants, and accreditation, while supporting program outcomes with robust documentation and data reporting.

The ideal candidate has 2+ years of utilization review experience and a Master’s in Social Work or Psychology, or a BSN with RN license, with a standard 40-hour

Qualifications

• 2+ years of utilization review experience.
• Experience with behavioral health documentation standards.
• Knowledge of Medicaid, grant, and regulatory requirements.

Responsibilities

• Conduct concurrent, prospective, and retrospective utilization reviews of clinical records.
• Audit assessments, treatment plans, IM+CANS, IATP, progress notes and discharge documentation.
• Monitor timeliness, completeness, and quality of documentation; identify deficiencies and recommend actions.
• Collaborate with clinical leaders to improve documentation quality and compliance outcomes.

Skills

Utilization review

Documentation compliance

Quality improvement

Education

Master's in Social Work

Master's in Psychology

BSN with RN

Tools

EPIC EHR

Job description

Northwestern Medicine Ben Gordon Center in DeKalb, IL, is seeking an Utilization Reviewer for Behavioral Health Programs. The role conducts concurrent, prospective, and retrospective reviews to ensure compliance across Medicaid, grants, and accreditation, while supporting program outcomes with robust documentation and data reporting.

The ideal candidate has 2+ years of utilization review experience and a Master’s in Social Work or Psychology, or a BSN with RN license, with a standard 40-hour