Behavioral Health Utilization Specialist

Northwestern Medicine; DeKalb (IL); On-site; USD 106,589,044 - 149,287,756; Full time

Benefits offered by this job

Tuition Reimbursement

Student Loan Repayment

Professional Development

Wellbeing Fund

401(k) Matching

Job summary

Northwestern Medicine Ben Gordon Center in DeKalb, Illinois, seeks a full-time Utilization Reviewer for Behavioral Health Programs. The role provides utilization review, documentation auditing, and grant compliance support across multiple behavioral health services, collaborating with leaders, clinical staff, and grant managers to improve outcomes.

The ideal candidate will have 2+ years in utilization review or chart auditing, a Master’s degree in Social Work or Psychology or a BSN with RN

Qualifications

• 2+ years of experience in utilization review, quality assurance, or chart auditing.
• Knowledge of Medicaid, grant, accreditation, and payer requirements.
• Experience with IM+CANS, IATP, and treatment planning documentation.
• Experience with EPIC or other behavioral health EHR systems.

Responsibilities

• Conduct concurrent, prospective, and retrospective utilization reviews of clinical records.
• Review documentation for compliance with Medicaid, grant, accreditation, payer, and program-specific requirements.
• Audit assessments, treatment plans, IM+CANS, IATP, progress notes, and related records.
• Monitor timeliness, completeness, and quality of documentation; identify trends and improvement actions.
• Collaborate with clinical leaders to improve documentation quality and compliance outcomes.
• Provide education and technical assistance to staff on documentation standards and requirements.

Skills

Utilization review

Clinical documentation

Regulatory compliance

EPIC EHR

Quality improvement

Education

Masters in Social Work or Psychology or BSN with RN license

Tools

EPIC EHR

Job description

Northwestern Medicine Ben Gordon Center in DeKalb, Illinois, seeks a full-time Utilization Reviewer for Behavioral Health Programs. The role provides utilization review, documentation auditing, and grant compliance support across multiple behavioral health services, collaborating with leaders, clinical staff, and grant managers to improve outcomes.

The ideal candidate will have 2+ years in utilization review or chart auditing, a Master’s degree in Social Work or Psychology or a BSN with RN