Behavioral Health Utilization Strategist

Tcn Behavioral Health Services; Xenia (OH); On-site; USD 52,000 - 76,000; Full time

Job summary

TCN Behavioral Health Services in Xenia, OH seeks a Behavioral Health Utilization Analyst to manage prior authorization, utilization management, and related data reporting for mental health and substance use disorder services.

You will collaborate with clinical staff, billing, MIS, and external payers to ensure medical necessity criteria are met, documentation is complete, and authorizations are tracked from start to finish, with attention to timeframes and payer requirements.

Qualifications

• Associate degree required; bachelor’s degree preferred in healthcare administration or related field.
• Experience with Medicaid, managed care, payer portals, and prior authorization forms preferred.
• Strong attention to detail and ability to manage multiple deadlines.
• Experience with data management, reporting, or analytics preferred.

Responsibilities

• Will handle prior authorizations and related denials.
• Prepare narratives and medical necessity summaries.
• Develop and maintain utilization reports and dashboards.
• Coordinate with clinical staff and payers.
• Maintain confidentiality per HIPAA.

Skills

Attention to detail

Multi-tasking

Communication

Education

Associate degree

Bachelor's degree preferred

Tools

SQL reporting

EHR systems

Job description

TCN Behavioral Health Services in Xenia, OH seeks a Behavioral Health Utilization Analyst to manage prior authorization, utilization management, and related data reporting for mental health and substance use disorder services.

You will collaborate with clinical staff, billing, MIS, and external payers to ensure medical necessity criteria are met, documentation is complete, and authorizations are tracked from start to finish, with attention to timeframes and payer requirements.