Clinical Utilization Liaison — QA, Insurance & Compliance

Avenues Recovery; Clarksville (IN); On-site; USD 52,000 - 76,000; Full time

Benefits offered by this job

Competitive Compensation

Generous Paid Time Off

401(k) with Company Match

Medical, Dental & Vision Insurance

Employer-Paid Life & AD&D Insurance

Short- and Long-Term Disability

Flexible Spending Accounts

Employee Assistance Program

Legal Coverage

Pet Insurance

Identity Theft Protection

Accident, Critical Illness & Hospital

Company Culture

Job summary

Avenues Recovery Center is seeking a detail-oriented Utilization Review Liaison to bridge clinical teams, leadership, and the Utilization Review department. This role focuses on documentation compliance, medical necessity, and coordinating insurance-related activities to uphold high-quality care.

The ideal candidate is organized, patient-centered, and capable of supporting admissions, treatment planning, and continuous improvement across our nationwide network of facilities.

Qualifications

• High School Diploma or GED required.
• Minimum one year of experience in behavioral health or related field preferred.
• Knowledge of medical terminology and utilization review processes preferred.
• Strong organizational, communication, and follow-up skills.
• If in recovery, a minimum of one year of sustained sobriety is required.

Responsibilities

• Quality Assurance & Compliance: Conduct regular chart audits to ensure documentation accuracy and regulatory compliance.
• Quality Assurance & Compliance: Monitor processes to identify opportunities for improvement.
• Quality Assurance & Compliance: Track missing documentation and ensure timely completion of chart elements.
• Quality Assurance & Compliance: Support accreditation and compliance initiatives.
• Utilization Review & Insurance Coordination: Liaise between staff, leadership, and Utilization Review.
• Utilization Review & Insurance Coordination: Assist with insurance authorizations, concurrent and peer reviews, and appeals.
• Utilization Review & Insurance Coordination: Support medical necessity determinations.
• Utilization Review & Insurance Coordination: Coordinate admissions, continued stay reviews, and discharge planning.
• Clinical & Team Support: Participate in treatment team meetings and collaborate with leadership.
• Clinical & Team Support: Engage with clients to support retention and individualized care.
• Clinical & Team Support: Assist with intake assessments, group facilitation, and clinical duties.
• Clinical & Team Support: Identify training and process improvement opportunities.

Skills

Organizational skills

Communication skills

Follow-up skills

Interpersonal skills

Collaboration

Sobriety

Education

High school diploma

Job description

Avenues Recovery Center is seeking a detail-oriented Utilization Review Liaison to bridge clinical teams, leadership, and the Utilization Review department. This role focuses on documentation compliance, medical necessity, and coordinating insurance-related activities to uphold high-quality care.

The ideal candidate is organized, patient-centered, and capable of supporting admissions, treatment planning, and continuous improvement across our nationwide network of facilities.