Impactful Utilization Review Specialist

International Executive Service Corps; Santa Clarita (CA); On-site; USD 85,000 - 105,000; Full time

Job summary

Henry Mayo Newhall Hospital in Valencia, CA is seeking a Utilization Review Specialist to ensure appropriate, cost-effective care. You will review service utilization, coordinate treatment, support discharge planning, and liaise with insurers, patients, families, and providers.

The role requires a Master’s in Social Work (or related field), CA licensure (LCSW/LMFT/ASW), and 2 years of acute care experience, with strong interpersonal and leadership skills to improve patient outcomes.

Qualifications

• Current CA license as LCSW, LMFT, or ASW.
• Current BLS provider card.
• Master’s degree in Social Work, Behavioral or Mental Health or related field preferred.
• Two years acute care experience.
• Prefer one year post licensure direct behavioral health care experience.

Responsibilities

• Performs utilization reviews and coordinates treatment.
• Interacts with insurers, patients, families, and care teams.
• Supports discharge planning and ensures regulatory compliance.
• Refers complex psycho-social cases to clinical social workers and educates staff on utilization practices.

Skills

Interpersonal skills

Communication

Team-building

Organizational skills

Leadership

Negotiation

Payer knowledge

Education

MSW or related health field

Job description

Henry Mayo Newhall Hospital in Valencia, CA is seeking a Utilization Review Specialist to ensure appropriate, cost-effective care. You will review service utilization, coordinate treatment, support discharge planning, and liaise with insurers, patients, families, and providers.

The role requires a Master’s in Social Work (or related field), CA licensure (LCSW/LMFT/ASW), and 2 years of acute care experience, with strong interpersonal and leadership skills to improve patient outcomes.