Remote Utilization Review Specialist — Behavioral Health

Fherehab; Deerfield Beach (FL); Remote; USD 39,000 - 52,000; Part time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

Life Insurance

401(k)

Paid Time Off

Employee Assistance Program

Professional Growth & Development

Free CEUs

CPR Certification

CPI Certification

Job summary

FHE Health is seeking a Utilization Review Specialist to manage clinical authorization processes and coordinate with insurance payers for timely authorizations. The role supports access to treatment while ensuring documentation reflects medical necessity and compliance.

The candidate should have 2–3 years of UR experience in behavioral health, with strong ASAM criteria knowledge and excellent communication with clinical teams and reviewers.

Qualifications

• Bachelor’s degree required in Nursing, Social Work, Behavioral Health or related field.
• 2-3 years of utilization review experience in behavioral health, addiction treatment or managed care.
• Strong understanding of ASAM criteria, LOCUS, DSM-5 and documentation requirements.
• Excellent clinical summarization and documentation review skills.
• Strong communication with clinical teams and insurance reviewers.
• Ability to problem-solve and manage time-sensitive deadlines.
• High attention to detailed accuracy.

Responsibilities

• Manage all clinical authorization processes to ensure timely, accurate, and compliant communication with insurance payers.
• Secure initial and continued-stay authorizations, preventing avoidable denials.
• Collaborate with clinical teams to ensure documentation reflects medical necessity per payer guidelines.
• Maximize reimbursement, maintain compliance, and support quality patient care across behavioral health services.

Skills

Utilization Review

ASAM criteria

Insurance payer communication

Documentation review

Time management

Problem solving

Clinical collaboration

Education

Bachelor’s Degree in Nursing, Social Work, Behavioral Health or related field

Job description

FHE Health is seeking a Utilization Review Specialist to manage clinical authorization processes and coordinate with insurance payers for timely authorizations. The role supports access to treatment while ensuring documentation reflects medical necessity and compliance.

The candidate should have 2–3 years of UR experience in behavioral health, with strong ASAM criteria knowledge and excellent communication with clinical teams and reviewers.