Utilization Review & Care Coordination Specialist

avenuesrecovery; Jackson (NJ); On-site; USD 55,000 - 70,000; Full time

Benefits offered by this job

401(k) with employer match

Medical, Dental, and Vision Insurance

Short- and Long-Term Disability

Life and AD&D Insurance

Pet Insurance

Employee Assistance Program

Flexible Spending Accounts

Job summary

Avenues Recovery Center is seeking a detail-oriented Utilization Review Specialist to join our corporate team in New Jersey. You will support authorization, clinical documentation integrity, and continued stay coordination across our network.

Responsibilities include managing UR workflows, collaborating with clinical and billing teams, and ensuring accurate electronic records that meet payer requirements. We value clear communication and teamwork in a fast-paced healthcare setting.

Qualifications

• High school diploma or GED required.
• Bachelor's degree preferred.
• Nursing background, clinical background or healthcare knowledge strongly preferred.

Responsibilities

• Field incoming calls, emails, and documentation requests related to client authorizations
• Ensure timely approval and continuation of services at the appropriate level of care
• Manage client caseloads and support authorization workflows across facilities
• Advocate for continued stay based on clinical documentation and treatment needs
• Work closely with billing and clinical teams to identify and resolve authorization issues
• Communicate with facility leadership regarding UR status and documentation needs
• Support coordination between treatment teams and administrative departments
• Maintain accurate electronic records of all UR activity and authorization communications
• Ensure documentation meets internal standards and payer requirements
• Assist in identifying gaps in charting and supporting improvements in documentation workflows
• Assist in creating standardized templates and UR workflows across facilities
• Work with site leaders to ensure consistent implementation of processes
• Support improvement of internal UR systems and efficiency initiatives

Skills

Strong communication

Interpersonal skills

Documentation accuracy

Case management

Critical thinking

Deadline management

Education

High school diploma or GED

Bachelor's degree preferred

Nursing background preferred

Job description

Avenues Recovery Center is seeking a detail-oriented Utilization Review Specialist to join our corporate team in New Jersey. You will support authorization, clinical documentation integrity, and continued stay coordination across our network.

Responsibilities include managing UR workflows, collaborating with clinical and billing teams, and ensuring accurate electronic records that meet payer requirements. We value clear communication and teamwork in a fast-paced healthcare setting.