Utilization Review Specialist - Behavioral Health (Remote)

Talentify.io; United States; Remote; USD 50,000 - 58,000; Full time

Job summary

A leading company in Behavioral Healthcare Management is seeking a qualified professional to conduct utilization reviews and collaborate with treatment teams. The role offers a starting pay of $50,000 per year, comprehensive benefits, and opportunities for professional growth. Ideal candidates will have a Bachelor's degree in a related field and relevant experience in psychiatric settings. This position allows you to make a meaningful impact on patient care.

Benefits

Free Teladoc access

Comprehensive benefits

Generous matching HSA contribution

Employee referral bonus program

Qualifications

• Minimum of three years’ experience in a psychiatric or chemical dependency setting.
• State licensure preferred (e.g., RN, LPN, LCSW, LMHC).

Responsibilities

• Conduct pre-authorizations and concurrent reviews for insurance payors.
• Collaborate with multidisciplinary treatment teams.
• Maintain communication with managed care companies.

Skills

Organizational Skills

Multitasking

Time Management

Communication

Education

Bachelor’s degree in a health or behavioral health-related field

Graduate degree in a health or behavioral health-related field

Job description

Employer Industry: Behavioral Healthcare Management

Why consider this job opportunity:
- Starting pay of $50,000 per year, based on experience
- Free Teladoc access for employees and eligible dependents
- Comprehensive benefits beginning on the first day of the month following the date of hire
- Generous matching HSA contribution of up to $1,500 per year
- Employee referral bonus program, with the potential to earn up to $4,000
- Opportunity to make a tangible difference in the lives of patients and their families

What to Expect (Job Responsibilities):
- Conduct pre-authorizations and concurrent reviews for insurance payors throughout the patient's treatment
- Collaborate with multidisciplinary treatment teams to gather necessary information for concurrent reviews
- Schedule peer-to-peer reviews and coordinate urgent or expedited appeals
- Maintain communication with managed care companies and coordinate with finance regarding client service authorizations
- Complete detailed daily documentation and follow standard utilization review policies and procedures

What is Required (Qualifications):
- Bachelor’s degree in a health or behavioral health-related field required; graduate degree preferred
- Minimum of three years’ experience in a psychiatric or chemical dependency setting
- Minimum of three years’ experience in utilization review preferred
- State licensure preferred (e.g., Registered Nurse, Licensed Practical Nurse, Licensed Clinical Social Worker, Licensed Mental Health Counselor)
- High School diploma or equivalent is acceptable with relevant state licensure

How to Stand Out (Preferred Qualifications):
- Graduate degree in a health or behavioral health-related field
- Experience with ASAM criteria and census report management
- Strong organizational, multitasking, and time management skills
- Proficiency in establishing effective communication with managed care companies
- Previous experience in a drug-free workplace environment

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