Utilization Review Specialist

Employer Industry: Behavioral Health Services

• Opportunity for career advancement and growth within the organization
• Comprehensive benefits package for full-time employees
• Supportive and collaborative work environment focused on mental health
• Chance to make a positive impact on access to behavioral healthcare
• Engage in meaningful work that addresses the mental health crisis
• Work remotely, allowing for flexibility in your work environment

• Oversee all functions of a virtual Intensive Outpatient Program (IOP) caseload
• Collaborate with management to problem-solve complex cases
• Complete pre-certifications and authorizations for virtual IOP clients promptly
• Follow up on outstanding authorizations and report barriers to management
• Deliver training to clinical teams for high-quality documentation standardization

• High School Diploma
• Minimum of 2 years of experience in a utilization role within the utilization review field
• Proficiency in Google applications
• Strong interpersonal and relationship-building skills
• Knowledge of utilization review processes and healthcare regulations

• Familiarity with Inter Qual, MCG, or similar clinical guidelines
• Strong project management skills in a fast-paced environment
• Experience advising and presenting to senior corporate personnel
• Proficiency with electronic medical records (EMR) and utilization management systems
• Understanding of HIPAA and patient confidentiality requirements

#Behavioral Health #Mental Health Care  #Remote Work #Career Opportunity #Healthcare Jobs