Utilization Review Specialist – Behavioral Health (Remote)

🌍 Remote, USA 🎯 Full-time 🕐 Posted Recently

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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Salary: USD 36000 - 60000 per year

Experience: 3 years required

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