Utilization Review Specialist
virtual vocationsNew York, NY
Utilization Review Specialist
virtual vocationsNew York, NY
8 days ago
Occupations
Substance Abuse and Behavioral Disorder CounselorsMental Health and Substance Abuse Social WorkersMedical Records SpecialistsIndustries
Outpatient Mental Health and Substance Abuse CentersPsychiatric and Substance Abuse HospitalsAll Other Miscellaneous Ambulatory Health Care ServicesAbout the role
To support the treatment of addiction and mental health issues, the full-time Remote Utilization Review Specialist will manage pre-authorizations and concurrent reviews, collaborating with case managers and the multidisciplinary treatment team to ensure compliance with insurance requirements.
Key responsibilities:
Completes pre-authorizations, concurrent reviews, and internal utilization reviews
Consults with the treatment team to gather necessary information for concurrent reviews
Schedules peer-to-peer reviews and coordinates urgent appeals as needed
Required qualifications:
Bachelor's degree in a health or behavioral health-related field required; graduate degree preferred
High School diploma or equivalent with a state license (e.g., RN, LPN, LCSW, LMHC) 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., RN, LPN, LCSW, LMHC)
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JOB OVERVIEW
Experience level
Senior
Location
New York, NY
Occupation
Substance Abuse and Behavioral Disorder Counselors
Industry
Outpatient Mental Health and Substance Abuse Centers
Posted
8 days ago
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