Utilization Review Specialist

We are seeking a Utilization Review Specialist to join our corporate team in Pompano Beach, FL. The position is responsible for contacting external case managers and managed care organizations for pre-authorization and concurrent reviews for the duration of a patient's treatment stay. They also establish and maintain contracts with managed care companies and requests rate increases when deemed appropriate.

Reports To:

Director of Utilization Review Schedule:

Full-Time, Weekdays (Weekend availability as needed).

Location:

Remote Manage a caseload of 50-75 patients and authorize 15-25 cases daily, ensuring timely utilization reviews and appropriate level of care. Verify insurance benefits , coordinate authorizations, and communicate effectively with managed care providers. Conduct admission and continuing-stay reviews to assess medical necessity and ensure compliance with treatment standards. Collaborate with clinical and billing departments to support discharge planning, documentation, and timely reimbursement. Identify and address over/underutilization trends and assist in resolving outstanding case issues with insurers. Manage a caseload of 50-75 patients and authorize 15-25 cases daily, ensuring timely utilization reviews and appropriate level of care. Verify insurance benefits , coordinate authorizations, and communicate effectively with managed care providers. Conduct admission and continuing-stay reviews to assess medical necessity and ensure compliance with treatment standards. Collaborate with clinical and billing departments to support discharge planning, documentation, and timely reimbursement. Identify and address over/underutilization trends and assist in resolving outstanding case issues with insurers. High School diploma or equivalent; graduate degree in a health or behavioral health related field preferred. Minimum of one-year experience working in a utilization review position (psychiatric or chemical dependency). This is more than a job, it's a chance to be a vital part of what recovery looks like after treatment. As a Utilization Review Specialist , you'll help ensure that each client leaves treatment with a clear plan, strong connections, and the resources they need to continue their recovery journey with confidence. Join a

Mission-Driven, Nationally Recognized Organization:

We're accredited by the Joint Commission and backed by TPG's Rise Fund, with 18 locations and Telehealth services nationwide. Champion the

Continuum of Care:

Be a key player in ensuring clients transition successfully from treatment into long-term recovery supports. Work in

Partnership:

Collaborate with clinical, operational, and business development teams, as well as families and external partners, to make sure no detail is missed.

Enjoy Comprehensive Benefits:

Including medical, vision, and dental insurance; whole and term life insurance; short- and long-term disability coverage; 401(k) with employer match; paid time off and holidays; and wellness, assistance, and referral programs. If you're passionate about building bridges to lasting recovery and ensuring every patient has a plan beyond our doors, apply today and help us continue making a difference at Banyan Treatment Centers. Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.