Job detail

Utilization Review Specialist

Banyan Treatment Centers

#Behavioral Health #Healthcare Administration #Managed Care #Joint Commission #Case Load Management #Psychiatric Care #Chemical Dependency #Medical Necessity #Utilization Management #Insurance Benefits

Full Time Remote Ok 0-2 yrs$45,000 - $65,000 / YEARPosted 8 days ago

Location

Pompano Beach, Florida

Salary

$45,000 - $65,000 / YEAR

Quick overview

Manage a caseload of patients by conducting pre-authorization and concurrent reviews to ensure medical necessity and appropriate levels of care. Coordinate with managed care organizations and internal clinical teams to facilitate timely reimbursement and discharge planning.

Requirements summary

Requires a high school diploma or equivalent, with a graduate degree in health or behavioral health preferred. Must have at least one year of experience in utilization review specifically within psychiatric or chemical dependency settings.

high schoolpostgraduate degreeCase ManagementClinical DocumentationInsurance VerificationDischarge PlanningUtilization ReviewPre-authorizationConcurrent ReviewMedical Necessity AssessmentManaged Care CoordinationReimbursement Coordination

Job description

Exciting opportunity with banyan treatment centers!

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.

Position Details

Reports To: Director of Utilization Review
Schedule: Full-Time, Weekdays (Weekend availability as needed).
Location: Remote

Key responsibilities

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.

Requirements

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).

Why join banyan treatment centers?

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.

Apply now!

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.

We are an equal opportunity employer and welcome applicants of all backgrounds. We encourage veterans, active-Duty military, and first responders to apply in support of our first responders program.