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MH

Utilization Management Reviewer

Mental Health Resource Center·Jacksonville, Florida

Full Time·On Site·2-5 yrs·Posted 13 days ago
Practice for this role

About the role

The reviewer monitors the utilization of clinical services and ensures the level of care is appropriate based on patient diagnosis and needs. They manage communications with third-party payers and coordinate psychiatric consultations between providers.

Benefits/Perks Medical, Dental, and Vision Insurance Life Insurance Disability Insurance 403b PTO Paid Holidays Flexible Spending Account Employee Assistance Program Company Overview Mental Health Resource Center is a not-for-profit Florida corporation that provides a wide range of mental health and behavioral health care services to the community such as 24-hour emergency services, inpatient psychiatric services for children, adolescents, and adults as well as outpatient services such as medication management, case management, and counseling.

Job Summary Mental Health Resource Center is looking for a Utilization Management Reviewer to monitor the utilization of clinical services provided at Mental Health Resource Center (MHRC), using predetermined criteria, review of medical records, and regular participation in treatment team meetings.

The crisis stabilization units provide services for adults, adolescents, and children.

Most patients are admitted involuntarily to the facility via the Baker Act, the mental health act of Florida.

The normal length of stay on the unit for patients is typically 3-5 days.

Due to the types of services provided, crisis stabilization units are a fast paced working environment and present employees with challenging and rewarding opportunities.

Employees work together and support one another in a friendly, team oriented atmosphere.

Responsibilities

Reviews medical records and attends treatment team meetings to review utilization of resources and the level of care provided. Ensures utilization and level of care are appropriate based on the diagnosis, needs, age and culture of the individual. Carries out appropriate telephone and written communication with insurers and third party payers regarding referrals, admissions, medication changes, discharges and changes in level of care. Coordinates on-site review of medical records with reviewers from third party payers. Documents, updates, and manages patient and provider information using internal electronic records system. Coordinates psychiatric consultations between internal and external providers. Investigates complaints, grievances, and medication variances. Reports findings to Utilization Management Manager and completes necessary follow up. Responds to changing needs of the departments (i.e., program design, forms development, reporting mechanisms, etc).Establishes and maintains effective working relationships with staff members to assure professional interactions.

Qualifications

In order to be considered candidates must have one of the following: Registered Nurse: Associate Degree in Nursing required. One year experience in psychiatric nursing required. Valid Florida RN License required. OR Licensed Practical Nurse: Graduation from an accredited school of Practical Nursing required. Two years experience in psychiatric nursing required. Valid Florida LPN License required. OR Master’s degree in Psychology or Human Services related field required. Three years experience in the mental health field required. UM experience preferred. Requires telephone and person-to-person interactions with individuals with mental illness on locked inpatient units.

Excellent communication skills are essential and this individual must be able to interact appropriately with internal and external customers, including families, caregivers, community service providers, supervisory staff and other department professionals.

Each employee contributes to the completeness and confidentiality of clinical records by ensuring documentation, paperwork and system entries meet internal and external guidelines for content, accuracy and timeliness.

Position Details: This is a full time position, Monday through Friday, 7:00am to 3:30pm

Renaissance Behavioral Health Systems and Mental Health Resource Center are Equal Opportunity Employers. Background screening and clearance through the Florida Care Provider Background Screening Clearinghouse is required for all positions: https://info.flclearinghouse.com

Requirements

Candidates must be a Registered Nurse with an associate degree, a Licensed Practical Nurse, or hold a Master's degree in Psychology or Human Services. Experience in psychiatric nursing or the mental health field is required along with a valid Florida license where applicable.

  • associate degree
  • postgraduate degree
  • Case Management
  • Clinical Documentation
  • Interdisciplinary Collaboration
  • Crisis Stabilization
  • Utilization Review
  • Medical Record Review
  • Psychiatric Nursing
  • Patient Coordination
  • Insurance Communication
  • Grievance Investigation

Benefits

  • Dental Insurance
  • Disability Insurance
  • Employee Assistance Program
  • Life Insurance
  • Paid Holidays
  • Paid Time Off
  • Vision Insurance
  • Medical Insurance
  • Flexible Spending Account
  • 403b

Posting details

Employment type
Full Time
Work arrangement
On Site
Experience
2-5 yrs
Location
Jacksonville, Florida
Posted
Jul 14, 2026
Application
Employer website
MH

Hiring organization

Mental Health Resource Center

MHRC provides a wide range of behavioral health services for adults, adolescents, children, and families. In 2022, MHRC provided services to more than 10,000 people. All MHRC programs are accredited by The Joint Commission. For the lastest job openings, please visit our website...

IndustryMental Health Care
TypeNonprofit
Size201-500 employees
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Market context

Behavioral health roles remain in steady demand

In Florida, behavioral-health roles are typically in steady demand across community clinics, schools, and care settings serving diverse populations. Competition often centers on licensure status, supervised experience, and the ability to work well with interdisciplinary teams while applying mental health ethics and cultural awareness. Review the full posting carefully and confirm your Master’s degree, Registered Intern License, and communication experience; this platform’s AI-summarized requirements and benefits can save you time by condensing the original job description.

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