QA Specialist / Utilization Review Liaison

Avenues Recovery • Lexington Park, MD

3d

About The Position

Avenues Recovery Center is seeking a detail-oriented and proactive Quality Assurance Specialist / Utilization Review Liaison to support clinical operations, documentation compliance, and utilization review processes. This role serves as a critical bridge between treatment teams, facility leadership, and the Utilization Review department, helping ensure high-quality care, regulatory compliance, and positive patient outcomes. The ideal candidate is highly organized, thrives in a fast-paced environment, and is passionate about maintaining clinical excellence while supporting individuals on their recovery journey.

Requirements

• High School Diploma or GED required.
• Minimum one year of experience in the behavioral health, addiction treatment, healthcare, or related field preferred.
• Knowledge of medical terminology, clinical documentation, and utilization review processes preferred.
• Strong organizational, communication, and follow-up skills.
• Excellent interpersonal, observational, and collaborative abilities.
• If in recovery, a minimum of one year of sustained sobriety is required.

Responsibilities

• Conduct regular chart audits to ensure documentation accuracy, completeness, and compliance with company, payer, and regulatory standards.
• Monitor clinical and operational processes to identify opportunities for improvement.
• Track missing documentation and ensure timely completion of all required chart elements.
• Support quality assurance initiatives and maintain adherence to accreditation and compliance requirements.
• Serve as a liaison between clinical staff, facility leadership, and the Utilization Review department.
• Assist with insurance authorizations, concurrent reviews, peer reviews, and appeals.
• Support level-of-care determinations and documentation of medical necessity.
• Coordinate communication regarding admissions, continued stay reviews, level-of-care changes, and discharge planning.
• Participate in treatment team meetings and collaborate with clinical leadership.
• Engage with clients throughout treatment to support retention and individualized care.
• Assist with intake assessments, group facilitation, and other clinical support duties as needed.
• Help identify training and process improvement opportunities to enhance quality of care.

Benefits

• Competitive Compensation
• Generous Paid Time Off
• 401(k) with Company Match
• Medical, Dental & Vision Insurance
• Employer-Paid Life & AD&D Insurance
• Short- and Long-Term Disability Options
• Flexible Spending Accounts (FSA)
• Employee Assistance Program (EAP)
• Legal Coverage
• Pet Insurance
• Identity Theft Protection
• Accident, Critical Illness & Hospital Indemnity Coverage

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED