Remote Utilization Manager - Inpatient
About The Position
AllHealth Network is seeking a dedicated Utilization Review Specialist to help ensure clients receive the care they need while collaborating with a team that values your expertise and commitment. This role is ideal for a compassionate nurse or social worker looking to make a real difference in behavioral health. The organization emphasizes a supportive, interdisciplinary environment with opportunities for ongoing learning, growth, and advancement, allowing employees to make a tangible impact on client outcomes and community well-being as part of a mission-driven organization dedicated to high-quality, client-centered care.
Requirements
- Registered Nurse (BSN/RN) or Master’s in a human services field
- Clinical license (LPC, LCSW) required
- Minimum 2 years’ experience in behavioral health utilization management, care coordination, or case management
- Strong communication, organization, and advocacy skills
- Experience with insurance processes, electronic records, and multidisciplinary teamwork
Nice To Haves
- Bilingual in English and Spanish (language proficiency testing required)
Responsibilities
- Advocate for clients by communicating clinical information to secure timely and appropriate care authorizations
- Lead utilization reviews for clients in our Acute Treatment and Crisis Stabilization Units
- Collaborate with nurses, social workers, case managers, and other healthcare professionals
- Ensure quality care by coordinating with payers, treatment teams, and billing staff
- Maintain accurate records and use problem-solving skills to navigate challenging cases
Benefits
- 10% compensation differential for bilingual individuals
- Generous benefits package
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
