Utilization Review Specialist - Behavioral Health, SUD Network

Avenues Recovery • Toms River, NJ

8d • Onsite

About The Position

Avenues Recovery Center is a nationwide network of drug and alcohol rehabilitation centers with eighteen locations across seven states. We provide highly individualized, evidence-based treatment in clean, modern settings across all levels of care including detox, residential, PHP, IOP, and outpatient services. Our success is driven by our people and a strong clinical model that has helped transform thousands of lives. We are seeking a Utilization Review Specialist to join our corporate team in New Jersey and support authorization, clinical documentation integrity, and continued stay coordination across our network.

Requirements

• High school diploma or GED required
• Strong communication (written and verbal)
• Excellent interpersonal and collaboration skills
• Strong attention to detail and documentation accuracy
• Ability to manage multiple cases and deadlines
• Sound judgment and critical thinking
• Flexible, team-oriented, and adaptable in a fast-paced environment

Nice To Haves

• Bachelor's degree preferred
• Nursing background, clinical background or healthcare knowledge strongly preferred
• Minimum 1 year of experience in behavioral health, healthcare, or treatment setting preferred
• Experience with utilization review, insurance authorization, or medical billing strongly preferred

Responsibilities

• Field incoming calls, emails, and documentation requests related to client authorizations
• Ensure timely approval and continuation of services at the appropriate level of care
• Manage client caseloads and support authorization workflows across facilities
• Advocate for continued stay based on clinical documentation and treatment needs
• Work closely with billing and clinical teams to identify and resolve authorization issues
• Communicate with facility leadership regarding UR status and documentation needs
• Support coordination between treatment teams and administrative departments
• Maintain accurate electronic records of all UR activity and authorization communications
• Ensure documentation meets internal standards and payer requirements
• Assist in identifying gaps in charting and supporting improvements in documentation workflows
• Assist in creating standardized templates and UR workflows across facilities
• Work with site leaders to ensure consistent implementation of processes
• Support improvement of internal UR systems and efficiency initiatives

Benefits

• 401(k) with employer match
• Medical, Dental, and Vision Insurance
• Accident, Critical Illness, and Hospital Indemnity coverage
• Employer-paid Life and AD&D Insurance
• Short- and Long-Term Disability options
• Legal coverage and Identity Theft Protection
• Pet Insurance
• Employee Assistance Program (EAP)
• Flexible Spending Accounts (Medical & Dependent Care)

What This Job Offers

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