Utilization Review Specialist

Banyan Treatment Centers•Pompano Beach, FL

6d•$45,000 - $65,000•Remote

About The Position

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. 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.

Requirements

High School diploma or equivalent
Minimum of one-year experience working in a utilization review position (psychiatric or chemical dependency).

Nice To Haves

graduate degree in a health or behavioral health related field preferred.

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.