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Behavioral Health Utilization Reviewer

8/15/2025

Remote

Job Summary

A company is looking for a Utilization Reviewer PRN in Behavioral Health Services.

Key Responsibilities
  • Conduct utilization review calls, including precertification, continued stay, discharge reviews, and retrospective reviews
  • Collaborate with clinical staff and physicians to advocate for patients with insurance and managed care companies
  • Communicate insurance information and assist with discharge planning and appeals for unfavorable utilization review decisions
Required Qualifications
  • 2+ years of experience in a relevant field
  • Master's Degree in Social Work or Psychology or BSN with RN License
  • Behavioral Health experience is preferred
  • Certifications such as BLS, CADC, CSADC, CPC, LCSW, MSW, or RN are preferred

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