Utilization Review Specialist

<div> <h4><span> </span><strong>Exciting Opportunity with Banyan Treatment Centers!</strong></h4> <div> <div> <p>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.</p> <h4><strong>Position Details:</strong></h4> <ul> <li><strong>Reports To: </strong>Director of Utilization Review</li> <li><strong>Schedule: </strong>Full-Time, Weekdays (Weekend availability as needed).</li> <li><strong>Location: Remote</strong></li> </ul> <h4><strong>Key Responsibilities:</strong></h4> <ul> <li> <p><strong>Manage a caseload</strong> of 50–75 patients and authorize 15–25 cases daily, ensuring timely utilization reviews and appropriate level of care.</p> </li> <li> <p><strong>Verify insurance benefits</strong>, coordinate authorizations, and communicate effectively with managed care providers.</p> </li> <li> <p><strong>Conduct admission</strong> and continuing-stay reviews to assess medical necessity and ensure compliance with treatment standards.</p> </li> <li> <p><strong>Collaborate</strong> with <strong>clinical and billing departments</strong> to support discharge planning, documentation, and timely reimbursement.</p> </li> <li> <p><strong>Identify and address over/underutilization trends</strong> and assist in resolving outstanding case issues with insurers.</p> </li> </ul> <h4><strong>Requirements:</strong></h4> <ul> <li><strong>High School diploma</strong> or <strong>equivalent;</strong> graduate degree in a health or behavioral health related field preferred.</li> <li><strong>Minimum of one-year experience </strong>working in a utilization review position (psychiatric or chemical dependency).</li> </ul> <ul></ul> </div> <div> <h4><strong>Why Join Banyan Treatment Centers?</strong></h4> <p>This is more than a job, it’s a chance to be a vital part of what recovery looks like after treatment. As a <strong>Utilization Review Specialist</strong>, 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.</p> <ul> <li><strong>Join a Mission-Driven, Nationally Recognized Organization:</strong> We’re accredited by the Joint Commission and backed by TPG’s Rise Fund, with 18 locations and Telehealth services nationwide.</li> <li><strong>Champion the Continuum of Care:</strong> Be a key player in ensuring clients transition successfully from treatment into long-term recovery supports.</li> <li><strong>Work in Partnership:</strong> Collaborate with clinical, operational, and business development teams, as well as families and external partners, to make sure no detail is missed.</li> <li><strong>Enjoy Comprehensive Benefits:</strong> Including medical, vision, and dental insurance; whole and term life insurance; short- and long-term disability coverage; 401(k) with employer match; paid time off and holidays; and wellness, assistance, and referral programs.</li> </ul> <h4><strong>Apply Now!</strong></h4> <p>If you're passionate about building bridges to lasting recovery and ensuring every patient has a plan beyond our doors, apply today and help us continue making a difference at Banyan Treatment Centers.</p> <h6>We are an Equal Opportunity Employer and welcome applicants of all backgrounds. We encourage veterans, active-duty military, and first responders to apply in support of our First Responders Program.</h6> </div> <div> </div> </div> </div> <div> <div> <div> </div> </div> </div>