Utilization Review Specialist

Advanced Recovery Systems, LLC

. Complete pre-authorizations, concurrent reviews, and internal utilization review reviews .

Posted 9/30/2026full-timeRemote • United StatesMid-LevelSenior💰 $50,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in Utilization Review processes, including pre-authorizations and concurrent reviews, while effectively communicating with multidisciplinary teams and managing documentation. Holds relevant state licensure and possesses a strong background in behavioral health settings.

Highest-signal resume keywords

Utilization Review ExperienceState Licensure (RN, LPN, LCSW, LMHC)Knowledge of ASAM CriteriaEffective Communication with Managed CareData Entry and Records Management

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Utilization ReviewConcurrent ReviewsPre-AuthorizationsCensus ReportsData EntryDocumentationAppeals ProcessRecords ManagementPsychiatric Setting ExperienceChemical Dependency Experience

Soft Skills

Organizational SkillsMultitaskingTime ManagementProactive Problem SolvingEffective Communication

Certifications & Qualifications

Registered NurseLicensed Practical NurseLicensed Clinical Social WorkerLicensed Mental Health Counselor

Industry Keywords

Behavioral HealthPsychiatric CareManaged CareGovernmental ComplianceAccrediting Agencies

About the role

Key responsibilities & impact

Complete pre-authorizations, concurrent reviews, and internal utilization review reviews
Consult with multidisciplinary treatment team members concerning information required for concurrent reviews
Schedule peer-to-peer reviews and coordinate urgent/expedited appeals
Staff individual cases with physicians as needed
Follow Utilization Review Department policies and procedures
Utilize the UR Census Report daily
Make all initial calls within 24 hours and follow-up calls every 24 hours
Perform data entry and records management
Assist with the appeals process
Complete detailed daily documentation
Work with the Finance Department regarding client service authorizations
Communicate frequently with the treatment team
Perform other duties as assigned

Requirements

What you’ll need

Bachelor’s degree in a health or behavioral health related field required, or High School diploma or equivalent and a State license (e.g., Registered Nurse, Licensed Practical Nurse, LCSW, LMHC) preferred
Graduate degree in a health or behavioral health related field preferred
Minimum of three years’ experience working in a psychiatric or chemical dependency setting
Minimum of three years’ Utilization Review experience preferred
State licensure preferred (Registered Nurse, Licensed Practical Nurse, Licensed Clinical Social Worker, Licensed Mental Health Counselor)
Proficiency in establishing and maintaining positive and effective communication with managed care companies
Ability to align medical and counseling staff to ensure services are provided at the appropriate level of care in a timely manner consistent with the patient’s condition and in compliance with governmental and accrediting agencies
Knowledge of concurrent reviews, utilization review, census reports, and ASAM criteria
Ability to be resourceful and proactive in dealing with issues that may arise
Ability to organize, multitask, prioritize, and work under pressure
Effective time management

Benefits

Comp & perks

Starting pay $50,000/yr, based on experience
Paid Time Off: Up to 2 weeks of paid time off per year plus sick pay & holiday pay
Benefits begin on the 1st day of the month following date of hire
Matching HSA - up to $1500/yr contribution from the company to your HSA
401(k)
Medical, dental, and vision insurance
Free Telehealth access
Employee Referral Bonus - you can earn up to $4000