Job Title: Utilization Review Specialist

Location: Denver, CO (Hybrid preferred, remote considered)

Industry: Behavioral Health and Substance Use Treatment

Pay: $28.75 - $38.25/hour (contract); $60,000 - $80,000 annually (if converted to permanent)

About Our Client

Our client is a growing and innovative organization focused on providing life-changing mental health and substance use treatment. They are committed to supporting recovery and giving individuals a second chance at life.

Job Description

This role involves managing utilization reviews to ensure patients receive the necessary authorizations for timely care. It is a fast-paced, high-impact position requiring strong attention to detail and a proactive approach to overcoming challenges.

Key Responsibilities

• Conduct multiple inbound and outbound calls daily to secure patient authorizations.
• Accurately document case details and maintain compliance with all regulations.
• Work closely with internal teams to streamline care authorization processes.
• Achieve high approval rates for initial care and support concurrent reviews for extended stays.
• Handle complex claims and single-case agreements with insurance payers.

Qualifications

Required:

• At least 1 year of experience in behavioral health, particularly with utilization review.
• Proficiency in managing complex claims and working with insurance payers.
• Strong knowledge of psychiatric and substance use disorder terminology.

Preferred:

• Familiarity with Alleva EHR and Google tech tools.
• Experience with out-of-network behavioral health providers.
• Personal Attributes:
• Tenacious, tech-savvy, and adaptable to fast-paced work environments.
• Curious and excited to learn new systems and processes.

Additional Details

• Hours: Primarily 8 AM - 5 PM with flexibility as needed.
• Contract Length: Minimum 4 weeks with a goal of 90 days. May transition to a permanent role based on performance.
• Start Date: 12/2/2024
• Dress Code: Business casual.
• Location Perks: Free onsite parking for hybrid schedules.

Perks

• Opportunity to work with a purpose-driven team focused on changing lives.
• Training and support from experienced leaders in behavioral health.
• Hybrid flexibility for local candidates, with remote options available.
• Potential for a long-term career path with competitive pay.