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Utilization Review Specialist

Role overview

Qualifications

  • High school diploma or equivalent
  • Minimum one year of utilization review experience in a psychiatric or chemical dependency setting
  • Strong organizational, documentation, and communication skills
  • Ability to manage high caseloads with accuracy and efficiency

Responsibilities

  • Manage a caseload of 50–75 patients, authorizing 15–25 cases daily and ensuring timely utilization reviews and appropriate level of care determinations
  • Conduct admission and continuing-stay reviews to assess medical necessity and ensure compliance with treatment standards
  • Verify insurance benefits, coordinate authorizations, and communicate effectively with external case managers and managed care organizations
  • Collaborate with clinical and billing departments to support discharge planning, documentation, and timely reimbursement

Key facts

Other skills

  • Organizational Skills
  • Verbal Communication Skills
  • Detail Oriented

About the company

Banyan Treatment Centers logo

Banyan Treatment Centers

Mental Health Care

The banyan tree is one of the most beautiful and iconic trees in the South Florida landscape. This tree provides a great metaphor for what our community looks like at Banyan. Without support of other trees, the banyan tree becomes exposed and weak, never reaching its full potential. However, with the help of the trees around it, the banyan can thrive for hundreds of years. With fourteen locations across the country and growing, Banyan Treatment Center stands as a leader in providing growth through recovery by offering our clients all levels of care which are detox, residential, partial hospitalization programming, stabilization, intensive outpatient services, mental health services and more. Our treatment team is comprised of master’s level, state licensed, and PhD. level clinicians who take pride in bringing our clients the highest standards of individualized, custom treatment plans. All of our programs and therapies are designed to treat the person as a whole- mind, body, and spirit. We prepare our clients for a successful transition back into being full-functioning members of society. We are a family of individuals that come from diverse backgrounds; however, addiction affects all of us in the same way. It devastates lives and families. We came together with a simple mission: to help people break free from the bonds of addiction. We are not a “one fits all place” and we have the experienced staff and infrastructure to truly offer individualized, custom treatment programs that are tailored to fit every need. Not many treatment centers have the ability to offer all levels of care and custom treatment plans.

Company details

Company typeLarge
IndustryMental Health Care
Company size1001 - 5000

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Job description

Utilization Review Specialist | Remote | Full-Time
$50,000 – $65,000 Annually | Weekdays (Weekend Availability as Needed)

Banyan Treatment Centers is seeking an experienced and detail-driven Utilization Review Specialist to join our corporate team. In this remote role, you'll manage a caseload of 50–75 patients, conducting admission and continuing-stay reviews, coordinating authorizations, and serving as a key liaison between Banyan's clinical operations and the managed care organizations that fund patient treatment. Your work directly protects patient access to care and keeps the business running.

This is a high-volume, relationship-driven role for someone who thrives on precision, knows how to navigate managed care, and understands the stakes on both sides of the authorization process.

 

About Banyan Treatment Centers

Banyan Treatment Centers is a leading national provider of intensive treatment for individuals facing substance use and mental health disorders. Backed by TPG, one of the nation’s largest private equity investors, Banyan is rapidly expanding access to high-quality, compassionate care.

 

Why Join Our Team?

  • Mission-driven work with real business impact — your authorizations directly determine whether patients stay in treatment. Few roles sit closer to the intersection of clinical care and organizational sustainability.
  • Nationally recognized organization — Joint Commission–accredited, with 18 locations and telehealth services nationwide, and the infrastructure to support your work at scale.
  • Remote flexibility — work from anywhere while collaborating with clinical, billing, and operations teams across the country.
  • Collaborative environment — partner closely with clinical, operational, and billing teams to resolve outstanding case issues, support discharge planning, and ensure timely reimbursement.
  • Room to grow — join a rapidly expanding organization where UR professionals have visibility across the enterprise and opportunities to advance.
  • Comprehensive benefits including medical, dental, and vision insurance; whole and term life insurance; short- and long-term disability; 401(k) with employer match; paid time off and holidays; wellness incentives; and employee assistance and referral programs.

 

Key Responsibilities

  • Manage a caseload of 50–75 patients, authorizing 15–25 cases daily and ensuring timely utilization reviews and appropriate level of care determinations
  • Conduct admission and continuing-stay reviews to assess medical necessity and ensure compliance with treatment standards
  • Verify insurance benefits, coordinate authorizations, and communicate effectively with external case managers and managed care organizations
  • Establish and maintain contracts with managed care companies and request rate increases when appropriate
  • Collaborate with clinical and billing departments to support discharge planning, documentation, and timely reimbursement
  • Identify and address over- and underutilization trends
  • Assist in resolving outstanding case issues with insurers

 

Qualifications

Required:

  • High school diploma or equivalent
  • Minimum one year of utilization review experience in a psychiatric or chemical dependency setting
  • Strong organizational, documentation, and communication skills
  • Ability to manage high caseloads with accuracy and efficiency
  • Comfortable working independently in a remote environment

Preferred:

  • Graduate degree in a health or behavioral health related field
  • Clinical licensure (LCSW, LMHC, LPC, RN, or equivalent) — valued but not required
  • Experience working with managed care organizations, insurance authorization, and level of care criteria
  • Familiarity with Joint Commission standards and behavioral health regulatory requirements

 

Apply Now

If you're experienced in utilization review, thrive in a fast-paced and high-volume environment, and want your work to matter beyond the spreadsheet, we'd like to meet you. Apply today to join the Banyan Treatment Centers corporate team.

Banyan Treatment Centers is an equal opportunity employer.

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MR

Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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