Utilization Review Specialist

About the Position:

Under general direction of the Director of Operations, the Utilization Review (UR) Specialist helps to manage the facility’s utilization management processes.  This includes preparing of documentation necessary for the pre-certification of admissions and extensions of hospital stays for all patients; serving as liaison with gatekeepers, HMO’s, OHCA, and insurance companies; and maintaining spreadsheets and logs daily. 
Elements to be included in data collection and analysis are; auditing of required medical record entries; inappropriate admissions; delays in services; delays in discharges; premature discharges; effectiveness of discharge planning; and over utilization and under utilization of resources.  When appropriate, will assist with coordination of transfers. This position will also contribute to the quality improvement process as well as compliance with JCAHO, Title XIX and other regulatory standards.  Will work closely with the Director of Operations and the medical, clinical and reimbursement staff to reduce the potential loss of collections.
The UR Specialist will participate in interdisciplinary treatment teams, clinical management meetings, agency meetings, and other duties as assigned. This position is not remote and does require patient interaction.

Job Type/Salary:

• Job Type: Full-time, Non-Exempt
• Work Schedule: Monday – Friday, 8:00 a.m. – 5:00 p.m.
• Annual Salary: $38,500 ($18.50 per hour)
• Posted until February 13th 2026

• Completion of a Bachelor’s Degree in social work, psychology, or related field from an accredited college or university plus one year of technical clerical, administrative, secretarial, or general office work.
• Equivalent combination of education and experience is accepted.
• Preferred: Experience in a mental health setting.

• Valid driver’s license and the ability to travel as needed for job-related duties.
• Must pass pre-employment and pre-placement drug and alcohol screening due to the safety-sensitive nature of this position.

• Comprehensive Benefits: Generous base salary with a competitive benefits allowance
• Health Coverage: Multiple insurance plan options, no pre-existing condition exclusions
• Flexible Spending: Healthcare and dependent care FSA options
• Time Off:
  • 11 paid holidays
  • 15 vacation days
  • 15 sick days in the first year
• Retirement Planning: Employer-matched retirement savings plan
• Employee Support: Employee Assistance Program (EAP)
• Longevity Pay: Bonuses for continued service
• Professional Growth: Ongoing training opportunities and CEU support

• This facility operates 24/7. Work hours, shifts, and locations may vary based on operational needs.
• Weekend and overtime work may be required.
• Reasonable accommodation for individuals with disabilities is available upon request.

We are an Equal Opportunity Employer.