What are the responsibilities and job description for the Utilization Review Specialist position at Banyan Brand?
Exciting Opportunity with Banyan Treatment Centers!
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.
Position Details:
- Reports To: Director of Utilization Review
- Schedule: Full-Time, Weekdays (Weekend availability as needed).
- Location: Remote
Key Responsibilities:
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Manage a caseload of 50–75 patients and authorize 15–25 cases daily, ensuring timely utilization reviews and appropriate level of care.
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Verify insurance benefits, coordinate authorizations, and communicate effectively with managed care providers.
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Conduct admission and continuing-stay reviews to assess medical necessity and ensure compliance with treatment standards.
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Collaborate with clinical and billing departments to support discharge planning, documentation, and timely reimbursement.
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Identify and address over/underutilization trends and assist in resolving outstanding case issues with insurers.
Requirements:
- High School diploma or equivalent; graduate degree in a health or behavioral health related field preferred.
- Minimum of one-year experience working in a utilization review position (psychiatric or chemical dependency).
Why Join Banyan Treatment Centers?
This is more than a job, it’s a chance to be a vital part of what recovery looks like after treatment. As a Utilization Review Specialist, 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.
- Join a Mission-Driven, Nationally Recognized Organization: We’re accredited by the Joint Commission and backed by TPG’s Rise Fund, with 18 locations and Telehealth services nationwide.
- Champion the Continuum of Care: Be a key player in ensuring clients transition successfully from treatment into long-term recovery supports.
- Work in Partnership: Collaborate with clinical, operational, and business development teams, as well as families and external partners, to make sure no detail is missed.
- Enjoy Comprehensive Benefits: 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.
Apply Now!
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.
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.