Cutting Edge Staffing LLC
Utilization Review Specialist
Cutting Edge Staffing LLC, Pompano Beach, Florida, United States, 33062
Job Description
Job Description
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:
Pompano Beach, FL (On-site). Key Responsibilities:
Manage a caseload
of 50–75 patients and authorize 15–25 cases daily, ensuring timely utilization reviews and appropriate level of care.
Verify insurance benefits , coordinate authorizations, and communicate effectively with managed care providers.
Conduct admission
and continuing-stay reviews to assess medical necessity and ensure compliance with treatment standards.
Collaborate
with
clinical and billing departments
to support discharge planning, documentation, and timely reimbursement.
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 an
Aftercare Coordinator , 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.
Job Description
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:
Pompano Beach, FL (On-site). Key Responsibilities:
Manage a caseload
of 50–75 patients and authorize 15–25 cases daily, ensuring timely utilization reviews and appropriate level of care.
Verify insurance benefits , coordinate authorizations, and communicate effectively with managed care providers.
Conduct admission
and continuing-stay reviews to assess medical necessity and ensure compliance with treatment standards.
Collaborate
with
clinical and billing departments
to support discharge planning, documentation, and timely reimbursement.
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 an
Aftercare Coordinator , 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.