UTILIZATION REV SPEC I
aspire health partnersHephzibah, GA
UTILIZATION REV SPEC I
aspire health partnersHephzibah, GASenior L5
Medical Records SpecialistsMental Health and Substance Abuse Social WorkersClinical Nurse Specialists
Outpatient Mental Health and Substance Abuse CentersPsychiatric and Substance Abuse HospitalsAll Other Outpatient Care Centers
APPLY NOW (opens in a new tab)Behavioral Health Utilization Review Specialist IEnsure you read the information regarding this opportunity thoroughly before making an application. Aspire Health Partners, Inc. Make a Difference in Behavioral Health CareAt Aspire Health Partners, we are dedicated to transforming lives through compassionate, high-quality behavioral healthcare. As Florida's largest nonprofit behavioral health provider, we serve diverse populations across Central Florida and are committed to clinical excellence and meaningful impact. We are currently seeking a Utilization Review Specialist to join our team and play a key role in ensuring our clients receive the care they need while supporting effective coordination with insurance providers.
Position Summary:
In this role, you will coordinate and manage insurance utilization review activities for hospitalized clients. You'll work closely with clinical teams, insurance representatives, and internal departments to ensure timely authorizations, support treatment planning, and contribute to high-quality patient outcomes.
Key Responsibilities:
- Partner daily with the Access Center and/or Crisis Response Center (CRC) to identify clients needing utilization review
- Communicate clinical information to insurance reviewers to secure authorizations and extended lengths of stay
- Collaborate with attending psychiatrists on clinical assessments and treatment recommendations
- Participate in interdisciplinary treatment team meetings to support care for managed care clients
- Provide constructive clinical feedback to enhance service delivery and patient care
- Ensure accurate authorization details are submitted to Patient Accounts for billing
- Review client charts for potential denial issues and support appeal processes when needed
- Maintain strict adherence to ethical standards, confidentiality, and organizational policies
Qualifications
Required:
- High School Diploma or equivalent
- Level II Background clearance- All Aspire Health Partners Internships and Careers require Level 2 clearance, with Aspire covering fingerprinting costs. Click to learn more.
- Valid driver's license with an acceptable driving record per organizational guidelines
Preferred:
- Experience in behavioral health, utilization review, or managed care environmentsLPN or RN experience
- Strong communication, documentation, and organizational skills
- Why Join Aspire?
- Mission-driven organization making a real impact in your community
- Collaborative, team-focused work environment
- Opportunities for growth and professional development
- A role where your work directly supports quality care and patient outcomes
Equal Opportunity Employer
Aspire Health Partners is a drug-free workplace and an Equal Opportunity Employer. We value diversity and are committed to creating an inclusive environment for all employees. xmcpwfu All qualified applicants will be considered without regard to race, color, religion, national origin, sex, age, disability, or veteran status.
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Level
Senior L5
Location
Hephzibah, GA
Occupation
Medical Records Specialists
Industry
Outpatient Mental Health and Substance Abuse Centers
Posted
today