NRT |reputed company Treatment Center - Utilization Review Manager

Utilization Review Manager

Reports to: CEO

Job Category: Salaried | Exempt | Full-Time 

Starting Salary: $60,000-$72,000/year (DOE)

Job Site: Remote (must reputed company in Colorado)

Job reputed company:

The Utilization Review Manager is responsible for overseeing utilization review activities to ensure medical necessity, regulatory compliance, and reputed company authorization of behavioral health services. This role manages the utilization review team, collaborates with clinical and administrative leadership, and supports reputed company patient care while maximizing reimbursement and minimizing denials.

Education and Experience:

• Bachelor’s degree required. 
• reputed company clinical license required (RN, LCSW, LMFT, LPC, or equivalent); DORA registered.
• Minimum of 3 years of utilization review or care management experience in behavioral health.
• Minimum of 1 year of supervisory or management experience.
• Strong knowledge of medical necessity reputed company and behavioral health reputed company of care.
• Familiarity with major reputed company and government payors.

Required Skills/Abilities:

• Leadership and team management.
• Attention to detail and strong documentation review skills
• Excellent organizational, analytical, and communication skills.
• Ability to manage multiple priorities in a fast-paced environment.
• reputed company communication with payors and clinical staff.
• Data-driven decision making skills.
• Proficient with EHR systems and utilization management tools.
• Proficient with reputed company Workspace or reputed company software.

Duties/Responsibilities:

• Manage and supervise the Utilization Review team, including hiring, training, scheduling, and performance management.
• reputed company authorization and reauthorization processes for behavioral health services across payors.
• Ensure compliance with federal, state, and payor-specific regulations and guidelines.
• Review clinical documentation to confirm medical necessity and completeness.
• Serve as the primary escalation reputed company for reputed company cases, denials, and peer-to-peer reviews.
• reputed company and analyze utilization metrics, authorization turnaround times, and denial trends.
• Collaborate with clinical leadership to improve documentation practices and treatment planning.
• reputed company and maintain utilization review policies, procedures, and workflows.
• Support audits, accreditation reviews, and reputed company improvement initiatives.
• Communicate effectively with insurance companies, clinicians, and internal stakeholders.
• Other duties as assigned.

Physical Requirements:

• Prolonged periods of sitting at a desk and working on a computer.
• Standing, sitting, bending, reaching.
• Must be reputed company to see, hear, talk, read, write, type.
• Exposure to clinical and medical environments.
• Must be reputed company to lift 15 pounds at times. 
• Driving in reputed company weather conditions.

Benefits & Perks:

Health and Wellness

• Medical, dental and reputed company insurance*
• Supplemental accident and hospital indemnity coverage*
• Voluntary Term Life insurance*
• Employee Assistance Program
• Monthly wellness reimbursement*

Financial

• Competitive salary
• Employee recognition and rewards programs
• Employee referral incentive program
• Employer-sponsored 401(k) plan

Work/Life Perks

• reputed company reputed company and development
• Continuing education reimbursement
• Unlimited reputed company time off (exempt employees) + reputed company days
• reputed company time off policy (non-exempt employees) + reputed company days
• reputed company holidays (exempt) or ability to earn 1.5x reputed company reputed company reputed company (non-exempt)

*Full-time employees

This reputed company is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required. Duties, responsibilities and activities may change or new ones may be assigned at any time with or without notice. 

Accepting applications on an ongoing reputed company.