Healthcare Utilization Specialist

7 days ago


Denver, Colorado, United States Addison Group Full time
Job Title:

Utilization Review Nurse

Location: Denver, CO (Hybrid preferred)

About Our Organization

We are a leading provider of mental health and substance use treatment, dedicated to giving individuals a second chance at life.

Compensation Package

The successful candidate will receive an hourly rate of $28.75 - $38.25/hour or an annual salary of $60,000 - $80,000, depending on the contract status.

Job Responsibilities

This role involves managing utilization reviews to ensure timely care authorizations. Key responsibilities include:

  • Securing patient authorizations through multiple inbound and outbound calls daily
  • Accurately documenting case details and maintaining compliance with regulations
  • Collaborating with internal teams to streamline care authorization processes
  • Achieving high approval rates for initial care and supporting concurrent reviews for extended stays
  • Handling complex claims and single-case agreements with insurance payers
Requirements

To be successful in this role, you will need:

  • At least 1 year of experience in behavioral health, particularly with utilization review
  • Proficiency in managing complex claims and working with insurance payers
  • Strong knowledge of psychiatric and substance use disorder terminology
Benefits and Perks

This is an excellent opportunity to work with a purpose-driven team focused on changing lives. Benefits include:

  • Training and support from experienced leaders in behavioral health
  • Hybrid flexibility for local candidates, with remote options available
  • Potential for a long-term career path with competitive pay


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