Remote Utilization Review Specialist (LPN/LVN, RN) – Florida

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:

• 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 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.