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Behavioral Utilization Review Specialist

Gardens of Arkansas LLC
Little Rock, AR

Quick Apply

Job Details

Permanent

Qualifications

Phone communication
Scanning
Video conferencing software
Video conferences (communication methods)
Physical document handling
Video conferencing systems operation
Office record organization

Full Job Description

Behavioral Utilization Review Specialist

Position Summary

The Behavioral Utilization Review Specialist is responsible for coordinating new client referrals, supporting the prior authorization process, maintaining referral records, and completing routine Medicaid eligibility screenings. This position works closely with discharge planners, Program Administrators, Clinical Directors, and other members of the referral and billing teams.

The ideal candidate will be highly organized, detail-oriented, comfortable reviewing behavioral health documentation, and able to manage multiple deadlines across all Gardens of Arkansas locations.

Essential Duties and Responsibilities- Assist the Chief Revenue Officer with the following:

Clinical Review & Assessment: Evaluate care related to mental health before, and during services to determine medical appropriateness
Prior Authorization Reviews: Assess and submit requests for behavioral health services to ensure they meet regulatory and clinical criteria
Concurrent Review: Monitor behavioral health records to assess treatment needs, and discharge planning.

Preferred Qualifications

Education: Bachelor’s degree in nursing, social work, counseling, or related field; Master’s degree preferred for behavioral health clinicians
Licensure: LMHC, LPC, LMHP, or LPN ,RN licensure.
Experience: 2–4 years in utilization review, case management, or related behavioral health roles preferred

Knowledge, Skills, and Abilities

Strong understanding of medical and behavioral health terminology

Proficiency in data analysis and regulatory compliance.
Excellent verbal and written communication and collaboration skills with healthcare teams and providers.

Excellent organizational skills and ability to prioritize a workload
Some Billing knowledge

Additional Responsibilities

Participate in meetings, training, and process-improvement activities as required.
Provide administrative support to the referral, clinical, billing, and leadership teams as needed.
Perform other duties as assigned.

Physical and Work Requirements

Prolonged periods of sitting and working at a computer.
Ability to communicate by telephone, email, video conferencing, and in person.
Ability to organize, review, scan, upload, and maintain electronic and paper records.
Ability to work in a fast-paced environment with frequent deadlines and interruptions.

Equal Employment Opportunity

The Gardens of Arkansas is an equal opportunity employer. Employment decisions are made without regard to race, color, religion, sex, national origin, age, disability, veteran status, or any other characteristic protected by applicable law.

Quick Apply

Refine Your Search

utilization review nurse jobs in north little rock ar

Behavioral Utilization Review Specialist

Utilization Specialist

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RN Unit Manager/Treatment Nurse

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I want to receive the latest job alert for utilization review nurse in north little rock ar

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Behavioral Utilization Review Specialist

Position Summary

Essential Duties and Responsibilities- Assist the Chief Revenue Officer with the following:

Preferred Qualifications

Knowledge, Skills, and Abilities

Additional Responsibilities

Physical and Work Requirements

Equal Employment Opportunity

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