Top 57 utilization review lcsw Jobs in texas

Utilization Review Specialist
ADDICTION AND MENTAL HEALTH SERVICES, LLC —Dallas, TX
- Weekends as needed
- Nursing
- Addiction Medicine
- RN License
- Loan repayment program
- Health insurance
Quick Apply
Executive Director
BasePoint Academy —North Richland Hills, TX
- From $100,000 a year
- Full-time
- LMFT
- Management
- Licensed Clinical Social Worker
- AD&D insurance
- Paid holidays
Quick Apply
Assistant Clinical Director
BasePoint Health Management —North Richland Hills, TX
- $80,000 - $95,000 a year
- Full-time
- LMFT
- CPR Certification
- Licensed Clinical Social Worker
- AD&D insurance
- Paid holidays
Quick Apply
8d
Clinical Quality Specialist
SonderMind —Dallas, TX
- $72,000 - $82,000 a year
- Full-time
- Remote
- LMFT
- Licensed Clinical Social Worker
- Mid-level
- Commuter assistance
- Paid parental leave
Quick Apply
Utilization Specialist - PRN
Rio Vista Behavioral Health —El Paso, TX
- PRN
- CPR Certification
- Nursing
- RN License
Licensed Behavioral Health Clinician Case Manager - Work at Home
CVS Health —Texas
- $60,522 - $129,615 a year
- Full-time
- LMFT
- Licensed Clinical Social Worker
- Mid-level
- Health insurance
- Dental insurance
Clinical Liaison
Baylor Scott & White Health —Waco, TX
- Nursing
- RN License
- Hospital
- Health insurance
- Tuition reimbursement
8d
Manager Community Clinical Support Services
Texas Children's Hospital —Katy, TX
- Full-time
- RN License
- Hospital
- Licensed Clinical Social Worker
Director, Behavioral Health
Harris Health —Houston, TX
- $122,000 - $156,000 a year
- Full-time
- LMFT
- 7 years
- Microsoft Outlook
- Health insurance
- Dental insurance
Discharge Planner
SUN Behavioral Houston —Houston, TX
- Full-time
- CPR Certification
- LVN
- Writing skills
8d
Transition of Care Coordinator Behavioral Health
CVS Health —Austin, TX
- $60,522 - $129,615 a year
- Full-time
- LMFT
- Microsoft Outlook
- Computer literacy
- Health insurance
- Dental insurance
9d
Clinic Assistant Director
Mindful Health —Rockwall, TX
- $90,000 - $100,000 a year
- Full-time
- LMFT
- CPR Certification
- 5 years
- Disability insurance
- Health insurance
Quick Apply
Intake Specialist CBH
Carrus Health —Sherman, TX
- Master of Social Work
- Psychiatry
- RN License
Quick Apply
Director of Case Management
Texas Nursing Services —North Richland Hills, TX
- $8,509 - $135,000 a year
- Full-time
- Acute care
- Nursing
- RN License
- Employee stock purchase plan
- Relocation assistance
Quick Apply
Case Manager
White Rock Medical Center LLC —Dallas, TX
- Full-time
- Master of Social Work
- Nursing
- RN License
- Paid holidays
- Disability insurance
Quick Apply
Case Manager
Memorial Hermann Health System —Houston, TX
- Part-time
- Master of Social Work
- Nursing
- RN License
Supp Case Manager
Memorial Hermann Health System —Houston, TX
- Part-time
- Master of Social Work
- Nursing
- RN License
UR COORDINATOR
Meridell Achievement Center —Liberty Hill, TX
- Full-time
- Background check
- LMFT
- Nursing
- Health insurance
- Dental insurance
Executive Director, Outpatient Behavioral Health PHP/IOP
Shepherd Recovery Centers —Missouri City, TX
- $90,000 - $120,000 a year
- Full-time
- Background check
- LMFT
- Management
Quick Apply
Clinical Team Lead - Utilization Management
The Harris Center for Mental Health and IDD —Houston, TX
- From $84,903 a year
- Full-time
- LMFT
- Word processing
- Writing skills
- Paid time off
- Gym membership

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Utilization Review Specialist

ADDICTION AND MENTAL HEALTH SERVICES, LLC -
Dallas, TX

Quick Apply

Job Details

Benefits

Loan repayment program
Health insurance
Dental insurance
Paid time off
Employee assistance program
Vision insurance
Pet insurance

Qualifications

Confidential information handling
Bachelor's degree

Full Job Description

This is a PRN position

About Company:

We’re officially a Great Place To Work®! We’ve always believed that supporting our team is just as important as supporting our patients. Now, we’re proud to share that we’ve earned Great Place To Work® Certification - based entirely on feedback from our own employees.

Read more here: https://ow.ly/YQ1C50WuRH1

This certification reflects the culture we’ve worked hard to build - one rooted in trust, inclusion, and purpose-driven leadership.

At Bradford Health Services, we are committed to providing exceptional care to our patients while fostering a supportive and rewarding workplace for our employees. We believe that taking care of our team allows them to take better care of others, which is why we offer a comprehensive benefits package designed to support their well-being.

Our benefits include:

Medical Coverage – Three new BCBSAL medical plans with better rates, improved co-pays, and enhanced prescription benefits.
Expanded Coverage – Options for domestic partners and a wider network of in-network providers.
Mental Health Support – Improved access to services and a new Employee Assistance Program (EAP) featuring digital wellness tools like Cognitive Behavioral Therapy (CBT) modules and wellness coaching.
Voluntary Coverages – Pet insurance, home and auto insurance, family legal services, and more.
Student Loan Repayment – Available for nurses and therapists.
Retirement Benefits – 401(k) plan through Voya to help employees plan for the future.
Generous PTO – A robust paid time off policy to support work-life balance.
Voluntary Benefits for Part-Time Employees – Dental, vision, life, accident insurance, and telehealth options for those working 20 hours or more per week.

At Bradford Health Services, we don’t just invest in our patients—we invest in our people.

About the Role:

The Utilization Review Coordinator plays a critical role in ensuring that patients at our facility receive the appropriate level of care while managing treatment costs. This position involves coordinating, assessing, and authorizing treatment plans, collaborating with medical staff, and maintaining compliance with healthcare regulations. The Utilization Review Coordinator works closely with insurance companies, clinicians, and support staff to ensure that treatment plans are clinically appropriate and reimbursable, advocating for the best interests of the patients and the hospital.

Key Responsibilities:

Case Review and Assessment
- Conduct daily reviews of patient charts, treatment plans, and progress notes to determine if the level of care provided aligns with clinical guidelines and insurance requirements.
- Monitor patient progress, reassess treatment needs, and recommend adjustments in care levels as needed.
- Collaborate with clinical teams to understand patient needs, assess treatment efficacy, and make informed recommendations.
Insurance Coordination
- Act as the primary point of contact with insurance providers for treatment authorization, concurrent review, and appeal processes.
- Submit required documentation to insurance companies in a timely manner, including clinical updates, to secure and maintain treatment authorization.
- Resolve reimbursement issues, advocating for patient treatment needs and securing necessary approvals.
Documentation and Compliance
- Ensure all documentation is complete, accurate, and in line with state, federal, and hospital policies to facilitate compliance and quality audits.
- Maintain a working knowledge of current insurance guidelines, DSM-5 criteria, and ASAM (American Society of Addiction Medicine) criteria.
- Participate in internal and external audits, preparing records and reports as necessary.
Collaboration and Communication
- Work closely with medical and support staff to ensure continuity of care and that utilization review processes are aligned with patient needs.
- Provide guidance to clinical staff regarding documentation best practices and criteria required for continued care authorizations.
- Participate in multidisciplinary team meetings to discuss patient care plans, discharge planning, and treatment adjustments.
Quality Improvement
- Identify trends in denied claims or treatment authorizations, providing recommendations for process improvements.
- Assist in training hospital staff on utilization review processes, criteria for different levels of care, and effective documentation practices.
- Collaborate in developing policies to improve efficiency, patient care outcomes, and financial performance.

Qualifications:

Education: Bachelor’s degree in Nursing, Social Work, or a related field required. Master’s degree in a health-related field preferred.
Experience: Minimum of 2 years in utilization review, case management, or related field, preferably within a behavioral health or chemical dependency setting.
Licensure: Current RN, LCSW, or LPC license preferred.
Skills and Competencies:
- In-depth understanding of mental health, substance abuse treatment and ASAM criteria.
- Strong analytical and critical thinking skills with the ability to make clinical judgments based on patient data.
- Excellent communication and interpersonal skills to facilitate interactions with insurers, staff, and patients.
- Proficiency with electronic medical records (EMR) and utilization review software.
- Knowledge of state, federal, and industry regulations related to chemical dependency and mental health care.

Working Conditions:

Full-time, primarily daytime hours, with occasional on-call duties or weekends as needed.
Must be able to work in a high-paced environment and handle sensitive information with discretion.
Physical demands may include sitting for extended periods, light lifting, and using a computer for most of the workday.

Quick Apply

Refine Your Search

utilization review lcsw jobs in texas

Utilization Review Specialist

Executive Director

Assistant Clinical Director

Clinical Quality Specialist

Utilization Specialist - PRN

Licensed Behavioral Health Clinician Case Manager - Work at Home

Clinical Liaison

Manager Community Clinical Support Services

Director, Behavioral Health

Discharge Planner

Transition of Care Coordinator Behavioral Health

Clinic Assistant Director

Intake Specialist CBH

Director of Case Management

Case Manager

Case Manager

Supp Case Manager

UR COORDINATOR

Executive Director, Outpatient Behavioral Health PHP/IOP

Clinical Team Lead - Utilization Management

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