Utilization Review Specialist

Job not on LinkedIn

🕒 October 19

🐊 Florida – Remote

🐊 Florida – Remote

⏱ Part Time

🟢 Junior

🟡 Mid-level

👻 Ghost score 15%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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FHE Health

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 1999

🏥 Healthcare

🧘 Wellness

Healthcare • Wellness

FHE Health is a licensed, accredited mental health and addiction treatment provider based in South Florida that offers a full continuum of care—from medically supervised detox and residential/inpatient programs to partial hospitalization, intensive outpatient, and alumni services. The campus emphasizes whole-person, brain-based care, combining evidence-based psychotherapies (CBT, DBT, EMDR, group and individual therapy) with advanced clinical services such as on-site psychiatry, medication-assisted treatment, ketamine infusions, transcranial magnetic stimulation (TMS), neurofeedback, qEEG brain mapping, and other NeuroRehab modalities. FHE Health operates specialized tracks (First Responders & Veterans, women’s and men’s programs), provides family and community support, accepts most major insurance plans, and serves patients nationally.

📋 Description

• Manage all clinical authorization processes to ensure timely, accurate, and compliant communication with insurance payers • Secure initial and continued-stay authorizations • Prevent avoidable denials • Collaborate with clinical teams to ensure documentation reflects medical necessity according to payer guidelines • Help maximize reimbursement and maintain compliance • Support quality patient care throughout the behavioral health and addiction treatment continuum

🎯 Requirements

• Bachelor’s Degree from accredited college or university in Nursing, Social Work, Behavioral Health or related field required preferred • 2-3 years of utilization review experience in behavioral health, addiction treatment, or managed care • Strong understanding of ASAM criteria, LOCUS, DSM-5, diagnostic standards, and documentation requirements • Excellent clinical summarization and documentation review skills • Strong communication with clinical teams and insurance reviewers • Ability to problem-solve, escalate appropriately, and manage time-sensitive deadlines • High attention to detailed accuracy

🏖️ Benefits

• Medical, Dental, and Vision Insurance • Supplemental Life & Disability Insurance • 401(k) Retirement Plan • Generous PTO & Vacation Time • Employee Assistance Program • Opportunities for Professional Growth & Development • Free CEU’s • Free CPR Certification • Free Crisis Prevention Certification (CPI)

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