Utilization Review Specialist (Remote | M–F | $45K–$65K)
Make an impact. Grow your career.
At Nova Recovery Center, we believe in providing more than treatment — we create hope and lasting recovery. As a Utilization Review Specialist, you’ll play a pivotal role in ensuring our clients receive the care they need while advocating for high-quality, cost-effective solutions. If you’re passionate about helping others, thrive in a collaborative environment, and want a career where your expertise truly makes a difference, we’d love to meet you.
What You’ll Do
- Lead pre-certification, prior approvals, concurrent and retrospective reviews, ensuring timely, accurate decisions.
- Determine medical necessity and appropriateness of services using established clinical criteria.
- Act as a client advocate, expediting care and collaborating with physicians, admissions, clinical, and billing teams.
- Partner with the Medical Director and leadership to identify quality issues, compliance risks, and opportunities for improvement.
- Play an active role in discharge planning and care coordination, helping clients transition successfully.
- Stay ahead of industry standards by continuing education in ASAM criteria, managed care requirements, case management, and compliance.
- Collaborate across departments to improve policies, streamline processes, and strengthen compliance.
What We’re Looking For
- Education: Bachelor’s degree in Social Work, Mental Health, or related field OR licensed RN in Texas (current & unrestricted).
- Experience: 3–5 years working with external review organizations, UR/UM processes, or direct clinical experience in psychiatric/mental health settings.
- Knowledge: Familiarity with Texas DSHS LOC Guidelines, TDI Criteria, ASAM Criteria, and Joint Commission standards.
- Skills: Exceptional communication, detail-oriented documentation, strong computer proficiency, and a self-starter mindset.
Position Details
- Schedule: Monday–Friday, flexible hours between 7 AM – 5 PM.
- Remote: Work-from-home opportunity if you live in Arkansas, Ohio or Texas
- Salary: $45,000 – $65,000, based on experience.
Why Join Nova Recovery?
We know great work deserves great support. That’s why we offer a comprehensive benefits package designed to support your well-being and work-life balance:
- Medical Insurance through Blue Cross Blue Shield (BCBS)
- Health Savings Account (HSA)
- Dental, Vision, and Life Insurance options available
- Paid Time Off (PTO) – accrue 5.85 hours per pay period after probationary period
- Work-life balance with remote flexibility and weekday hours
Ready to make a difference while growing your career? Apply today and join Nova Recovery Center in creating lasting recovery and hope for our clients.
