PRN Utilization Review Specialist

Co-Den Aspenmid

Healthcare Non-ClinicalUtilization Review Specialist

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Quick Summary

Key Responsibilities

Independently manages utilization of the continuum of services, serves as a liaison to managed care organizations, optimizes reimbursement,

Requirements Summary

Bachelor's Degree in Nursing; Alternatively, Master's degree or above in counseling, social work, psychology, or marriage and family.

Technical Tools

Healthcare Non-ClinicalUtilization Review Specialist

At ERC Pathlight, we’re on a mission to change lives—and we’re looking for people who feel called to do the same.

As one of the nation’s leading treatment providers for eating disorders and mood, anxiety, and trauma-related conditions, we bring innovative, evidence-based, and deeply compassionate care to patients across the country. With multiple locations nationwide and extensive virtual programming, we meet patients exactly where they are and help them move toward lasting recovery.

Founded in 2008 by renowned psychiatrists and psychologists, ERC Pathlight now supports more than 6,000 patients each year. And as the need for world-class mental health care continues to rise, our commitment is stronger than ever: to expand access, elevate the standard of care, and empower every patient to rebuild their life with dignity and hope.

What We Offer

~1 min read

When you join ERC Pathlight, you become part of a team that shows up every day to make a real difference. You’ll work alongside passionate clinicians, dedicated support staff, and mission-driven leaders who believe in collaboration, growth, and doing the right thing—always.

Here, your work matters. Your ideas matter. You matter.

If you’re energized by purpose, motivated by impact, and ready to help transform the future of mental health treatment, you belong here.

This is a PRN (as-needed) role. Weekend availability is not required; however, candidates must be available to provide coverage during days surrounding major holidays, as this is a critical business need.

Responsibilities

~1 min read

Independently manages utilization of the continuum of services, serves as a liaison to managed care organizations, optimizes reimbursement, and monitors the delivery of quality treatment to patients at the appropriate level of care.

→Advocates for optimal patient care in clinical care determination reviews with licensed mental health clinicians and RNs at managed care organizations
→Proactively and independently reviews and synthesizes the medical record to formulate a compelling clinical case presentation to managed care organizations that effectively advocates for optimal patient care
→Assesses and reports quality of clinical documentation in the medical record
→Confers with medical, nursing, and other professional staff to assess legitimacy of treatment and length of stay
→Participates in regular treatment team meetings to share relevant information and aid in clinical case conceptualization

Requirements

~1 min read

Bachelor's Degree in Nursing; Alternatively, Master's degree or above in counseling, social work, psychology, or marriage and family.

Fully independent clinical licensure in a behavioral health discipline (LPC, LMFT, LCSW, Licensed Psychologist or similar) or licensed as an RN (Preferred)

Knowledge, Skills and Abilities

1 year+ of experience in behavioral health (Required)
Prior experience working with eating disorder (Preferred)
Willingness to work occasional nights and weekends

The compensation range for this position is based upon candidate experience and market expectations.

Colorado pay range

$32—$37 USD

What We Offer

At ERC Pathlight, caring for people is our mission and that begins with caring for our own team. Your well-being matters, and our benefit program is designed to support every part of your life.

We offer competitive compensation; comprehensive medical, dental, and vision coverage; generous Paid Time Off; Parental Leave benefits; Retirement benefits; and tuition reimbursement to help you continue growing in your career.

We also recognize that mental health is part of every person’s experience. That’s why we strive to create a workplace where you feel supported, seen, and encouraged—personally, professionally, and at home.

When you thrive, you can do your best work. And your best work changes lives.