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Charlie Health

Utilization Review Specialist

Reposted 2 Days Ago
Remote
Hiring Remotely in United States
53K-70K
Junior
Remote
Hiring Remotely in United States
53K-70K
Junior
The Utilization Review Specialist oversees a virtual IOP caseload, ensuring organized utilization processes and timely communication with insurance payors for patient care.
The summary above was generated by AI
 Why Charlie Health?

We are currently facing a nationwide mental health epidemic marked by rising rates of depression, anxiety, trauma, substance use disorders, and suicide. At the same time, those seeking help often encounter barriers—whether geographic, financial, or systemic—that prevent them from receiving timely and effective care. This urgent need calls for a reimagined approach to behavioral health treatment.

At Charlie Health, our mission is to connect the world to life-saving mental health treatment. Our innovative virtual programs combine curated group sessions, individual therapy, and family therapy, delivered through personalized, evidence-based treatment plans designed for sustainable healing from the comfort of home. By connecting individuals with shared experiences and fostering supportive communities, Charlie Health provides a pathway to long-term recovery, with over 90% of our clients seeing improvement in their most challenging mental health symptoms.

Every member of our team shares a deep commitment to this mission. If you’re driven to make a meaningful impact, we invite you to join us in reshaping the future of mental healthcare.

About the Role

The purpose of this position is to ensure that the utilization process is thorough, organized and streamlined to provide the best possible length of stays for our patients.  Given the complex nature of insurance these days, it is crucial to have timely communication with these payors so that families can focus on what’s important, getting their loved ones the care they need.   

Our team is comprised of passionate, forward-thinking professionals eager to take on the challenge of the mental health crisis and play a formative role in providing life-saving solutions. We are looking for a candidate who is inspired by our mission and excited by the opportunity to build a business that will impact millions of lives in a profound way.

Responsibilities

  • Oversees all functions of a virtual IOP caseload 
  • Completes peer reviews on cases with insurance
  • Collaborates at a high level to problem solve on complex cases with Manager
  • Completes pre-certs and continued stay authorizations for virtual IOP clients in a timely manner
  • Follows up on all outstanding authorizations and reports all barriers to Manager
  • Collaborates with Revenue Team and Admissions to improve patient experience from the front door through discharge
  • Partners with Manager and Director to troubleshoot workflows and processes to achieve efficiency gains in current and future company systems 
  • Delivers frequent training to clinical teams for high quality documentation standardization
  • Consulting across teams, providing mentorship, and contributing specialized knowledge

Requirements

  • Master’s Degree in healthcare field preferred 
  • 2+ years of experience in a utilization role within the healthcare field required
  • Microsoft Office and Salesforce proficiency
  • Strong interpersonal, relationship-building and listening skills, with a natural, consultative style
  • Ability to energize, communicate, and build rapport at all levels within an organization
  • Strong project management skills, with a demonstrable ability to corral and manage details in a fast-paced, fluid environment
  • Experience advising, presenting to, and persuading senior corporate personnel
  • Knowledge of all confidentially requirements regarding patients and strict maintenance of proper confidentiality on all such information.
  • Excellent written and verbal communication skills 
  • Organizational skills 
  • Ability to maintain a high level of integrity and confidentiality of medical information 
  • Strict attention to details

Benefits

Charlie Health is pleased to offer comprehensive benefits to all full-time, exempt employees. Read more about our benefits here.

Additional Information

The total target base compensation for this role will be between $53,000 and $70,000 per year at the commencement of employment. In addition to base compensation, this role offers a target performance-based bonus. The target total cash compensation range, including potential bonus, will be between $58,000 and $77,000 per year. Please note, pay will be determined on an individualized basis and will be impacted by location, experience, expertise, internal pay equity, and other relevant business considerations. Further, cash compensation is only part of the total compensation package, which, depending on the position, may include stock options and other Charlie Health-sponsored benefits. 

#LI-REMOTE

Note to Colorado applicants: Applications will be accepted and reviewed on a rolling basis.

Our Values
  • Connection: Care deeply & inspire hope.
    • We care personally about every single person in the Charlie Health ecosystem: our clients, providers, and team members alike.
    • We inspire hope with every interaction, reminding our clients that we truly and unconditionally believe in them.
  • Congruence: Stay curious & heed the evidence.
    • We ask “why” five times before we’re satisfied with the answer. We don’t stick to the status quo; we challenge our assumptions and remain humble.
    • Above all, we’re results-oriented. When we find data that calls our original plan into question, we modify or pivot.
  • Commitment: Act with urgency & don’t give up.
    • We work as swiftly as possible. The mental health crisis is relentless, and so are we.
    • Our clients don’t give up and neither do we. Persistence is our superpower.

Please do not call our public clinical admissions line in regard to this or any other job posting.

Please be cautious of potential recruitment fraud. If you are interested in exploring opportunities at Charlie Health, please go directly to our Careers Page: https://www.charliehealth.com/careers/current-openings. Charlie Health will never ask you to pay a fee or download software as part of the interview process with our company. In addition, Charlie Health will not ask for your personal banking information until you have signed an offer of employment and completed onboarding paperwork that is provided by our People Operations team. All communications with Charlie Health Talent and People Operations professionals will only be sent from @charliehealth.com email addresses. Legitimate emails will never originate from gmail.com, yahoo.com, or other commercial email services.

Recruiting agencies, please do not submit unsolicited referrals for this or any open role. We have a roster of agencies with whom we partner, and we will not pay any fee associated with unsolicited referrals.

At Charlie Health, we value being an Equal Opportunity Employer. We strive to cultivate an environment where individuals can be their authentic selves. Being an Equal Opportunity Employer means every member of our team feels as though they are supported and belong. We value diverse perspectives to help us provide essential mental health and substance use disorder treatments to all young people.

Charlie Health applicants are assessed solely on their qualifications for the role, without regard to disability or need for accommodation.

By submitting your application, you agree to receive SMS messages from Charlie Health regarding your application. Message and data rates may apply. Message frequency varies. You can reply STOP to opt out at any time. For help, reply HELP.

Top Skills

MS Office
Salesforce

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