Utilization Review Specialist

Location: Remote in Las Vegas, NV Employment Type: Full-Time

Are you a detail-oriented problem-solver with a passion for ensuring patients get the mental health care they need? Do you have strong knowledge of utilization management, medical necessity, and patient status determination? If so, Healthy Minds wants you on our team!

At Healthy Minds, we are on a mission to raise Nevada’s mental health ranking from 51st to 1st—and we need a sharp, strategic thinker to navigate the complexities of utilization review.

What You'll Do:

Ensure compliance with insurance and regulatory requirements to maximize approvals for patient care Review and track utilization data to optimize processes and improve outcomes Train staff on utilization management best practices and collaborate across teams Advocate for patients by preparing and submitting strong medical necessity documentation Identify and solve problems in the UM process to minimize delays and denials

Why You’ll Love This Role:

You thrive on solving complex problems—especially when it means getting patients the care they deserve You enjoy working across multiple teams—clinical, medical, billing, compliance—you name it! You love organization and efficiency—we’ll even let you create a new system or two You’re not afraid to speak up—you’ll advocate for both our clinicians and our clients You appreciate balance—we put clinical care and patient outcomes ahead of cost constraints

Benefits:

Competitive salary Comprehensive health, dental, and vision insurance Short-term & long-term disability insurance Life, critical illness, and accident insurance Paid time off (2-6 weeks) + 11 paid holidays 401(k) retirement plan Financial advising benefit On-site supervision & professional development opportunities Employee Assistance Program (EAP) Supportive and collaborative work environment Opportunities for career advancement

- Bachelor's degree in Social Work, Psychology, or related field, OR RN/LPN preferred.
- 2 years' experience in mental health/substance use treatment & utilization review preferred.
- Strong knowledge of medical necessity criteria, ASAM, and DSM.
- Excellent communication and problem-solving skills.
- Proficiency with technology including Microsoft Suite, EMR, and adept Googling skills.
- Ability to thrive under pressure and advocate effectively for ethical practices. 

If this sounds like your perfect job, click APPLY NOW and join our mission to change mental health care for the better!