07/14/2026
Seeking an experienced Utilization Reviewer
Are you passionate about making a difference in your community? Is mental health or autism near and dear to your heart? The Mental Health & Autism Insurance Project (www.mhautism.org) is a mission-driven advocacy organization.
We are seeking a part-time mental health utilization reviewer
Be part of a dynamic non-profit of committed professionals, working to create a more just mental health care system. We are seeking a qualified Utilization Reviewer to join our non-profit team of mental health and autism advocates. The Utilization Reviewer will be responsible for the following:
1) Reviewing and summarizing medical records and other relevant documentation pertaining to residential, partial hospital, and IOP treatments for teens and youth with mental health conditions
2) Contacting clients' health plans and requesting pre- and ongoing authorizations, ensuring medical necessity and compliance with insurance guidelines.
3) Requesting network exceptions and single case agreements, as needed.
4) Conducting verification of benefits
5) Communicating determinations and recommendations to providers, families, and insurance representatives.
6) Collaborating with multidisciplinary teams to facilitate timely and accurate reviews.
7) Arrange for peer-to-peer reviews
8) Maintain thorough documentation and adherence to regulatory and payer requirements.
9) Submitting claims, and following up on claims payment (training provided).
**Required Qualifications:**
• Experience in utilization review, case management, or insurance authorization in behavioral health services required.
• Strong knowledge of DSM-5, ICD-10, and best practices in mental health and autism care.
• Excellent written and verbal communication skills.
**Preferred Qualifications:**
• Clinical mental health experience preferred.
• Familiarity with payer policies and commercial insurance guidelines preferred.
**Position Details:**
• Part-time, variable hours
• Remote, work from home, must be available during US work hours
• Competitive hourly compensation
• Opportunities for growth, including learning to write appeals and do other kinds of advocacy.
To apply, please submit your resume and cover letter detailing relevant experience and credentials to [email protected].
Must be able to legally work in the US. Equal Opportunity Employer.
