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Utilization Review Specialist

BriteLife Recovery

Englewood, New Jersey

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Englewood, New Jersey · RN

RNUtilization ReviewBehavioral HealthSubstance Use

Posted Aug 8, 2026 · Last seen active Aug 9, 2026

About this role

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The Utilization Review (UR) Specialist is a critical member of the administrative team at Advanced Revenue Solutions and is responsible for overseeing and coordinating all aspects of utilization review and insurance authorization for clients receiving substance use disorder (SUD) treatment at Britelife Recovery. This role ensures timely approvals and continued stay authorizations from insurance payers by effectively communicating clinical information and advocating for appropriate levels of care. The UR Specialist works closely with clinical staff, admissions, medical providers, and third-party payers to support patient access to treatment and maintain financial viability for the organization. Success in this role requires strong clinical judgment, documentation skills, familiarity with ASAM criteria, and a working knowledge of insurance guidelines specific to behavioral health.

Requirements

Minimum of 2-3 years of experience in utilization review, case management, or insurance coordination in a behavioral health or substance use treatment setting
Knowledge of ASAM criteria and levels of care for substance use and co-occurring disorders
Familiarity with managed care principles, insurance authorizations, and payer requirements
Bachelor's degree in Nursing, Social Work, Psychology, or a related field required
Advanced degree or licensure (e.g., RN, LCSW, LPC, LMHC, or CADC) preferred
Excellent organizational, communication, and time management skills
Proficiency in Electronic Health Records (EHRs), insurance portals, and Microsoft Office tools
Experience or working knowledge with Collaborative MD and KIPU

Living in Englewood, NJ

Englewood sits just across the Hudson from Manhattan, offering a leafy suburban feel with easy NYC access. Downtown Englewood has walkable restaurants and shops along Engle Street, giving nurses a quieter home base without sacrificing big-city proximity.