Interqual Jobs in Arizona (NOW HIRING)

Job Title: Utilization Review (UR) Coordinator / Authorization Representative [Clinical Experience Preferred] – Behavioral HealthEmployment Type: Full-TimeSchedule: In-office, Monday through Friday Position OverviewWe are seeking a detail-oriented and highly organized Utilization Review (UR) Coordinator / Authorization Representative [clinical experience preferred]. This role is responsible for managing authorizations, ensuring medical necessity documentation, and maintaining compliance with AHCCCS (Arizona Health Care Cost Containment System) requirements.The ideal candidate thrives in a fast-paced environment, demonstrates strong knowledge of behavioral health utilization management, and has a proven ability to manage high client volumes while maintaining strict adherence to timely filing and regulatory standards. Key ResponsibilitiesObtain, track, and manage initial and concurrent authorizations for behavioral health servicesCoordinate and complete utilization review processes in compliance with AHCCCS guidelines and medical necessity criteriaSubmit timely and accurate authorization requests, ensuring adherence to payer-specific timely filing requirementsMonitor authorizations for expiration and proactively manage concurrent reviews to prevent gaps in coverageCommunicate effectively with clinical staff, payers, and case managers to gather necessary documentation and ensure continuity of careMaintain accurate and up-to-date records in the EHR and authorization tracking systemsReview clinical documentation for completeness and alignment with medical necessity standardsManage a high volume of client cases, prioritizing tasks to meet deadlines and avoid service disruptionsFollow up on pending authorizations, denials, and appeals as neededEnsure compliance with all federal, state, and AHCCCS regulations, as well as internal policies and procedures QualificationsMinimum of [2+] years of experience in utilization review, authorizations, or behavioral health administrationClinical experience (peer service, clinician, etc.) that could aid in the review of clinical necessity.Strong working knowledge of AHCCCS requirements, including authorization processes and compliance standardsExperience with timely filing requirements and payer-specific guidelinesProven ability to manage high caseloads and concurrent reviews in a fast-paced environmentFamiliarity with behavioral health levels of care (e.g., RTC, PHP, IOP, outpatient)Excellent organizational skills and attention to detailStrong written and verbal communication skillsExperience with EHR systems and authorization tracking toolsAbility to work independently and as part of a multidisciplinary team Preferred QualificationsExperience working with Medicaid/managed care plans, specifically AHCCCSKnowledge of InterQual, ASAM, or other medical necessity criteria toolsPrevious experience handling denials, appeals, and peer-to-peers CompensationPay Range: $24–$29 per hour (DOE) Key CompetenciesTime management and prioritizationAccuracy and compliance-driven mindsetCritical thinking and problem-solvingAbility to handle sensitive information with confidentiality (HIPAA compliance)Adaptability in a high-volume, deadline-driven environment Why Join UsOpportunity to make a meaningful impact in behavioral health careCollaborative and mission-driven team environmentCompetitive compensation and benefits packageProfessional growth and development opportunities Note: This position requires strict adherence to AHCCCS guidelines, timely filing requirements, and all applicable regulatory standards. Candidates must demonstrate the ability to manage multiple concurrent authorizations while maintaining accuracy and compliance.As part of our commitment to maintaining a safe and productive work environment, Sanctuary Recovery Centers conducts background checks and drug screenings for all potential employees. Please note the following:Background Check: All offers of employment are contingent upon the successful completion of a background check. This may include verification of employment history, education, criminal records, and other relevant information.Drug Screening: Candidates must pass a drug screening test as a condition of employment. This test will screen for the presence of illegal substances and may include random testing during employment.APS Registry: Candidates must pass an APS (Adult Protective Services) registry check before an offer of employment can be extended.Confidentiality: All information obtained during the background check, drug screening, and APS registry check process will be kept confidential and used solely for employment purposes.Compliance: Sanctuary Recovery Centers complies with all applicable federal, state, and local laws regarding background checks, drug screenings, and APS registry checks.By applying for this position, you acknowledge and consent to these procedures.