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Remote Behavioral Health Utilization Review Jobs in Illinois

AltaStaff, LLC

UM RN Care Review Clinician

Chicago, IL · Remote

$40 - $42/hr

This is a fully remote role but candidates must have a valid RN license in Illinois*** Position Purpose: Care Review Clinician works with the Utilization Management team primarily responsible for ...

Med-Metrix

Physician Advisor - Remote

Chicago, IL · On-site +1

Demonstrates behavior that supports the organization's mission. Participates in required ... Board Certification by the American Board of Quality Assurance and Utilization Review Physicians ...

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Remote Behavioral Health Utilization Review information

What is a remote behavioral health utilization review?

A Remote Behavioral Health Utilization Review job involves evaluating behavioral health treatment plans and services to ensure they meet insurance guidelines, medical necessity, and regulatory requirements. Professionals in this role review clinical documentation, assess patient needs, and collaborate with healthcare providers to determine appropriate levels of care. They work remotely, often for insurance companies or healthcare organizations, to authorize or deny coverage based on established criteria. Strong clinical knowledge, attention to detail, and communication skills are essential for success in this role.

What are the typical daily responsibilities for someone working in remote behavioral health utilization review?

In a Remote Behavioral Health Utilization Review role, your daily tasks often include reviewing clinical documentation, assessing medical necessity for behavioral health services, and making authorization or denial recommendations according to established guidelines. You’ll frequently interact with providers, case managers, and insurance representatives to gather information and clarify care requests. Additionally, your day may involve documenting decisions, participating in case review meetings, and staying updated on evolving policies. Working remotely, you'll communicate primarily via secure electronic systems, phone, and video conferencing. This structure typically offers flexibility but also requires strong self-motivation and organization.

What are the key skills and qualifications needed to thrive in remote behavioral health utilization review, and why are they important?

To excel in Remote Behavioral Health Utilization Review, candidates generally need a clinical background such as a nursing or social work license, strong analytical skills, and experience with behavioral health diagnoses and treatment planning. Familiarity with utilization management software, electronic health records (EHRs), and insurance coding systems is often required, along with certifications like CCM (Certified Case Manager) or URAC accreditation being valued. Excellent communication, critical thinking, and organizational skills help professionals handle complex cases and collaborate effectively in a virtual team environment. These competencies ensure accurate review of mental health services, compliance with payer requirements, and optimal patient outcomes.

What are the most commonly searched types of Behavioral Health Utilization Review jobs in Illinois?

The most popular types of Behavioral Health Utilization Review jobs in Illinois are:

What are popular job titles related to Remote Behavioral Health Utilization Review jobs in Illinois?

For Remote Behavioral Health Utilization Review jobs in Illinois, the most frequently searched job titles are:

What job categories do people searching Remote Behavioral Health Utilization Review jobs in Illinois look for?

The top searched job categories for Remote Behavioral Health Utilization Review jobs in Illinois are:

What cities in Illinois are hiring for Remote Behavioral Health Utilization Review jobs?

Cities in Illinois with the most Remote Behavioral Health Utilization Review job openings:

Remote Behavioral Health Utilization Review jobs near you
Infographic showing various Remote Behavioral Health Utilization Review job openings in Illinois as of August 2026, with employment types broken down into 85% Full Time, 10% Part Time, and 5% Contract. Highlights an 3% Hybrid, and 97% Remote job distribution.

ABA Utilization Review (UR) Specialist

Skokie, IL • On-site, Remote

Spectrum Billing Solutions
Finance and Insurance • 51 - 200 employees
Learn more about Spectrum Billing Solutionsexternal

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 3 days ago

Job description

Spectrum Billing Solutions offers industry-leading revenue cycle management services for healthcare providers. Our team has deep industry knowledge, technology, and experience to ensure our client's revenue cycle is managed in the most efficient and streamlined manner.
We are seeking to add an ABA Utilization Review (UR) Specialist to our growing team. The ABA UR Specialist will utilize his or her knowledge and skills to review clinical information and obtain initial and continuing authorizations for ABA and related services. The ideal candidate is passionate, motivated, detail-oriented and interested in working in a cohesive and rewarding environment.
This is a fully remote or office/home hybrid position.
Your Responsibilities:
  • Review patient admission and clinical information to ensure medical necessity and compliance of utilization review guidelines.
  • Obtain initial and continuing authorization for treatment services.
  • Manage authorization denials including referral for peer review.
  • Document and record all necessary information.
  • Monitor and track new and ongoing authorization cases.
  • Collaborate and communicate with clinical staff to ensure necessary information is obtained and timely reviews are performed.
  • Assist external clients in understanding payer requirements for authorizations.
  • Participate in team meetings.
  • Maintain confidentiality of patient information and adhere to HIPAA regulations.
What we offer you:
  • Flexible work environment
  • Competitive Salary
  • A close-knit team of talented and skilled individuals.
  • Growth opportunities
  • Benefits - Medical, Dental, Vision
  • Flexible Paid Time Off
  • 401K with Company match
  • Supplemental Benefits
Qualifications:
  • 3-5 years of related ABA and/or Behavioral Health experience.
  • Bachelor's or master's degree preferred.
  • Superior written and oral communication skills
  • Attention to detail to ensure necessary information is captured and properly documented.
  • Ability to work independently and within a team.
  • Ability to multi-task, prioritize and meet expected deadlines.
  • Solid understanding of insurance benefits and coverages.
  • Strong computer skills (Word, Excel, billing software).
  • Understanding of mental and behavioral health treatment services.
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