Utilization Review Specialist

Why Charlie Health?

Millions of people across the country are navigating mental health conditions, substance use disorders, and eating disorders, but too often, they’re met with barriers to care. From limited local options and long wait times to treatment that lacks personalization, behavioral healthcare can leave people feeling unseen and unsupported.

Charlie Health exists to change that. Our mission is to connect the world to life-saving behavioral health treatment. We deliver personalized, virtual care rooted in connection—between clients and clinicians, care teams, loved ones, and the communities that support them. By focusing on people with complex needs, we’re expanding access to meaningful care and driving better outcomes from the comfort of home.

As a rapidly growing organization, we're reaching more communities every day and building a team that’s redefining what behavioral health treatment can look like. If you're ready to use your skills to drive lasting change and help more people access the care they deserve, we’d love to meet you.

About the Role

The purpose of this position is to ensure that the utilization process is thorough, organized and streamlined to provide the best possible length of stays for our patients. Given the complex nature of insurance these days, it is crucial to have timely communication with these payors so that families can focus on what’s important, getting their loved ones the care they need.

We’re a team of passionate, forward-thinking professionals eager to take on the challenge of the mental health crisis and play a formative role in providing life-saving solutions. If you’re inspired by our mission and energized by the opportunity to increase access to mental healthcare and impact millions of lives in a profound way, apply today.

Responsibilities

Oversees all functions of a virtual IOP caseload

Collaborates at a high level to problem solve on complex cases with Manager

Completes pre-certs and authorizations for virtual IOP clients in a timely manner

Completes peer to peer reviews with insurance MDs to advocate for treatment post first line denial outcomes.

Follows up on all outstanding authorizations and reports all barriers to Manager

Collaborates with Revenue Cycle Team and Admissions to improve patient experience from the front door through discharge Partners with Manager and Director to troubleshoot workflows and processes to achieve efficiency gains in current and future company systems

Delivers training to clinical teams for high quality documentation standardization

Participate in denial management, appeals, and peer-to-peer review processes

Requirements

Active, Unrestricted Professional License: You must hold a current, active, and unencumbered license to practice independently in a U.S. state or territory. Common credentials include:

Physicians: MD or DO (typically Board Certified in Psychiatry or Child/Adolescent Psychiatry).

Psychologists: PsyD or PhD (Licensed Psychologist).

Master's-Level Clinicians: LCSW, LMFT, LPC, or LCPC.

2+ years of experience in a utilization role within the behavioral health field required

Google proficiency

Strong interpersonal, relationship-building and listening skills, with a natural, consultative style