Utilization Review Clinical Specialist

Job overview

The Utilization Review Clinical Specialist role is onsite in Queensbury, NY, with a Monday–Friday schedule from 8:30 a.m. to 4:30 p.m. Compensation is $75,000 per year. The role supports utilization management across BHSN programs, with an emphasis on the Certified Community Behavioral Health Clinic (CCBHC) model. The specialist evaluates medical necessity, level of care, service intensity, frequency, and duration to support clinically appropriate services aligned with individual needs. Through clinical consultation and collaboration with treatment teams, the role contributes to quality improvement, continuity of care, responsible resource use, and regulatory compliance.

What you'll do

• Conduct prospective, concurrent, retrospective, and continued-stay reviews
• complete continued-need reviews within established timeframes
• identify underutilization, overutilization, and changes in clinical need
• review and recommend level-of-care changes
• provide clinical consultation to supervisors, program leadership, and treatment teams
• identify engagement barriers and collaborate on outreach and care planning
• and review utilization across disciplines and levels of care.

What we're looking for

Skills & competencies

utilization review clinical specialist

queensbury ny

behavioral health services north

behavioral health

ccbhc

clinical utilization review

medical necessity

level of care

monday–friday

8:30 a.m.–4:30 p.m.

$75,000/year

Work arrangement

• Weekend coverage required

Benefits & perks

• Personalized health coverage, paid time off, holiday pay, training opportunities, community discounts, and loan forgiveness.

Why this role

Emphasizes utilization management within the CCBHC model and requires a master’s degree and current New York State license in a listed behavioral health discipline.

About the employer

Behavioral Health Services North Inc is hiring for this role. Industry: Offices of Mental Health Practitioners (except Physicians). Sector: 62.