Utilization Review Specialist: Responsible for ensuring adherence to Mindful Health’s utilization review plan by evaluating the efficiency, effectiveness, and medical necessity of outpatient services, including admissions and extended treatment. Establish processes to verify the medical necessity and appropriateness of outpatient admissions Conduct concurrent reviews to ensure extended stays are justified and properly documented Track patient lengths of stay and continued-stay days Refer non-compliant cases to the Physician Advisor for further evaluation Collaborate with the Utilization Review Committee to identify and resolve review-related issues Flag quality-of-care concerns and escalate them to the Quality Assurance Committee Coordinate with Social Services to support timely discharge planning Prepare and present monthly utilization reports and key metrics