Details: Under minimal supervision, provides medical and/or behavioral health utilization management for members of Medical Plan in accordance with the schedule of benefits and network criteria ...
Details: Under minimal supervision, provides medical and/or behavioral health utilization management for members of Medical Plan in accordance with the schedule of benefits and network criteria ...
RN- MANAGED CARE ADMINISTRATION
Denver, CO ยท On-site
Provides medical and/or behavioral health utilization management for members of facility medical plan in accordance with the schedule of benefits and network criteria defined by the Plans various ...
RN- MANAGED CARE ADMINISTRATION
Denver, CO ยท On-site
Provides medical and/or behavioral health utilization management for members of facility medical plan in accordance with the schedule of benefits and network criteria defined by the Plans various ...
Behavioral Health Utilization Management Clinical Coordinator - Remote in Colorado preferred
Grand Junction, CO ยท Hybrid
Substance use treatment experience and/or behavioral health treatment experience * Ability to work Monday - Friday, 930am-6pm Mountain Standard Time Preferred Qualification: * Utilization Management ...
Behavioral Health Utilization Management Clinical Coordinator - Remote in Colorado preferred
Grand Junction, CO ยท Hybrid
Substance use treatment experience and/or behavioral health treatment experience * Ability to work Monday - Friday, 930am-6pm Mountain Standard Time Preferred Qualification: * Utilization Management ...
Manager of Behavioral Health
Denver, CO ยท On-site
This includes care management, utilization management, compliance, quality improvement, population ... Master's degree in behavioral health or related field preferred. Equivalent combination of ...
Manager of Behavioral Health
Denver, CO ยท On-site
This includes care management, utilization management, compliance, quality improvement, population ... Master's degree in behavioral health or related field preferred. Equivalent combination of ...
Highlands Behavioral Health System is an 86 bed, acute care psychiatric hospital located in ... The UM Coordinator manages medical necessity by evaluating the patient medical records to determine ...
Highlands Behavioral Health System is an 86 bed, acute care psychiatric hospital located in ... The UM Coordinator manages medical necessity by evaluating the patient medical records to determine ...
Highlands Behavioral Health System is an 86 bed, acute care psychiatric hospital located in ... The UM Coordinator manages medical necessity by evaluating the patient medical records to determine ...
Highlands Behavioral Health System is an 86 bed, acute care psychiatric hospital located in ... The UM Coordinator manages medical necessity by evaluating the patient medical records to determine ...
Utilization Review Coordinator - Behavioral Health Setting
Highlands Ranch, CO ยท On-site
$33.33 - $49.99/hr
Highlands Behavioral Health System is an 86 bed, acute care psychiatric hospital located in ... The UM Coordinator manages medical necessity by evaluating the patient medical records to determine ...
Utilization Review Coordinator - Behavioral Health Setting
Highlands Ranch, CO ยท On-site
$33.33 - $49.99/hr
Highlands Behavioral Health System is an 86 bed, acute care psychiatric hospital located in ... The UM Coordinator manages medical necessity by evaluating the patient medical records to determine ...
The UM Coordinator manages medical necessity by evaluating the patient medical records to determine ... Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory ...
New
The UM Coordinator manages medical necessity by evaluating the patient medical records to determine ... Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory ...
New
Utilization Review Coordinator - Behavioral Health Setting
Louisville, CO ยท On-site
$33.33 - $49.99/hr
The UM Coordinator manages medical necessity by evaluating the patient medical records to determine ... Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory ...
Utilization Review Coordinator - Behavioral Health Setting
Louisville, CO ยท On-site
$33.33 - $49.99/hr
The UM Coordinator manages medical necessity by evaluating the patient medical records to determine ... Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory ...
The UM Coordinator manages medical necessity by evaluating the patient medical records to determine ... Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory ...
New
The UM Coordinator manages medical necessity by evaluating the patient medical records to determine ... Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory ...
New
The Utilization Management Coordinator possesses knowledge of Substance Use Disorders and diagnosis ... Experience in substance use residential services as well as integrated behavioral health and/or ...
The Utilization Management Coordinator possesses knowledge of Substance Use Disorders and diagnosis ... Experience in substance use residential services as well as integrated behavioral health and/or ...
West Pines Behavioral Hospital is a new 144-bed inpatient behavioral health facility serving Denver ... Prepare and analyze clinical data for research purposes, process improvement, utilization ...
West Pines Behavioral Hospital is a new 144-bed inpatient behavioral health facility serving Denver ... Prepare and analyze clinical data for research purposes, process improvement, utilization ...
Behavioral Health Case Manager
Pueblo, CO ยท On-site
$22.11 - $26.01/hr
Utilizes population health management strategies including basic analysis of data including social ... Computer skills including database utilization required. * Conversational Spanish desirable.
Behavioral Health Case Manager
Pueblo, CO ยท On-site
$22.11 - $26.01/hr
Utilizes population health management strategies including basic analysis of data including social ... Computer skills including database utilization required. * Conversational Spanish desirable.
Behavioral Health Case Manager
Pueblo, CO ยท On-site
$22.11 - $26.01/hr
Utilizes population health management strategies including basic analysis of data including social ... Computer skills including database utilization required. * Conversational Spanish desirable.
Behavioral Health Case Manager
Pueblo, CO ยท On-site
$22.11 - $26.01/hr
Utilizes population health management strategies including basic analysis of data including social ... Computer skills including database utilization required. * Conversational Spanish desirable.
Manager, Medical Utilization and Care Management
Denver, CO ยท On-site
$95K - $130K/yr
About Judi Health Judi Health is an enterprise health technology company providing a comprehensive ... Provide oversight for vendors conducting utilization management, care management, and clinical ...
Manager, Medical Utilization and Care Management
Denver, CO ยท On-site
$95K - $130K/yr
About Judi Health Judi Health is an enterprise health technology company providing a comprehensive ... Provide oversight for vendors conducting utilization management, care management, and clinical ...
Director of Health Information Management
$91K - $115K/yr
Overview West Pines Behavioral Hospital is a new 144-bed inpatient behavioral health facility ... Prepare and analyze clinical data for research purposes, process improvement, utilization ...
Director of Health Information Management
$91K - $115K/yr
Overview West Pines Behavioral Hospital is a new 144-bed inpatient behavioral health facility ... Prepare and analyze clinical data for research purposes, process improvement, utilization ...
The Behavioral Health medical Coding & Compliance Specialist ("Behavioral Health medical Coding ... Collaborates with Utilization Manager and QI Manager to implement, track, and monitor client ...
The Behavioral Health medical Coding & Compliance Specialist ("Behavioral Health medical Coding ... Collaborates with Utilization Manager and QI Manager to implement, track, and monitor client ...
Senior Director, Health Plan Utilization Management - Denver Health Medical Plan (Must Live in Color
Denver, CO ยท On-site
$143K - $237K/yr
Job Summary The Senior Director of Health Plan Utilization Management is a senior leader for the Denver Health Medical Plan (DHMP) with responsibility for providing strategic and operational ...
Senior Director, Health Plan Utilization Management - Denver Health Medical Plan (Must Live in Color
Denver, CO ยท On-site
$143K - $237K/yr
Job Summary The Senior Director of Health Plan Utilization Management is a senior leader for the Denver Health Medical Plan (DHMP) with responsibility for providing strategic and operational ...
Senior Director, Health Plan Utilization Management - Denver Health Medical Plan (Must Live in Color
Denver, CO ยท On-site
$143K - $237K/yr
Job Summary The Senior Director of Health Plan Utilization Management is a senior leader for the Denver Health Medical Plan (DHMP) with responsibility for providing strategic and operational ...
Senior Director, Health Plan Utilization Management - Denver Health Medical Plan (Must Live in Color
Denver, CO ยท On-site
$143K - $237K/yr
Job Summary The Senior Director of Health Plan Utilization Management is a senior leader for the Denver Health Medical Plan (DHMP) with responsibility for providing strategic and operational ...
The Behavioral Health medical Coding & Compliance Specialist is responsible for managing all ... Collaborates with Utilization Manager and QI Manager to implement, track, and monitor client ...
The Behavioral Health medical Coding & Compliance Specialist is responsible for managing all ... Collaborates with Utilization Manager and QI Manager to implement, track, and monitor client ...
Behavioral Health Utilization Management information
See Colorado salary details
$22.50 - $27.05
2% of jobs
$27.05 - $31.60
9% of jobs
$34.71 is the 25th percentile. Wages below this are outliers.
$31.60 - $36.15
21% of jobs
The median wage is $39.83 / hr.
$36.15 - $40.70
23% of jobs
$40.70 - $45.25
13% of jobs
$48.78 is the 75th percentile. Wages above this are outliers.
$45.25 - $49.80
10% of jobs
$49.80 - $54.35
8% of jobs
$54.35 - $58.90
5% of jobs
$58.90 - $63.45
5% of jobs
$63.45 - $67.99
2% of jobs
$67.99 - $72.54
2% of jobs
$22
$44
$72
How much do behavioral health utilization management jobs pay per hour?
What is the difference between Behavioral Health Utilization Management vs Behavioral Health Case Manager?
| Aspect | Behavioral Health Utilization Management | Behavioral Health Case Manager |
|---|---|---|
| Credentials | Licenses (e.g., RN, LCSW), certifications in utilization review | Licenses (e.g., LCSW, LPC), case management certifications |
| Work Environment | Insurance companies, healthcare organizations, utilization review departments | Hospitals, community clinics, outpatient facilities |
| Employer & Industry Usage | Health insurance providers, managed care organizations | Behavioral health agencies, hospitals, outpatient clinics |
Behavioral Health Utilization Management focuses on reviewing and authorizing mental health services to ensure appropriate care and cost management. In contrast, Behavioral Health Case Managers coordinate ongoing patient care, providing support and resources to improve treatment outcomes. Both roles require relevant licenses and certifications but differ in their primary responsibilities and work settings.
What are common challenges in behavioral health utilization management and how are they addressed?
What is behavioral health utilization management?
What skills and qualifications are needed for behavioral health utilization management?

Full-time
Medical, Life
Re-posted 6 days ago
Job description
Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing.
Details:
Under minimal supervision, provides medical and/or behavioral health utilization management for members of Medical Plan in accordance with the schedule of benefits and network criteria defined by the Plan's various lines of business and Center of Medicare & Medicaid Services ("CMS") regulatory requirements. Completes clinical review to determine whether a request can be approved using nationally recognized criteria such as InterQual or MCG, or requires additional review by the Plan's Medical Director.
MINIMUM QUALIFICATIONS:
Education:
Bachelor's degree in Nursing. A combination of education and experience may be substituted for the B.S.N. requirement.
Experience:
Typically, three years of medical utilization management experience working with a health insurance plan, hospital, skilled nursing facility, or surgical center. Managed Care experience is highly preferred.
Responsibilities:
Facility seeks 2 F/T RN Case Managers for excellent contract working in Managed Care department.
Must have BSN, 3 years' experience in medical utilization management, and experience working with a health insurance plan.
Managed Care experience is preferred however hospital experience is also considered.
Seeking highly skilled individual with experience with InterQual and MCG.
Provides medical and/or behavioral health utilization management for members of facility medical plan in accordance with the schedule of benefits and network criteria defined by the Plans various lines of business and Center of Medicare & Medicaid Services.
Regards,
Riya Khem
Life Science Recruiter
Integrated Resources, Inc.
IT Life Sciences Allied Healthcare CRO
(Direct) 732-844-8721 | (W) 732-549-2030 x 311 | (F) 732-549-5549
"INC 5000's FASTEST GROWING, PRIVATELY HELD COMPANIES" (8th Year in a Row)
About Integrated Resources
Sourced by ZipRecruiter
Integrated Resources Inc (IRI), based in Edison, NJ, US, is an esteemed player in the staffing solutions industry with a credible presence on their official website irionline.com. Notably, IRI provides a range of professional staffing services including contract, contract-to-hire, and direct hire solutions to a wide spectrum of industries such as healthcare, life sciences, manufacturing, financial, insurance, and others. Since its inception, IRI has been committed to delivering top-talent and optimum solutions to meet its clients' diverse needs.
Industry
Recruiting and staffing services
Company size
51 - 200 Employees
Headquarters location
Edison, NJ, US
Year founded
1996