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Behavioral Health Utilization Management Jobs in Colorado

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Behavioral Health Utilization Management information

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$22

$44

$72

How much do behavioral health utilization management jobs pay per hour?

As of Sep 7, 2026, the average hourly pay for behavioral health utilization management in Colorado is $44.46, according to ZipRecruiter salary data. Most workers in this role earn between $35.14 and $51.06 per hour, depending on experience, location, and employer.

What is behavioral health utilization management?

Behavioral Health Utilization Management is a process used by insurance companies and healthcare organizations to evaluate the necessity, appropriateness, and efficiency of behavioral health services such as mental health and substance use treatments. This process helps ensure that patients receive the right level of care based on clinical guidelines while managing healthcare costs. Utilization managers review treatment plans, authorize services, and coordinate with providers to promote quality outcomes and avoid unnecessary services. Their work is essential in balancing patient needs with resource allocation in the healthcare system.

What skills and qualifications are needed for behavioral health utilization management?

To thrive as a Behavioral Health Utilization Management professional, you need a background in behavioral health or clinical care, often with an RN, LCSW, LPC, or similar licensure and experience in mental health care settings. Familiarity with utilization review software, insurance guidelines, and electronic health record (EHR) systems is crucial. Strong analytical thinking, communication, and negotiation skills are essential soft skills to effectively evaluate treatment plans and coordinate with providers. These competencies are vital to ensuring appropriate, cost-effective care while maintaining compliance with regulatory and payer requirements.

What are common challenges in behavioral health utilization management and how are they addressed?

Behavioral Health Utilization Management professionals often encounter challenges such as managing high caseloads, keeping up with evolving clinical guidelines, and ensuring timely communication with providers and insurance companies. Balancing the need for cost containment with advocating for appropriate patient care can also be demanding. These challenges are typically addressed through ongoing training, strong teamwork, and the use of evidence-based criteria and decision-support tools to guide determinations and streamline workflows.

What is the difference between Behavioral Health Utilization Management vs Behavioral Health Case Manager?

AspectBehavioral Health Utilization ManagementBehavioral Health Case Manager
CredentialsLicenses (e.g., RN, LCSW), certifications in utilization reviewLicenses (e.g., LCSW, LPC), case management certifications
Work EnvironmentInsurance companies, healthcare organizations, utilization review departmentsHospitals, community clinics, outpatient facilities
Employer & Industry UsageHealth insurance providers, managed care organizationsBehavioral 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 popular job titles related to Behavioral Health Utilization Management jobs in Colorado?

For Behavioral Health Utilization Management jobs in Colorado, the most frequently searched job titles are:

What job categories do people searching Behavioral Health Utilization Management jobs in Colorado look for?

The top searched job categories for Behavioral Health Utilization Management jobs in Colorado are:

What cities in Colorado are hiring for Behavioral Health Utilization Management jobs?

Cities in Colorado with the most Behavioral Health Utilization Management job openings:

Behavioral Health Utilization Management jobs near you
Infographic showing various Behavioral Health Utilization Management job openings in Colorado as of August 2026, with employment types broken down into 91% Full Time, 7% Part Time, and 2% Contract. Highlights an 95% In-person, 3% Hybrid, and 2% Remote job distribution, with an average salary of $92,477 per year, or $44.5 per hour.

Utilization Review Coordinator

Alsos Behavioral Health

Aurora, CO • On-site

$64K/yr

Full-time

Posted 14 days ago

Key responsibilities

  • Complete pre-certification, initial, concurrent, and discharge reviews with payers for residential SUD levels of care.

  • Coordinate, prepare, and schedule peer-to-peer reviews between facility physicians and payer medical directors, and support the appeals process.

  • Review clinical documentation daily to ensure alignment with billed levels of care and provide real-time coaching to clinicians.

Job description

EOE Statement
We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status or any other characteristic protected by law.
Description
Position Summary
Salary $64,000
The UR and RCM Support Coordinator is responsible for securing and maintaining payer authorizations across all levels of care for residential substance use disorder (SUD) treatment, including ASAM Levels 3.5 and 3.7, while also providing cross-functional support to the Revenue Cycle Management department. This role serves as a key link between the clinical team, payers, and the RCM department, ensuring that medical necessity is clearly documented, communicated, and defended throughout each patient's episode of care.
Reporting to the Director of Utilization Review with a dotted-line relationship to the Director of Revenue Cycle Management, the UR and RCM Support Coordinator works in close partnership with billing, denials, appeals, and clinical leadership to drive authorization approval rates, prevent denials at the front end, and protect revenue across the multi-state network of facilities. This is a high-visibility role with direct impact on length of stay, denial rates, and net collections.
Essential Duties and Responsibilities
Authorization Management
  • Complete pre-certification, initial, concurrent, and discharge reviews with commercial, Medicaid, and Medicaid managed care payers for residential SUD levels of care (ASAM 3.1, 3.5, 3.7, and detox where applicable).
  • Submit clinical information to payers within required timeframes, using ASAM criteria and payer-specific medical necessity guidelines to justify admission, continued stay, and level of care.
  • Track all authorization requests, approvals, days approved, next review dates, and denials in the UR tracking system; ensure no patient day is at risk due to a missed or expired authorization.
  • Escalate authorization issues, denials, or peer-to-peer requests to the Director of Utilization Review and Director of RCM in real time, along with clinical leadership as appropriate.

Peer-to-Peer and Denial Prevention
  • Coordinate, prepare, and schedule peer-to-peer reviews between facility physicians and payer medical directors; provide the rendering clinician with a written summary of medical necessity points prior to each call.
  • Document peer-to-peer outcomes, including outcome reason, reviewer name, and any payer-specific feedback for use in future submissions.
  • Partner with the Director of Utilization Review and Director of RCM, along with the appeals team, to identify trends in concurrent denials and translate findings into documentation and clinical workflow improvements.
  • Support the appeals process by providing UR notes, clinical timelines, and the authorization history needed for first- and second-level appeals.

Clinical Documentation Partnership
  • Review clinical documentation daily for alignment between the billed level of care and the documented level of care; flag and address mismatches before they generate denials (a known driver of pre-payment review and payer recoupment risk).
  • Provide real-time coaching and written feedback to clinicians, therapists, and medical providers on documentation elements required to meet ASAM 3.5 and 3.7 medical necessity (e.g., dimensional risk ratings, withdrawal management needs, biomedical and behavioral complications, treatment response, and continued-stay justification).
  • Partner with clinical leadership to maintain documentation templates and standards that satisfy commercial payer, state Medicaid, and accreditation requirements across Arkansas, Colorado, Indiana, Kentucky, and Ohio.

Revenue Cycle Coordination
  • Work alongside the RCM team to support resolution of authorization-driven holds, write-off recommendations, and pre-payment review responses, providing UR expertise and clinical context as needed.
  • Provide the billing team with accurate authorization numbers, approved date ranges, level-of-care designations, and modifier guidance to ensure clean claim submission.
  • Participate in standing meetings with the Director of Utilization Review, Director of RCM, billing manager, and denials/appeals leads to review denial trends, hold billing volume, AR aging by payer, and authorization-related risk.
  • Contribute to executive-facing reporting on UR performance, including authorization approval rates, average days authorized, peer-to-peer outcomes, and denial root cause.
  • Support the RCM team as needed with cash posting, billing, and denial reconciliation activities, particularly during peak volume, staff coverage gaps, or special projects.
  • Participate in the implementation, testing, and rollout of new software platforms, payer portals, and operational processes; provide UR-side workflow input, validate functionality, and assist with end-user training and adoption across facilities.

Payer Relationships and Compliance
  • Maintain working knowledge of payer-specific medical necessity criteria, review timelines, submission portals, and documentation requirements for Ambetter, UnitedHealthcare, Optum, Aetna, Cigna, Anthem/Elevance, Colorado Access, state Medicaid programs, and Medicaid managed care plans operating in network states.
  • Track payer policy changes, level-of-care criteria updates, and contract requirements; communicate impact to RCM and clinical leadership.
  • Support payer pre-payment reviews, audits, and medical record requests by assembling complete UR packets within required timeframes.
  • Maintain strict compliance with HIPAA, 42 CFR Part 2, state confidentiality laws, and organizational policy in all payer communications.

Position Requirements
Qualifications
Required
  • Active, unrestricted clinical license in good standing (RN, LPN, LCSW, LPC, LMFT, LCDC/LADC, or equivalent behavioral health license) OR equivalent UR experience acceptable to the organization.
  • Minimum of 2 years of utilization review, case management, or care coordination experience in behavioral health, substance use disorder, or mental health treatment.
  • Demonstrated working knowledge of ASAM Criteria, with the ability to apply dimensional assessments to medical necessity submissions.
  • Direct experience completing concurrent reviews with commercial and/or Medicaid payers for residential SUD or behavioral health levels of care.
  • Strong written and verbal communication skills, with the ability to summarize complex clinical information into concise medical necessity language.
  • Proficient in electronic health records, payer portals, and Microsoft Office (Excel, Word, Outlook, Teams).

Preferred
  • Experience supporting multi-state operations or multi-facility provider networks.
  • Prior experience working within or alongside a Revenue Cycle Management department, including familiarity with denials, appeals, and AR workflows.
  • Working knowledge of state Medicaid behavioral health billing requirements (e.g., Ohio rendering practitioner/NPI rules, Colorado HCPF supervising clinician and modifier requirements, Kentucky and Indiana ASAM billing structures, Arkansas OBHS billing).
  • Experience handling pre-payment reviews and supporting payer audit responses.

Knowledge, Skills, and Abilities
  • Ability to think both clinically and financially - to recognize when documentation will not support the billed level of care and intervene before claims are submitted.
  • Strong organizational skills and the ability to manage a high volume of concurrent reviews across multiple facilities, payers, and time zones without missing deadlines.
  • Comfort working independently in a remote environment while maintaining tight collaboration with clinical, billing, and leadership teams.
  • Sound judgment in escalating risk: when to request a peer-to-peer, when to engage the Director of Utilization Review or Director of RCM, and when to involve clinical leadership.
  • Discretion and professionalism in all payer-facing communications; the UR Coordinator represents the organization to payer medical directors and case managers.

Key Performance Indicators
Performance will be evaluated against, but not limited to, the following measures:
  • Initial authorization approval rate by payer and level of care.
  • Concurrent review approval rate and average days approved per review.
  • Peer-to-peer overturn rate.
  • Concurrent denial rate and root-cause distribution (medical necessity vs. documentation vs. timeliness).
  • Timeliness of review submission (meeting or exceeding payer deadlines).
  • Authorization-related hold billing volume and aging.

Working Conditions and Physical Requirements
  • Primarily remote, office-based work; extended periods of computer and phone use.
  • Standard business hours with occasional flexibility required to meet payer deadlines or accommodate peer-to-peer scheduling across time zones.
  • Occasional travel to facilities or payer meetings may be required.

Full-Time/Part-Time
Full-Time
Shift
-not applicable-
Position
Utilization Review Coordinator
Division
Sheridan Grove Recovery
Number of Openings
1
Exempt/Non-Exempt
Non-Exempt
Hiring Manager(s)
Tracy Polk
Location
DEN1
About the Organization
Healing with Dignity, Recovery with Purpose.
Oak Grove Recovery proudly serves the Columbus, Ohio, community by providing compassionate, judgment-free addiction treatment. Our dedicated team is available 24/7 to support each individual on their healing journey, offering care rooted in dignity, purpose, and unwavering respect.
This position is currently accepting applications.

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