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Behavioral Health Utilization Management Jobs in Georgia

This role ensures appropriate use of healthcare services, regulatory compliance, and optimal ... In conjunction with the Corp VP, Case Management & Utilization, develop and implement a system-wide ...

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Behavioral Health Utilization Management information

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$18

$35

$58

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

As of Aug 1, 2026, the average hourly pay for behavioral health utilization management in Georgia is $35.70, according to ZipRecruiter salary data. Most workers in this role earn between $28.22 and $41.01 per hour, depending on experience, location, and employer.

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 some common challenges faced by Behavioral Health Utilization Management professionals, and how are they typically 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 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 are the key skills and qualifications needed to thrive as a Behavioral Health Utilization Management professional, and why are they important?

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 popular job titles related to Behavioral Health Utilization Management jobs in Georgia? For Behavioral Health Utilization Management jobs in Georgia, the most frequently searched job titles are:
What job categories do people searching Behavioral Health Utilization Management jobs in Georgia look for? The top searched job categories for Behavioral Health Utilization Management jobs in Georgia are:
What cities in Georgia are hiring for Behavioral Health Utilization Management jobs? Cities in Georgia with the most Behavioral Health Utilization Management job openings:
Infographic showing various Behavioral Health Utilization Management job openings in Georgia as of July 2026, with employment types broken down into 67% Full Time, 29% Part Time, 2% Temporary, and 2% Contract. Highlights an 93% In-person, 5% Hybrid, and 2% Remote job distribution, with an average salary of $74,260 per year, or $35.7 per hour.

Manager Utilization Management-Behavioral Health

Piedmont Healthcare Inc.

Atlanta, GA

Full-time

Posted yesterday

New


Piedmont Healthcare rating

7.1

Company rating: 7.1 out of 10

Based on 465 frontline employees who took The Breakroom Quiz

376th of 887 rated healthcare providers


Job description

Provide system-level leadership and operational oversight of the Behavioral Health Utilization Review (UR) and Utilization Management (UM) processes across two hospital campuses and multiple Behavioral Health programs, including inpatient, ED-based, and specialty BH services. Responsible for ensuring consistent, compliant, and effective UR operations that support appropriate level-of-care determination, medical necessity, denial prevention, and financial performance. Serves as a primary point of contact and collaborative partner with multiple system teams, including but not limited to Revenue Cycle, Case Management, Compliance, Finance, HIM, Epic, Physician Advisors, and Executive Leadership, to align utilization practices with regulatory, payer, and organizational expectations.
Education
  • Bachelors Degree in Nursing, Business Administration, Health Administration, Social Work, or a closely related field Required
Work Experience
  • 5 years of experience in Behavioral Health Utilization Management and Utilization Review processes using medical necessity criteria (InterQual and/or Milliman).

  • 2 years Experience requirement above, to include, 2 years of demonstrated leadership or management experience in a hospital, medical practice, or other healthcare setting Required

  • Experience working in a system-level or multi-site environment Preferred
Licenses and Certifications
  • RN - Registered Nurse - Georgia State Licensure and/or NLC/eNCL Multistate Licensure Required or

  • LPC-Licensed Professional Counselor Required or

  • LMSW - Licensed Medical Social Worker - State Licensure Required or

  • LCSW- License Clinical Social Worker Required or

  • Licensed Marriage and Family Therapist (LMFT) Required

  • IQCI Certification Required

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