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Behavioral Health Utilization Management Jobs in Ohio

Elevance Health

Wound Care Utilization Management RN

Cincinnati, OH · On-site

$39.34 - $56.20/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Carelon, a proud member of the Elevance Health family of companies, is a healthcare services ... We put people at the center-connecting physical, behavioral, social, and pharmacy services, along ...

syfs

UR Manager

Columbus, OH · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

... ages 12 to 17, withmental health and behavioral disorders. We have a 20-bed acute ... Maintain compliancy with regulation changes affecting utilization management. PositionRequirements ...

Elevance Health

Utilization Management Representative II

Mason, OH · On-site

$17.33 - $26.59/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Here's what Elevance Health offers: * A career path with opportunity for growth. * Ability to ... Our values and behaviors are the root of our culture. They are how we achieve our strategy, power ...

Elevance Health

Utilization Management Representative II

Mason, OH · On-site

$17.33 - $26.59/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Here's what Elevance Health offers: * A career path with opportunity for growth. * Ability to ... Our values and behaviors are the root of our culture. They are how we achieve our strategy, power ...

Crown Behavioral Health

Behavioral Health Tech

Columbus, OH · On-site

$15.75 - $19.25/hr

Communicate effectively with clinical, medical, case management, and leadership teams regarding ... Experience in behavioral health, substance use treatment, residential housing, sober living, or ...

Crown Behavioral Health

Behavioral Health Tech

Columbus, OH · On-site

$15.75 - $19.25/hr

Communicate effectively with clinical, medical, case management, and leadership teams regarding ... Experience in behavioral health, substance use treatment, residential housing, sober living, or ...

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Showing results 21-40

All JobsBehavioral Health Utilization Management JobsBehavioral Health Utilization Management Jobs in Ohio

Behavioral Health Utilization Management information

See Ohio salary details

$20

$40

$65

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

As of Aug 13, 2026, the average hourly pay for behavioral health utilization management in Ohio is $40.20, according to ZipRecruiter salary data. Most workers in this role earn between $31.78 and $46.15 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 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 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 popular job titles related to Behavioral Health Utilization Management jobs in Ohio?

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

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

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

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

Cities in Ohio 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 Ohio as of August 2026, with employment types broken down into 1% As Needed, 79% Full Time, 13% Part Time, and 7% Contract. Highlights an 96% Physical, 1% Hybrid, and 3% Remote job distribution, with an average salary of $83,610 per year, or $40.2 per hour.

RN Utilization Rvw Spclst - Utilization Management

Kettering Health Network

Miamisburg, OH • On-site

Other

Posted 10 days ago

Job description

Utilization Management

Part-time position in Miamisburg with varied shifts.

Responsibilities And Requirements
  • Registered professional nurse with education, knowledge and experience.
  • Role focuses on review of inpatient and observation admissions to ensure correct assignment of Admit status.
  • Communicates concurrently and resolves medical necessity discrepancies with physicians and other hospital leadership as needed.
  • Responsible for completing clinical review on all assigned patients and communicates these reviews to payers.
  • Identifies potential or actual denials for admission or ongoing stay both during the patient's hospital stay and post discharge.
  • Review and decide the validity of medical necessity payer denials. Submits payer denial appeals.
  • Participates in design of work flows and procedure to reduce incidence of denials.
  • Current unrestricted Ohio RN licensure, BSN required.
  • Experience with computers required.
Preferred Qualifications
  • 5 years clinical experience with 2 years case management
  • Case Management certification
  • Works independently
  • Familiar with MCG Care guidelines
  • Ability to adapt quickly to changing priorities and regulations
  • Experience with Microsoft applications and EPIC software
Overview

Kettering Health is a not-for-profit system of 14 medical centers and more than 120 outpatient facilities serving southwest Ohio. Our mission is to live God's love by promoting and restoring health. Our commitment to our patients is to help individuals be their best. With that context, safety is our top priority. We provide an integrated system of healthcare experts committed to providing exceptional care.

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