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Behavioral Health Utilization Management Jobs in Virginia

Sentara Healthcare

Sentara Health is looking to hire a Behavior Health Utilization Management Care Coordinator Standard working hours: 8am to 5pm EST, MF This position will work with members under Sentara Health Plans ...

UHS

Director of Utilization Management

Danville, VA · On-site

The Director of Utilization Management assists admissions in screening patients at the pre-hospital ... Through its subsidiaries, UHS operates inpatient acute care facilities, inpatient behavioral health ...

UHS

Director of Utilization Management

Danville, VA

The Director of Utilization Management assists admissions in screening patients at the pre-hospital ... Through its subsidiaries, UHS operates inpatient acute care facilities, inpatient behavioral health ...

UHS

Director of Utilization Management

Danville, VA

The Director of Utilization Management assists admissions in screening patients at the pre-hospital ... Through its subsidiaries, UHS operates inpatient acute care facilities, inpatient behavioral health ...

UHS

Director of Utilization Management

Danville, VA

The Director of Utilization Management assists admissions in screening patients at the pre-hospital ... Through its subsidiaries, UHS operates inpatient acute care facilities, inpatient behavioral health ...

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Behavioral Health Utilization Management information

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$41

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

As of Sep 10, 2026, the average hourly pay for behavioral health utilization management in Virginia is $41.92, according to ZipRecruiter salary data. Most workers in this role earn between $33.12 and $48.12 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 Virginia?

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

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

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

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

Cities in Virginia 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 Virginia as of September 2026, with employment types broken down into 2% As Needed, 74% Full Time, 18% Part Time, 5% Contract, and 1% Nights. Highlights an 92% Physical, 1% Hybrid, and 7% Remote job distribution, with an average salary of $87,192 per year, or $41.9 per hour.

Board Certified Behavior Analyst (BCBA)/Behavioral Health Utilization Management

Norfolk, VA • On-site

Sentara Healthcare Inc
Hospitals • 10K+ employees
Learn more about Sentara Healthcare Incexternal

$71K - $87K/yr

Other

Posted 4 days ago

Sentara Health rating

6.8

Company rating: 6.8 out of 10

Based on 417 frontline employees who took The Breakroom Quiz

495th of 898 rated healthcare providers

Job description

Sentara Health is hiring for a Board Certified Behavior Analyst (BCBA)/Behavioral Health Utilization Management- Remote in VA!

Status: Full-Time,permanent position (40 hours)

Standard working hours: 8am to 5pm EST, M-F.

Location: Remote in Virginia only

Job Profile Summary:

Board Certified Behavior Analyst (BCBA) Utilization Management Professional applies critical thinking and is knowledgeable in clinically appropriate treatment, evidence-based care and clinical practice guidelines for Behavioral Health, specific to Behavior Analysis. Utilizes clinical experience and skills in a collaborative process to assess appropriateness of treatment plans across levels of care, applying evidence-based standards, and practice guidelines to treatment where appropriate.

Job Description:

  • Uses clinical knowledge, communication skills, and independent critical thinking skills towards interpreting criteria, understanding complex issues and policies and procedures to determine the best and most appropriate services.
  • Coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members.
  • Gathers clinical information and applies the appropriate clinical criteria/guideline, policy, procedure and clinical judgment to render coverage.
  • Coordinates with providers and other parties to facilitate optimal care/treatment and treatment and to educate and address clinical necessity concerns and ABA (applied behavior analysis) compliance requirements.
  • Identifies members at risk for poor outcomes and facilitates referral opportunities to integrate with other products, services and/or programs.
  • Identifies opportunities to promote quality effectiveness of healthcare services and benefit utilization.
  • Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function.
  • Ensures appropriate and accurate information is entered into the claims system for processing of payment.

Education:

  • MLD - Master's Level Degree REQUIRED

Certification/Licensure:

  • Board Certified Behavior Analyst (BCBA) REQUIRED
  • Licensed Behavioral Analyst in Virginia (LBA) REQUIRED

Experience:

  • Knowledge of managed care contracting, medical necessity, Mental Health Services (MHS), behavioral health services, DMAS protocols, clinical protocols, and clinical review requirements REQUIRED
  • Knowledge of contractual, regulatory and compliance requirements for government payers, self-funded and commercial payers REQUIRED
  • ABA (applied behavior analysis) with ASD (autism spectrum disorder) experience REQUIRED
  • Health Plan experience preferred
  • 3 years of related experience REQUIRED

Keywords: Talroo- Health Plan, Remote, VA, Virginia, Healthcare, Health Plan, MCO, Managed Care, Behavioral Health, Mental, Psych, BH, Utilization Management, UM, ABA, Applied behavior analysis, ASD, autism spectrum disorder, Mental Health Services, MHS, DMAS, Licensed Behavioral Analyst, LBA, BCBA

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