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Behavioral Health Utilization Management Jobs in Virginia

UHS

Director of Utilization Management

Danville, VA · On-site

$79K - $95K/yr

Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory ... Three to five years of experience in utilization review and case management. RN, LCSW, LPC, LMFT, ...

Colonial Behavioral Health

$18.27 - $19/hr

Colonial Behavioral Health is growing. We are hiring for our new Center for Support and Wellness ... Duties will include mileiu management for the Crisis Stabilization Service units, supporting ...

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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 Jul 27, 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 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 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 July 2026, with employment types broken down into 60% Full Time, and 40% Part Time. Highlights an 100% In-person job distribution, with an average salary of $87,192 per year, or $41.9 per hour.

Behavioral Healthcare Utilization Review Spec

Horizon Behavioral Heal

Lynchburg, VA • On-site

$46K - $74K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 4 days ago

Job description

Hours: full-time (37.5 hours per week)

Location: Lynchburg VA, 24501

Compensation dependent on experience


Position Summary

The Behavioral Healthcare Utilization Review Specialist works on-site, and will proactively monitor utilization of services for clients, reviewing for quality of services and medical necessity. The employee will review clients’ medical records to ensure appropriate utilization of treatment resources, medical necessity, proper documentation, and compliance with federal and state regulations, and certification requirements of insurance plans or other managed care organizations (MCOs). This position will report to the CQI Manager.

Education Requirements

  • Bachelor's degree from an accredited college/university in an applicable human services field. Preferred: Master’s degree in social work, Mental Health Counseling, or related health field preferred.

Types of Experience

  • (2) Two years of continuous quality improvement and/or utilization review experience. Preference will be given to individual with at least one year of managed care experience. Behavioral Health experience is desirable.
  • An equivalent combination of education and experience that provides the candidate with the required knowledge, skills and abilities may be considered.

Related Knowledge, Skills and Abilities

  • Knowledge of behavioral healthcare terminology, the course and progress of substance abuse treatment and medical terminology;
  • Knowledge of Medicaid and MCO regulations and policies, relevant to behavioral healthcare and substance use;
  • Knowledge of Utilization Review protocols and auditing skills;
  • Knowledge of DSM 5, CPT Codes and ICD 10;
  • Knowledge of levels of care and medical necessity;
  • Ability to review and understand medical records, treatment plans and progress notes;
  • Proficiency in MS Office software and EMR systems;
  • Ability to extract and analyze data;
  • Ability to develop and present statistical and narrative reports;
  • Must be proficient in MS Office software and EMR systems.
  • Able to collaborate with all members of clinical team/medical providers;
  • Excellent verbal and written communication skills;
  • Ability to work independently as well as with a team;
  • Excellent organizational and time management skills;
  • Willing and available to work modified schedules (weekends, holiday, etc.) as required;
  • Ability to drive and must possess a valid driver's license. May be required to travel to different Horizon worksites during the day based on operational needs or provide admin support at other locations. Regular attendance at trainings and Horizon meetings may require travel to a variety of Horizon sites.

THE BEST BENEFITS FOR THOSE WHO TAKE CARE OF THE COMMUNITY

We’re proud to offer some of the best benefits options in Central Virginia. Participation in the Virginia Retirement System (VRS) is exclusively for public service workers in Virginia, while several options exist for life, health, dental, and vision insurance. Emphasis on work-life balance means a generous annual leave policy ensuring time for wellness with separate time allocated for sick leave and additionally for paid holidays. Stay active with Horizon’s annual wellness programs and various opportunities to interact with the community through the year. Horizon’s clinical sites are NHSC/HRSA approved for clinical student loan repayment and qualify for both the Public Service Loan Forgiveness (PSLF) and the Behavioral Health State Loan Repayment (BHLRP) programs. If you are interested in continuing your education, working at Horizon qualifies you to receive discounts at some local universities.

To Apply – Please visit our online career center at https://www.horizonbh.org/careers/

Horizon Behavioral Health is an Equal Opportunity Employer (EOE).