ZipRecruiter

Log In

1

Behavioral Health Utilization Management Jobs in Hanover, MD

MedStar Health

Director Case Management

Columbia, MD · On-site

The Director of Case Management (DCM) oversees case management activities that may include behavioral health utilization management and care management functions and serves as a liaison to government ...

ICONMA

Spec, Utilization Management

Baltimore, MD · On-site

Spec, Utilization Management Our client, a Health Insurance company, is looking for a Spec ... behavioral health. The role requires determining medical necessity and appropriateness by ...

next page

Showing results 1-20

All JobsBehavioral Health Utilization Management JobsBehavioral Health Utilization Management Jobs in Hanover, MD

Behavioral Health Utilization Management information

See Hanover, MD salary details

$21

$42

$68

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

As of Aug 30, 2026, the average hourly pay for behavioral health utilization management in Hanover, MD is $42.07, according to ZipRecruiter salary data. Most workers in this role earn between $33.27 and $48.32 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 job categories do people searching Behavioral Health Utilization Management jobs in Hanover, MD look for?

The top searched job categories for Behavioral Health Utilization Management jobs in Hanover, MD are:

What cities near Hanover, MD are hiring for Behavioral Health Utilization Management jobs?

Cities near Hanover, MD 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 Hanover, MD as of August 2026, with employment types broken down into 2% As Needed, 76% Full Time, 16% Part Time, and 6% Contract. Highlights an 95% Physical, 1% Hybrid, and 4% Remote job distribution, with an average salary of $87,506 per year, or $42.1 per hour.

Behavioral Health Utilization Management Reviewer

Amerihealth Caritas

Washington, DC • On-site, Remote

Full-time

Medical, Retirement, PTO

Posted 19 days ago

AmeriHealth Caritas rating

8.3

Company rating: 8.3 out of 10

Based on 73 frontline employees who took The Breakroom Quiz

133rd of 315 rated insurance

Job description

Role Overview

Under the direction of the Supervisor, the Behavioral Health Utilization Management (BHUM) Reviewer is responsible for completing medical necessity reviews. Using clinical knowledge and experience, the clinician reviews provider requests for inpatient and outpatient services, working closely with members and providers to collect all information necessary to perform a thorough medical necessity review. It is within the BH UM Reviewer’s discretion to retain requests for additional information and/or request clarification. The BH UM Reviewer will use professional judgment to evaluate the request to ensure that appropriate services are approved and recognize care coordination opportunities and refer those cases to integrated care management as needed. The BH UM Reviewer will apply medical health benefit policy and medical management guidelines to authorize services and appropriately identify and refer requests to the Medical Director when indicated. The BH UM Reviewers are responsible to ensure that treatment delivered is appropriately utilized and meets the member’s needs in the least restrictive, least intrusive manner possible. The BH UM Reviewer will maintain current knowledge and understanding of the laws, regulations, and policies that pertain to the organizational unit’s business and uses clinical judgment in their application.

Work Arrangement

  • This role will work 4 days a week in the DC office located at 1201 Maine SW; the 5th day of the week is a remote work day.
  • Monday through Friday from 8:00 AM EST to 5:00 PM EST
  • Must work 4 out of 10 recognized company holidays to include Thanksgiving and Christmas (rotating)
  • Must be willing to work 2 to 3 weekends per year. Weekend rotation based on business needs

Education & Experience

  • Registered Nurse candidates: Associate Degree in Nursing required; Bachelor Degree in Nursing preferred
  • Licensed Social Worker candidates: Master Degree in Social Work required
  • Minimum of 2 years of independent clinical practice experience assessing and treating individuals with behavioral health/substance use/co-occurring disorders in an inpatient or outpatient acute care setting

  • Utilization management experience in a managed care organization preferred

Licensure

  • Requirements for LSW: Active and unencumbered professional licensure/independent licensure in DC: LPC, LICSW, LCMHC, LMFT
    • Must have ability to obtain additional licensure in LA, NC, NH and OH within 12 months from date of hire
  • Requirements for RN: Active and unencumbered RN license in DC
    • Must have ability to obtain additional licensure in LA, NC, NH and DC within 12 months from date of hire

Skills & Abilities

  • Proficiency in Microsoft Office, including Word, Excel, Teams, and Outlook
  • Consistent and accurate typing skills
  • Ability to communicate in a positive/professional manner both orally and written
  • Strong problem-solving skills and decision making skills
  • Strong organizational and time management skills
  • Ability to follow detailed instructions with a high degree of accuracy
  • Ability to work independently; complete tasks in the allotted time frame

Our Comprehensive Benefits Package

Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.

The targeted hiring range for this role is expected to be between $77,700 and 105,900.The range displayed in this job posting reflects the minimum and maximum for new hire salaries for the position in the D.C. office. Within the range, individual pay is determined by additional factors, including, without limitation, job-related skills, experience, and relevant education, certifications, or training.

For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required. Those fully remote associates residing in states where service is required by contract, law, or regulation will be allowed to submit for reimbursement.

Your career starts now. We’re looking for the next generation of health care leaders.

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

Discover more about us at www.amerihealthcaritas.com.

What AmeriHealth Caritas employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply