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Behavioral Health Utilization Management Jobs in Raleigh, NC

Duke Health

Behavioral Health Therapist

Durham, NC · On-site

$58K - $77K/yr

... manage mental health and/or substance use problems in patients. - May participate in on-call or ... Outpatient Behavioral Health Therapist Knowledge, Skills, and Abilities: - Adherence to the ...

Duke Health

Behavioral Health Therapist

Durham, NC · On-site

$58K - $77K/yr

... manage mental health and/or substance use problems in patients. - May participate in on-call or ... Outpatient Behavioral Health Therapist Knowledge, Skills, and Abilities: - Adherence to the ...

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Behavioral Health Utilization Management information

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

As of Sep 14, 2026, the average hourly pay for behavioral health utilization management in Raleigh, NC is $41.10, according to ZipRecruiter salary data. Most workers in this role earn between $32.50 and $47.21 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 Raleigh, NC?

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

What job categories do people searching Behavioral Health Utilization Management jobs in Raleigh, NC look for?

The top searched job categories for Behavioral Health Utilization Management jobs in Raleigh, NC are:

What cities near Raleigh, NC are hiring for Behavioral Health Utilization Management jobs?

Cities near Raleigh, NC 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 Raleigh, NC as of September 2026, with employment types broken down into 2% As Needed, 72% Full Time, 18% Part Time, and 8% Contract. Highlights an 87% Physical, 1% Hybrid, and 12% Remote job distribution, with an average salary of $85,491 per year, or $41.1 per hour.

Behavioral Health Admissions Manager

Garner, NC • On-site

Summit BHC
Health Care and Social Assistance • 501 - 1,000 employees
Learn more about Summit BHCexternal

Full-time

This job post has expired 2 days ago. Applications are no longer accepted.

Job description

Behavioral Health Admissions Manager | Raleigh Oaks Behavioral Health | Garner, North Carolina
About the Job:
Schedule: Monday- Friday 1pm-9pm with occasional weekends or mornings depending on business needs.
The Intake Manager is responsible for assisting the Director in managing all the different aspects of the patient assessment, referral, and admission process. Responsibilities include intake screenings for incoming patients, providing clinical direction in psychiatric and chemical dependency assessment services including evaluation, crisis intervention and referrals, staff supervision, communicating with all other facility staff members to have a smooth admission outcome, developing and nurturing professional relationships with payers, physicians and other clinicians in acute care hospitals, community mental health centers and other organizations. Ensures appropriate and accurate billing information is available for all admissions.
Roles and Responsibilities:
ESSENTIAL FUNCTIONS:
  • Manages the intake, admissions, and prior authorization process for incoming patients. Provides clinical evaluations of prospective patients determining patients' appropriateness for the program and coordinates the psychiatric assessment process with the medical staff.
  • Identifies and prioritizes issues of importance, including those priority issues as set by leadership. Collaborates with department leaders and corporate leaders, as needed.
  • Communicates instructions, expectations and timelines clearly and concisely.
  • Manages a team of highly engaged members through hiring, orienting, performance assessment and management, motivating, training, scheduling, and coaching to meet department goals and ensure effective and efficient department operation.
  • Maintains productivity levels that are aligned with patient census, curtailing unnecessary overtime and/or excessive staff work hours.
  • Manages staff scheduling and maintains an updated plan for contingency staffing.
  • Maintains accountability expectations for self and staff in all areas of job performance.
  • Engages staff in quality and safety basics to ensure sustained, measurable compliance.
  • Identifies staff educational needs and ensures they are addressed with education programs that are attended by staff.
  • Holds staff accountable for non-compliance and patient safety concerns, as well as attendance, following policies, behavior, and adherence to code of conduct.
  • Continually assesses processes and workflows involved with pre-admission performance and maintains an intake continuous improvement plan for the department.
  • Monitors call volumes and service requests to ensure proper staffing during peak call times.
  • Establishes results-producing relationships with the referral community including physicians, social workers, state officials, and payers.
  • Educates team members and referral sources about company services as related to industry changes, specific clinical programs and capabilities, clinical outcomes, and appropriate patient referrals/admissions.
  • Ensures that appropriate and accurate billing information is available for all admissions and coordinates with Business Office and Utilization Management. Provides insurance verification training to staff.
  • Serves as liaisons between hospitals and facilities in the event of transfer. When appropriate, refers the patient to an alternate level of care based on their needs and wishes.
  • Ensures that all related admission documentation is complete and entered timely.
  • Serves as a link between Admissions and other departments to ensure the efficient transfer of information essential to operations. Works with Department Heads and Medical Staff to assure admissions services are effectively integrated into hospital operations.
  • Provides the patient, family members, referral sources, significant others with assessment and voluntary/involuntary admission information.
  • Provides additional coverage for the Admissions team and Call Center - e.g. answers phones, processes admission requests, completes clinical screenings and Intake Assessments, verifies insurance, and assists with insurance pre-certifications during times of high volume

EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:
  • Registered Nurse or Master's Degree from an accredited college or university in social work, counseling, psychology, mental health, or a related clinical field required.
  • One or more years' healthcare admissions experience required. Behavioral health field preferred.
  • Working knowledge of psychiatric diagnosis, of the Addiction & Recovery field and experience in clinical interviewing, patient assessment, referral, treatment planning, communicating with external review organizations or comparable entities.

LICENSES/DESIGNATIONS/CERTIFICATIONS:
  • RN License or LCSW licensure required.
  • CPR and de-escalation and restraint certification required (training available upon hire and offered by facility).
  • First aid may be required based on state or facility requirements.

WORK LOCATION:
This position is onsite and is not a remote position.
SUPERVISORY REQUIREMENTS:
One or more years proven supervisory/management experience required, preferably in Admissions.
Why Raleigh Oaks Behavioral Health?Raleigh Oaks Behavioral Health offers a comprehensive benefit plan and a competitive salary commensurate with experience and qualifications. Qualified candidates should apply by submitting a resume. Raleigh Oaks Behavioral Health is an EOE.
Veterans and military spouses are highly encouraged to apply. Summit BHC is dedicated to serving Veterans with specialized programming at our treatment centers across the country. We recognize and value the unique strengths of the military community in supporting our mission to serve those who have served.
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About Summit BHC

Sourced by ZipRecruiter

Summit BHC, based in Franklin, TN, USA, is a recognized leader in the field of addiction treatment and behavioral health care services. The company operates a nationwide network of treatment centers aimed at caring for individuals battling substance abuse and mental health disorders. Summit BHC was established with the mission to provide high-quality, addiction treatment and behavioral health services to those in need throughout the United States. With compassion, dignity, and respect as their core values, they endeavor to instill hope during the journey to recovery and beyond.

Industry

Health care and social assistance

Company size

501 - 1,000 Employees

Headquarters location

Franklin, TN, US

Year founded

2013

Social media

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