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Behavioral Health Utilization Management Jobs in Raleigh, NC

April Health

Behavioral Health Care Manager

Durham, NC · On-site +1

$53K - $58K/yr

April Health partners with primary care, women's health, and pediatric practices to provide a hybrid behavioral health solution that combines human care management with AI-driven support to improve ...

April Health

Behavioral Health Care Manager

Durham, NC · Hybrid

$53K - $58K/yr

April Health partners with primary care, women's health, and pediatric practices to provide a hybrid behavioral health solution that combines human care management with AI-driven support to improve ...

KMRG LLC

Behavioral Health Case Manager

Raleigh, NC · On-site

$95K - $115K/yr

Provide clinical case-management services for Soldiers enrolled in the Psychological Readiness Program * Conduct biopsychosocial assessments and identify behavioral-health needs * Develop ...

Humana

Compliance UM Nurse (Wed - Sun)

Raleigh, NC · On-site

... of home health?utilization?management experience for a health plan?? * Effective telephonic and virtual communication skills?? * Comprehensive knowledge of Microsoft Word,?Outlook?and Excel?

Duke Health

Behavioral Health Therapist

Durham, NC · On-site

$58K - $77K/yr

Duke University Health System- Behavioral Health Therapist • Behavioral Health Therapist may work ... Epic experience preferred). • Ability to resolve/manage conflict. • Ability to help implement ...

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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All JobsBehavioral Health Utilization Management JobsBehavioral Health Utilization Management Jobs in Raleigh, NC

Behavioral Health Utilization Management information

See Raleigh, NC salary details

$20

$41

$67

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

As of Aug 11, 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 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 Raleigh, NC? For Behavioral Health Utilization Management jobs in Raleigh, NC, the most frequently searched job titles are:
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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 August 2026, with employment types broken down into 1% As Needed, 76% Full Time, 18% Part Time, and 5% Contract. Highlights an 95% Physical, 1% Hybrid, and 4% Remote job distribution, with an average salary of $85,491 per year, or $41.1 per hour.

Behavioral Health Care Manager II - ABA - GA/NC

Elevance Health

Raleigh, NC • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 9 days ago

Elevance Health rating

7.7

Company rating: 7.7 out of 10

Based on 351 frontline employees who took The Breakroom Quiz

200th of 304 rated insurance

Job description

Anticipated End Date:

2026-08-08

Position Title:

Behavioral Health Care Manager II - ABA - GA/NC

Job Description:

Work location - Virtual

This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law.

Please note: The successful candidate will be a certified BCBA and a licensed LBA in NC and/or GA. Residency in these states would not be required, just the LBA licensure.

The Behavioral Health Care Manager II - ABA is responsible for managing ABA pre-certification health benefits through telephonic or written review.

Primary duties may include but are not limited to:

  • Uses appropriate screening criteria knowledge and clinical judgment to assess member needs to ensure access to medically necessary quality behavioral healthcare in a cost-effective setting in accordance with UM Clinical Guidelines and contract.

  • Refers cases to Peer Reviewers as appropriate.

  • Reviews ABA assessment, coordination, implementation, case planning, monitoring, and evaluating to promote quality member outcomes to optimize member health benefits and to promote effective use of health benefits and community resources.

  • Will serve as a resource to other BH Care Managers.

  • Assists with more complex cases and may participate in inter and intradepartmental teams projects and initiatives.

Minimum requirements:

  • Requires MA/MS in social work counseling or a related behavioral health field or a degree in nursing, and minimum of 3 years of experience with facility-based and/or outpatient psychiatric and substance abuse or substance abuse disorder treatment; or any combination of education and experience which would provide an equivalent background.

  • Current active unrestricted license such as RN, LCSW, LMSW, LMHC, LPC, LBA (as allowed by applicable state laws), LMFT, or Clinical Psychologist to practice as a health professional within the scope of licensure in applicable states or territory of the United States required.

  • Licensure is a requirement for this position.

  • Prior managed care experience required.

  • However, for states that do not require licensure, a Board Certified Behavioral Analyst (BCBA) is also acceptable if all of the following criteria are met: performs UM approvals only, reviews requests for Applied Behavioral Analysis (ABA) services only, and there is licensed staff supervision.

  • Previous experience in case management/utilization management with a broad range of experience with complex psychiatric/substance abuse cases required.

  • For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.

Job Level:

Non-Management Exempt

Workshift:

1st Shift (United States of America)

Job Family:

MED > Licensed/Certified Behavioral Health Role

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.


Who We Are

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.


How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.


We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.


Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.


The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.


Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process should submit the following form: Accessibility Accommodation Request Form and a member of the team will be in contact. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.


Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.


NOTE: Workday keeps job postings active through 11:59:59 PM on the day before the listed end date. Example: If the end date is 3/13, the posting will automatically come down on 3/12 at 11:59:59 PM. In other words - the job is posted until 3/13, not through 3/13.

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About Elevance Health

Sourced by ZipRecruiter

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. A Fortune 20 company with a longstanding history in the healthcare industry, we are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Indianapolis, IN, US

Year founded

2004

Social media

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