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Behavioral Health Utilization Management Jobs in Riverside, CA

Astiva Health

UM Nurse Reviewer

Orange, CA · On-site

Join us in our mission to transform healthcare delivery and make a meaningful difference in the lives of our members. SUMMARY: The Utilization Management Authorization Review Nurse is responsible for ...

Newport Healthcare

Behavioral Health Specialist

Orange, CA · On-site

$18 - $22/hr

The Behavioral Health Specialist (BHS) plays a vital, hands-on role in shaping the daily experience ... If you need further support, you are also welcome to reach out to our careers and management team ...

Claremont Hacienda

Behavioral Health Clinician

Claremont, CA · On-site

$61K - $84K/yr

Behavioral Health Clinican (LCSW, LMFT, ACSW, AMFT, LPCC, APCC) $75,000-$110,000 DOE Claremont, CA ... Provide weekly individual and group therapy focused on symptom management, legal education, coping ...

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Behavioral Health Utilization Management information

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$22

$44

$71

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

As of Jul 4, 2026, the average hourly pay for behavioral health utilization management in Riverside, CA is $44.11, according to ZipRecruiter salary data. Most workers in this role earn between $34.86 and $50.67 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 Riverside, CA? For Behavioral Health Utilization Management jobs in Riverside, CA, the most frequently searched job titles are:
What job categories do people searching Behavioral Health Utilization Management jobs in Riverside, CA look for? The top searched job categories for Behavioral Health Utilization Management jobs in Riverside, CA are:
What cities near Riverside, CA are hiring for Behavioral Health Utilization Management jobs? Cities near Riverside, CA with the most Behavioral Health Utilization Management job openings:
Behavioral Health Utilization Management jobs near you
Director of Health Information Management

Director of Health Information Management

Acadia Healthcare

Riverside, CA • On-site

$85K - $120K/yr

Full-time

Posted 15 days ago

Acadia Healthcare rating

6.1

Company rating: 6.1 out of 10

Based on 188 frontline employees who took The Breakroom Quiz

715th of 877 rated healthcare providers

Job description

Overview
Salary Range: $85,000 - 120,000
PURPOSE STATEMENT:
Responsible for the overall leadership and management of the Health Information Management Department (HIM) in the capacity of planning, organizing and managing electronic and paper clinical content, electronic data integrity, accessibility, use, and protection of health information.
Responsibilities
ESSENTIAL FUNCTIONS:
  • Maintain department productivity, quality and efficiency for all processes within the department.
  • Responsible for information governance to ensure facility-wide health data integrity, privacy, and security.
  • Implement processes and systems to support accurate and complete medical record documentation.
  • Oversee and assist with data collection, storage, retrieval, assembly, analysis, filing and retention of medical records/data.
  • Prepare and analyze clinical data for research purposes, process improvement, utilization management, mandatory reporting, and more.
  • Provide staff management to including hiring, development, training, performance management and communication to ensure effective and efficient department operation.
  • Work with physicians to improve the quality of documentation.
  • Work with coding staff to ensure accurate coding for reimbursement and clinical care.
  • Oversee data collection, storage, retrieval, filing and retention of medical records/data.
  • Audit records and data for accuracy, compliance and timeliness. Review results with administration, medical, nursing and clinical staff.
  • Ensure documentation is filed in the medical records in an accurate and timely manner and ensure that the medical record is complete (including signatures) and closed within facility guidelines.
  • Interface with inside/outside legal counsel regarding content of medical records.
  • Work as liaison between facility and transcription vendor to ensure high quality, accurate, complete and timeliness of transcribed documents.
  • Ensure HIM Key Indicators are tracked and reported monthly to the Performance Improvement Committee.
  • Ensure State Reporting is accurate, complete and reported timely.
  • May oversee and/or complete coding according to current ICD and/or CPT coding classifications.
  • May serve as the facility Privacy Officer.

OTHER FUNCTIONS:
  • Perform other functions and tasks as assigned.

Qualifications
EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:
  • High school diploma or equivalent required. Bachelor's degree with specialization in health information administration preferred.
  • Four or more years' experience managing/supervising a medical record department required.
  • Two or more years' of behavioral health experience preferred.
  • Working knowledge in ICD-10-PCS and DSM IV coding systems required.

LICENSES/DESIGNATIONS/CERTIFICATIONS:
  • Registered Health Information Technician (RHIT) required.
  • Registered Health Information Administrator (RHIA) preferred.

AHCORP
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We are committed to providing equal employment opportunities to all applicants for employment regardless of an individual's characteristics protected by applicable state, federal and local laws.

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About Acadia Healthcare

Sourced by ZipRecruiter

Acadia Healthcare is a leading provider in the healthcare and hospital industry, based in Franklin, Tennessee, United States. The company is recognised for its commitment to creating a behavioural health network that provides accessible, high-quality treatment options for individuals suffering from mental health issues, addiction, eating disorders, and PTSD. Acadia Healthcare was founded in 2005, with the mission to create a world-class organization that sets the standard of excellence in the treatment of specialty behavioural health and addiction disorders.

Industry

Hospitals

Company size

10,000+ Employees

Headquarters location

Franklin, TN, US

Year founded

2005

Social media

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