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Behavioral Health Utilization Management Jobs in Riverside, CA

Astiva Health, Inc

UM Nurse Reviewer

Orange, CA · On-site

Utilization Management Authorization Review Nurse Astiva Health, Inc., located in Orange, CA is a premier healthcare provider specializing in Medicare and HMO services. With a focus on delivering ...

KPC Global MSO

Utilization Review Tech

Santa Ana, CA · On-site

SUMMARY Under direction of the Utilization Review Technician Supervisor, the Utilization Review ... in a health plan medical management documentation system a plus * Extremely proficient with ...

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 ...

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All JobsBehavioral Health Utilization Management JobsBehavioral Health Utilization Management Jobs in Riverside, CA

Behavioral Health Utilization Management information

See Riverside, CA salary details

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

As of Aug 16, 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 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 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
Infographic showing various Behavioral Health Utilization Management job openings in Riverside, CA as of August 2026, with employment types broken down into 1% As Needed, 77% Full Time, 16% Part Time, and 6% Contract. Highlights an 95% Physical, 1% Hybrid, and 4% Remote job distribution, with an average salary of $91,752 per year, or $44.1 per hour.

Behavioral Health Clinician

St Johns Community Health

San Bernardino, CA • On-site

$73K - $135K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 14 days ago

Job description

The Behavioral Health Clinician is a primarily field-based position that provides integrated behavioral health services through intensive street outreach to individuals experiencing mental health conditions, substance use disorders, homelessness, justice involvement, and other complex psychosocial needs. The clinician actively engages hard-to-reach and underserved populations in the community, builds trusting relationships, conducts behavioral health assessments, provides crisis intervention, individual and group counseling, and develops person-centered treatment plans that promote recovery, improve health outcomes, and reduce barriers to stability.

Working as part of a multidisciplinary team, the Behavioral Health Clinician collaborates with medical providers, case managers, peer staff, and community partners to connect participants with behavioral health, substance use treatment, housing, and other supportive services. The clinician maintains timely and accurate clinical documentation, participates in interdisciplinary care planning, and delivers trauma-informed, evidence-based services that support participant engagement, continuity of care, and long-term stability.

Benefits:

  • Free Medical, Dental & Vision
  • 13 Paid Holidays + PTO
  • 403 (B) retirement match
  • Life insurance, EAP
  • Tuition Reimbursement
  • SEIU Union
  • Flexible Spending Account
  • Continued workforce development & training
  • Succession plans, growth within

Required Skills/Qualifications:

Education & Experience

  • Master's Degree in Social Work, Marriage and Family Therapy, or Professional Clinical Counseling
  • Minimum of three (3) years of experience in a community mental health or integrated care setting
  • Experience working with multi-ethnic and underserved communities
  • Experience in a Managed Care or FQHC setting (preferred)
  • Bilingual in Spanish and English (preferred)

Licensure

Candidates must hold one of the following active California credentials:

  • LCSW – Licensed Clinical Social Worker
  • ACSW – Associate Clinical Social Worker
  • LMFT – Licensed Marriage and Family Therapist
  • AMFT – Associate Marriage and Family Therapist

All associate-level clinicians must be registered with the California Board of Behavioral Sciences (BBS) and actively working toward full licensure under approved supervision.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

Performs a combination, but not necessarily all, of the following duties:

Clinical patient care

  • Deliver brief, solution-focused individual and group therapy within an integrated behavioral health model, typically ranging from 6 to 12 sessions.
  • Conduct behavioral health assessments, screenings, and mental health evaluations in collaboration with primary care providers.
  • Triage urgent and routine referrals from medical providers and program staff.
  • Develop client-centered treatment plans that align with the brief intervention model.
  • Consult with medical providers on psychosocial factors influencing patient health and medical visits.
  • Coordinate linkage to case management, specialty mental health, emergency services, insurance resources, and community referrals as appropriate.
  • Collaborate with primary care, psychiatry, prescribing physicians, and program staff to ensure continuity of care.
  • Engage in regular case conferencing with interdisciplinary team members.
  • Conduct intensive, field-based street outreach to engage hard-to-reach and underserved populations, build rapport with individuals experiencing behavioral health, substance use, homelessness, or justice-related challenges, and encourage participation in treatment and supportive services through trauma-informed, person-centered engagement.
  • Respond to community referrals and field-based behavioral health crises by collaborating with community organizations, outreach teams, first responders, and other partners to assess needs, provide crisis intervention, de-escalation, and facilitate timely linkage to appropriate behavioral health, medical, and social services.

Communication and support

  • Provide timely feedback to medical providers and program staff on referred patients.
  • Prepare case presentations for the multidisciplinary team as needed.
  • Participate in IBH clinical, staff, and organizational meetings as assigned.
  • Engage in scheduled clinical and administrative supervision sessions.
  • Provides case conferencing support to case managers and multidisciplinary teams to ensure alignment with patient care plans, treatment goals, and service coordination efforts.

Administrative

  • Maintain active licensure or registration in good standing with the California BBS.
  • Complete all Electronic Health Record (EHR) documentation accurately and in a timely manner, including visit notes, billing, and prior authorizations.
  • Meet or exceed productivity and documentation standards.
  • Adhere to scheduling requirements across assigned clinic locations.
  • Support program evaluation, data collection, and reporting activities as needed.
  • Completes all reporting requirements in a timely manner, in accordance with established schedules and as needed.

St. John’s Community Health is an Equal Employment Opportunity employer.