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

As of Jul 2, 2026, the average hourly pay for behavioral health utilization management in the United States is $42.28, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 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.
More about Behavioral Health Utilization Management jobs
What cities are hiring for Behavioral Health Utilization Management jobs? Cities with the most Behavioral Health Utilization Management job openings:
What states have the most Behavioral Health Utilization Management jobs? States with the most job openings for Behavioral Health Utilization Management jobs include:
What job categories do people searching Behavioral Health Utilization Management jobs look for? The top searched job categories for Behavioral Health Utilization Management jobs are:
Behavioral Health Utilization Management jobs near you
Infographic showing various Behavioral Health Utilization Management job openings in the United States as of June 2026, with employment types broken down into 14% Full Time, 79% Part Time, and 7% Contract. Highlights an 96% Physical, 1% Hybrid, and 3% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.
Medical Director, Behavioral Health (FL)

Medical Director, Behavioral Health (FL)

Molina Healthcare

Long Beach, CA • On-site

Full-time

Posted 24 days ago

Molina Healthcare rating

8.0

Company rating: 8.0 out of 10

Based on 192 frontline employees who took The Breakroom Quiz

143rd of 277 rated insurance

Job description

JOB DESCRIPTION Job SummaryProvides medical oversight and expertise related to behavioral health and chemical dependency services, and assists with implementation of integrated behavioral health care programs within specific markets/regions. Contributes to overarching strategy to provide quality and cost-effective member care. 
Essential Job Duties 
Provides behavioral health oversight and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs and chemical dependency services - working closely with regional medical directors to standardize behavioral health utilization management policies and procedures to improve quality outcomes and decrease costs. 
Facilitates behavioral health-related regional medical necessity reviews and cross coverage. 
Standardizes behavioral health-related utilization management, quality, and financial goals across all lines of businesses. 
Responds to behavioral health-related requests for proposal (RFP) sections and reviews behavioral health portions of state contracts. 
Assists behavioral health medical director lead trainers in the development of enterprise-wide education on psychiatric diagnoses and treatment. 
Provides second level behavioral health clinical reviews, peer reviews and appeals. 
Supports behavioral health committees for quality compliance. 
Implements behavioral health specific clinical practice guidelines and medical necessity review criteria. 
Tracks all clinical programs for behavioral health quality compliance with National Committee for Quality Assurance (NCQA) and Centers for Medicare and Medicaid Services (CMS). 
Assists with the recruitment and orientation of new psychiatric medical directors. 
Ensures all behavioral health programs and policies are in line with industry standards and best practices. 
Assists with new program implementation and supports for health plan in-source behavioral health services. 
Required Qualifications 
At least 3 of relevant experience, including 2 years of medical practice experience in psychiatry/behavioral health, or equivalent combination of relevant education and experience. 
Doctor of Medicine (MD) or Doctor of Osteopathy (DO). License must be active and unrestricted in state of practice. 
Board Certification in Psychiatry. 
Working knowledge of applicable national, state, and local laws and regulatory requirements affecting medical and clinical staff. 
Ability to work cross-collaboratively within a highly matrixed organization. 
Strong organizational and time-management skills. 
Ability to multi-task and meet deadlines. 
Attention to detail. 
Critical-thinking and active listening skills. 
Decision-making and problem-solving skills. 
Strong verbal and written communication skills. 
Microsoft Office suite/applicable software program(s) proficiency, and ability to learn new programs. 
Preferred Qualifications 
Experience with utilization/quality program management. 
Managed care experience. 
Peer review experience. 
Certified Professional in Healthcare Management (CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of America (CMSA) or other health care or management certification. 
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. 
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

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About Molina Healthcare

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Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Long Beach, CA, US

Year founded

1980

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