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Behavioral Health Utilization Review Nurse Jobs (NOW HIRING)

Fusion HCR

Utilization Review Nurse

Las Vegas, NV · On-site

Direct Hire - Utilization Review Nurse, this is an onsite position, working with our client in ... Collaborative healthcare environment Apply Now If you have strong Utilization Review, InterQual ...

CommonSpirit Health

Utilization Review Nurse

Job Summary and Responsibilities As our Utilization Review Nurse, you will ensure the medical ... You will collaborate with the healthcare team, patients, families, and both internal/external ...

Umpqua Health

Utilization Review Nurse

$85K - $105K/yr

Utilization Review Nurse Remote Ability to travel on-site to 3031 NE Stephens St., Roseburg OR ... We provide integrated, whole-person care through primary care, specialty care, behavioral health ...

Oscar Health

Utilization Review Nurse

Atlanta, GA · Remote

$35 - $45.94/hr

We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... We're on a mission to change health care -- an experience made whole by our unique backgrounds and ...

UNC Health

Utilization Review Nurse

Kinston, NC · On-site

Utilization Review Nurse Become part of an inclusive organization with over 40,000 teammates, whose mission is to improve the health and well-being of the unique communities we serve. Summary: This ...

Global Force

Utilization Review Nurse

Las Vegas, NV · On-site

About the job Utilization Review Nurse Sign on bonus may apply up to $15,000 Position Summary ... Joint Commission Accredited Health care Organizations standards, state statutes governing hospital ...

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How much do behavioral health utilization review nurse jobs pay per hour?

As of Aug 6, 2026, the average hourly pay for behavioral health utilization review nurse 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 a behavioral health utilization review nurse?

A Behavioral Health Utilization Review Nurse is a registered nurse who evaluates the medical necessity, appropriateness, and efficiency of mental health and substance use treatment services. They review clinical information, coordinate with healthcare providers, and ensure that care meets established guidelines and insurance requirements. Their role helps ensure patients receive appropriate care while preventing unnecessary or excessive services, supporting both patient well-being and cost-effective care.

What is the difference between Behavioral Health Utilization Review Nurse vs Behavioral Health Case Manager?

AspectBehavioral Health Utilization Review NurseBehavioral Health Case Manager
Primary RoleReviews and approves behavioral health services for insurance coverageCoordinates and manages ongoing behavioral health treatment plans
Work EnvironmentInsurance companies, healthcare facilities, utilization review departmentsHospitals, outpatient clinics, community health organizations
CredentialsRN license, certification in utilization review preferredRN or social work degree, certification in case management often preferred

While both roles involve behavioral health, the Utilization Review Nurse focuses on evaluating and authorizing services for insurance purposes, whereas the Case Manager actively manages patient treatment plans and coordinates care. Understanding these differences helps in choosing the right career path or job search focus.

How does a behavioral health utilization review nurse typically collaborate with other healthcare professionals?

Behavioral Health Utilization Review Nurses frequently work with multidisciplinary teams that include physicians, therapists, social workers, and case managers. They are responsible for reviewing patient cases to ensure that treatment plans are appropriate and align with insurance guidelines, often requiring clear and timely communication with both providers and payers. Strong collaboration is essential, as these nurses provide clinical insights during case reviews and help coordinate care transitions or discharge planning. This teamwork ensures patients receive optimal care while also meeting utilization and regulatory standards.

What are the key skills and qualifications needed to thrive as a behavioral health utilization review nurse, and why are they important?

To thrive as a Behavioral Health Utilization Review Nurse, you need a strong background in psychiatric nursing, knowledge of mental health diagnoses, and an active RN license. Familiarity with utilization management software, electronic health records, and guidelines such as MCG or InterQual is typically required. Excellent critical thinking, attention to detail, and communication skills help in evaluating care plans and collaborating with providers. These competencies ensure appropriate care utilization, regulatory compliance, and optimal patient outcomes in behavioral health settings.
More about Behavioral Health Utilization Review Nurse jobs
What cities are hiring for Behavioral Health Utilization Review Nurse jobs? Cities with the most Behavioral Health Utilization Review Nurse job openings:
What states have the most Behavioral Health Utilization Review Nurse jobs? States with the most job openings for Behavioral Health Utilization Review Nurse jobs include:
What job categories do people searching Behavioral Health Utilization Review Nurse jobs look for? The top searched job categories for Behavioral Health Utilization Review Nurse jobs are:
Behavioral Health Utilization Review Nurse jobs near you
Infographic showing various Behavioral Health Utilization Review Nurse job openings in the United States as of August 2026, with employment types broken down into 89% Full Time, and 11% Part Time. Highlights an 89% In-person, and 11% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

Supervisor Behavioral Health Utilization Review

Saint Luke's Health System

Kansas City, MO • On-site

Full-time

Re-posted 18 days ago

Saint Luke's Health System (Kansas City) rating

7.1

Company rating: 7.1 out of 10

Based on 109 frontline employees who took The Breakroom Quiz

377th of 887 rated healthcare providers

Job description

Job Description
Saint Luke's Crittenton Children's Center in South Kansas City, MO is seeking a Supervisor of Behavioral Health Utilization Review to join our team.
This role facilitates and directs the Utilization Review Department, Case Management and Reception teams of a 24/7 inpatient residential and hospital program. Additionally, ensures compliance with all pertinent regulations, analyzes trends related to denials & authorizations, builds strong relationships with third party payers. Positive relationships with physicians, nursing supervisors and senior administration are required to ensure empathic and timely response to individual patient and community needs.
Job Details:
  • Monday - Friday, dayshift, 9am -5pm. Remote work not preferred, but occasional opportunity, must be primarily onsite. No weekend or holiday rotations.
  • Supervises and completes daily operations as assigned by Manager of Intake and Utilizations Review.
  • Oversees resources and functions related to utilization review and regulatory compliance adherence.
  • Responsible for training of staff, discipline and evaluations.
  • Monitors and maintains data to achieve quality outcomes and progression with the departmental strategic plan.
  • Collaborates and communicates with the multidisciplinary team to ensure communication of patient's treatment to the managed care provider.
  • Review clinical charts in order to file appeals on denied accounts.
  • Oversees scheduling and supervision needs for the Reception team.
  • Must have a master's degree and current clinical licensure for State of Missouri (LPC or LCSW)
  • 1-3 years in a leadership or team lead role preferred

Job Requirements
Applicable Experience:
2 years
Licensed Professional Counselor - Various
Master's Degree
Job Details
Full Time
Day (United States of America)
The best place to get care. The best place to give care. Saint Luke's 12,000 employees strive toward that vision every day. Our employees are proud to work for the only faith-based, nonprofit, locally owned health system in Kansas City. Joining Saint Luke's means joining a team of exceptional professionals who strive for excellence in patient care. Do the best work of your career within a highly diverse and inclusive workspace where all voices matter.
Join the Kansas City region's premiere provider of health services. Equal Opportunity Employer.

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