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Behavioral Health Utilization Review Nurse Jobs (NOW HIRING)

MNCP Staffing

Utilization Review Nurse

Las Vegas, NV · On-site

Reviews patient admissions for appropriateness, efficiency of resource utilization and compliance ... Joint Commission Accredited Health care Organizations standards, state statutes governing hospital ...

Medix

Utilization Review Nurse

Orange, CA · On-site

$38 - $53/hr

Job Summary Our client is seeking a Utilization Review Nurse responsible for managing the complete ... Direct experience working within an IPA, MSO, Delegation model, or Health Plan setting. * Proven ...

Bracane Co

Utilization Review Nurse

Plano, TX · Remote

... Health Care Insurance Company. * Knowledge of medical terminology and procedures. * Verbal and ... Utilization management experience LOCATION: REMOTE in Texas ( Richardson area ? Dallas/Collin ...

Albanymed

Utilization Review Nurse

Albany, NY · On-site

$77K - $119K/yr

While performing utilization review identifies areas for clinical documentation improvement and ... Collaborates with the health care team and appropriate department in the management of care across ...

Medix

Utilization Review Nurse

Southfield, MI · On-site

$42 - $46/hr

Job Summary Our client is seeking a Utilization Review Nurse to manage the full lifecycle of ... Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 ...

Medix

Utilization Review Nurse

Fort Worth, TX · On-site

$38.46 - $43.27/hr

Job Summary Our client is seeking a skilled Utilization Review Nurse to join their team. This role ... Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 ...

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

As of Aug 22, 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.

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.

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.

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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:

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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 81% Full Time, 12% Part Time, 2% Temporary, and 5% Contract. Highlights an 79% In-person, 2% Hybrid, and 19% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

Behavioral Health Utilization Management Specialist

Row Partners

Draper, UT • On-site, Remote

$60K - $70K/yr

Full-time

Medical, Dental, Vision, PTO

Re-posted 8 days ago

Job description

Behavioral Health Utilization Management Specialist

Location: Utah (Hybrid & Remote Options Available)

Job Type: Full-time

Department: Behavioral Health / Utilization Management

Who We Are

At Row Partners, we’re more than a healthcare support organization — we’re a passionate team dedicated to empowering behavioral health facilities and their patients. We believe that compassionate, accessible, and high-quality care starts with the right people on our team.

Our Behavioral Health division is growing, and we’re looking for a Behavioral Health Utilization Management Specialist who shares our commitment to improving access, ensuring appropriate care, and supporting patient success stories every day.

If you’re driven by purpose, thrive in a collaborative environment, and want your work to make a real difference, this role is for you.

The Role

As a Behavioral Health Utilization Management Specialist, you will be the bridge between clinical care and insurance coverage — ensuring patients receive the right services, at the right time, for the right reasons. Your expertise will help providers, patients, and payers work together toward the shared goal of better behavioral health outcomes.

What You’ll Do

  • Champion patient care by reviewing medical records and clinical documentation to determine medical necessity and appropriateness of behavioral health services.
  • Collaborate and connect with clinicians, medical staff, and insurance providers to make sure patients get timely access to the services they need.
  • Conduct clinical reviews for inpatient, outpatient, and residential behavioral health services.
  • Ensure quality of care by reviewing treatment plans, discharge plans, and progress toward goals.
  • Support evidence-based treatment by applying clinical criteria and guidelines to approve and recommend necessary care.
  • Stay ahead of industry standards, insurance requirements, and treatment protocols.
  • Advocate for patients by facilitating communication and resolving barriers between providers, patients, and payers.
  • Document with precision for utilization reviews, audits, and compliance needs.

What You Bring

Proven Success

  • A history of professional growth, creative problem-solving, and a commitment to excellence.
  • Integrity, accountability, and a collaborative spirit that uplifts your team and patients alike.

Preferred Experience

  • 2+ years in utilization management, case management, or behavioral health services
  • Familiarity with mental health and substance use disorder diagnoses.
  • Understanding of insurance coding, billing, and behavioral health authorization procedures.

Preferred Skills

  • Strong knowledge of Behavioral Health diagnosis, Treatments, and evidence-based practices.
  • Comfort with utilization management tools (ASAM, MCG, InterQual).
  • Excellent communication and relationship-building skills.
  • Ability to multitask in a fast-paced environment.
  • EHR system proficiency.

(If you don’t have all the experience listed, but have the passion and potential to succeed, we’re willing to train the right candidate.)

Work Location

  • Based in Sandy, Utah — remote work available for those living more than 50 miles from the office.

Why You’ll Love Working With Us

  • Competitive salary & comprehensive benefits (health, dental, vision).
  • Paid time off, sick leave, and paid holidays.
  • Opportunities for growth, training, and continuing education.
  • Supportive, team-first culture where your contributions matter.
  • The chance to impact lives and improve care outcomes every single day.

If you’re ready to use your skills to make a lasting difference in behavioral health care, we’d love to hear from you. Apply today and join a team thats shaping the future of patient care.