Gadsden, AL · On-site
Medical
Dental
Vision
Life
Retirement
PTO
This role works closely with insurance providers, health plans, Utilization Review teams, the Business Office, and Case Managers to help ensure timely follow-up on authorizations, reviews, appeals ...
Posted today
Gadsden, AL · On-site
Medical
Dental
Vision
Life
Retirement
PTO
This role works closely with insurance providers, health plans, Utilization Review teams, the Business Office, and Case Managers to help ensure timely follow-up on authorizations, reviews, appeals ...
Posted today
Medical
Dental
Vision
Life
Retirement
PTO
This role works closely with insurance providers, health plans, Utilization Review teams, the Business Office, and Case Managers to help ensure timely follow-up on authorizations, reviews, appeals ...
Posted today
Medical
Dental
Vision
Life
Retirement
PTO
This role works closely with insurance providers, health plans, Utilization Review teams, the Business Office, and Case Managers to help ensure timely follow-up on authorizations, reviews, appeals ...
Posted today
... members of the healthcare team. Establishes a caring relationship with patients and their ... Must adhere to the DCH Behavioral Standards including creating positive relationships with patients ...
... members of the healthcare team. Establishes a caring relationship with patients and their ... Must adhere to the DCH Behavioral Standards including creating positive relationships with patients ...
... members of the healthcare team. Establishes a caring relationship with patients and their ... Must adhere to the DCH Behavioral Standards including creating positive relationships with patients ...
... members of the healthcare team. Establishes a caring relationship with patients and their ... Must adhere to the DCH Behavioral Standards including creating positive relationships with patients ...
... members of the healthcare team. Establishes a caring relationship with patients and their ... Must adhere to the DCH Behavioral Standards including creating positive relationships with patients ...
... members of the healthcare team. Establishes a caring relationship with patients and their ... Must adhere to the DCH Behavioral Standards including creating positive relationships with patients ...
... members of the healthcare team. Establishes a caring relationship with patients and their ... Must adhere to the DCH Behavioral Standards including creating positive relationships with patients ...
... members of the healthcare team. Establishes a caring relationship with patients and their ... Must adhere to the DCH Behavioral Standards including creating positive relationships with patients ...
... members of the healthcare team. Establishes a caring relationship with patients and their ... Must adhere to the DCH Behavioral Standards including creating positive relationships with patients ...
... members of the healthcare team. Establishes a caring relationship with patients and their ... Must adhere to the DCH Behavioral Standards including creating positive relationships with patients ...
Birmingham, AL · On-site
$115K - $130K/yr
Medical
Dental
Vision
Life
Retirement
PTO
Demonstrated Behavioral Health and/or substance use disorder (SUD) treatment experience required ... Experience managing concurrent review, medical necessity, payer authorizations, appeals, and ...
Birmingham, AL · On-site
$115K - $130K/yr
Medical
Dental
Vision
Life
Retirement
PTO
Demonstrated Behavioral Health and/or substance use disorder (SUD) treatment experience required ... Experience managing concurrent review, medical necessity, payer authorizations, appeals, and ...
Birmingham, AL · On-site
$115K - $130K/yr
Medical
Dental
Vision
Life
Retirement
PTO
Demonstrated Behavioral Health and/or substance use disorder (SUD) treatment experience required ... Experience managing concurrent review, medical necessity, payer authorizations, appeals, and ...
Birmingham, AL · On-site
$115K - $130K/yr
Medical
Dental
Vision
Life
Retirement
PTO
Demonstrated Behavioral Health and/or substance use disorder (SUD) treatment experience required ... Experience managing concurrent review, medical necessity, payer authorizations, appeals, and ...
... members of the healthcare team. Establishes a caring relationship with patients and their ... Must adhere to the DCH Behavioral Standards including creating positive relationships with patients ...
... members of the healthcare team. Establishes a caring relationship with patients and their ... Must adhere to the DCH Behavioral Standards including creating positive relationships with patients ...
... members of the healthcare team. Establishes a caring relationship with patients and their ... Must adhere to the DCH Behavioral Standards including creating positive relationships with patients ...
... members of the healthcare team. Establishes a caring relationship with patients and their ... Must adhere to the DCH Behavioral Standards including creating positive relationships with patients ...
Document reviews and ensure compliance with state, federal, and health-plan requirements ... Utilization Review Pharmacist opening.
New
Document reviews and ensure compliance with state, federal, and health-plan requirements ... Utilization Review Pharmacist opening.
New
Montgomery, AL · On-site
$16.25 - $24.73/hr
Knowledge of behavioral health reimbursement systems and funding sources. Strong analytical ... utilization review, healthcare reimbursement, benefits coordination, case management, medical ...
Quick apply
Montgomery, AL · On-site
$16.25 - $24.73/hr
Knowledge of behavioral health reimbursement systems and funding sources. Strong analytical ... utilization review, healthcare reimbursement, benefits coordination, case management, medical ...
Assess and coordinate discharge planning needs with healthcare team members. * May prepare statistical analysis and utilization review reports as necessary. * Oversee and coordinate compliance to ...
Assess and coordinate discharge planning needs with healthcare team members. * May prepare statistical analysis and utilization review reports as necessary. * Oversee and coordinate compliance to ...
Birmingham, AL · On-site
Medical
PTO
Assess and coordinate discharge planning needs with healthcare team members. * May prepare statistical analysis and utilization review reports as necessary. * Oversee and coordinate compliance to ...
Birmingham, AL · On-site
Medical
PTO
Assess and coordinate discharge planning needs with healthcare team members. * May prepare statistical analysis and utilization review reports as necessary. * Oversee and coordinate compliance to ...
Position Overview Provide health care services regarding admissions, case management, discharge planning and utilization review. Review admissions and service requests within assigned unit for ...
Position Overview Provide health care services regarding admissions, case management, discharge planning and utilization review. Review admissions and service requests within assigned unit for ...
Assess and coordinate discharge planning needs with healthcare team members. * May prepare statistical analysis and utilization review reports as necessary. * Oversee and coordinate compliance to ...
Assess and coordinate discharge planning needs with healthcare team members. * May prepare statistical analysis and utilization review reports as necessary. * Oversee and coordinate compliance to ...
Birmingham, AL · On-site
Medical
PTO
Assess and coordinate discharge planning needs with healthcare team members. * May prepare statistical analysis and utilization review reports as necessary. * Oversee and coordinate compliance to ...
Birmingham, AL · On-site
Medical
PTO
Assess and coordinate discharge planning needs with healthcare team members. * May prepare statistical analysis and utilization review reports as necessary. * Oversee and coordinate compliance to ...
Birmingham, AL · On-site
$18 - $24.25/hr
Workplace Options is proud to support our sister organization, Behavioral Health Systems (BHS), in ... Participate in utilization review and quality assurance activities, as directed. Coordinate U.R ...
Birmingham, AL · On-site
$18 - $24.25/hr
Workplace Options is proud to support our sister organization, Behavioral Health Systems (BHS), in ... Participate in utilization review and quality assurance activities, as directed. Coordinate U.R ...
Birmingham, AL · On-site
$18 - $24.25/hr
Workplace Options is proud to support our sister organization, Behavioral Health Systems (BHS), in ... Participate in utilization review and quality assurance activities, as directed. Coordinate U.R ...
Quick apply
Birmingham, AL · On-site
$18 - $24.25/hr
Workplace Options is proud to support our sister organization, Behavioral Health Systems (BHS), in ... Participate in utilization review and quality assurance activities, as directed. Coordinate U.R ...
$19.39 - $23.31
2% of jobs
$23.31 - $27.24
9% of jobs
$29.92 is the 25th percentile. Wages below this are outliers.
$27.24 - $31.16
21% of jobs
The median wage is $34.33 / hr.
$31.16 - $35.08
23% of jobs
$35.08 - $39
13% of jobs
$42.05 is the 75th percentile. Wages above this are outliers.
$39 - $42.92
10% of jobs
$42.92 - $46.84
8% of jobs
$46.84 - $50.77
5% of jobs
$50.77 - $54.69
5% of jobs
$54.69 - $58.61
2% of jobs
$58.61 - $62.53
2% of jobs
$19
$38
$62
A Behavioral Health Utilization Review (UR) job involves assessing the medical necessity, appropriateness, and efficiency of mental health and substance use disorder treatments. UR professionals review clinical documentation, apply insurance guidelines, and collaborate with providers to ensure patients receive appropriate care while ensuring compliance with policies and regulations. They help manage healthcare costs by preventing unnecessary services while advocating for necessary treatments. This role is common in insurance companies, hospitals, and managed care organizations. Strong knowledge of behavioral health guidelines and communication skills are essential for success.
Behavioral Health Utilization Review professionals frequently work within multidisciplinary teams that may include clinicians, case managers, claims specialists, and provider relations staff. Collaboration involves regularly reviewing patient records, discussing complex cases, and communicating with both internal and external healthcare providers to ensure appropriate levels of care are authorized. This role often requires coordination across departments to resolve authorization issues, clarify clinical information, and meet regulatory requirements. Effective teamwork is key to maintaining efficient workflows, supporting patient outcomes, and ensuring compliance with payer policies.
To thrive in Behavioral Health Utilization Review, you typically need a clinical background in mental health or nursing, strong analytical abilities, and knowledge of insurance guidelines. Familiarity with medical coding, utilization management software (such as InterQual or MCG), and current behavioral health regulations is highly valued, and licensure (RN, LCSW, LPC, or similar) is often required. Attention to detail, critical thinking, effective communication, and strong organizational skills set top candidates apart. These competencies ensure accurate evaluation of medical necessity, efficient authorization processes, and collaboration with providers for optimal patient care.
Other
Medical, Dental, Vision, Life, Retirement, PTO
Posted 22 hours ago
Posted today
6.4
Based on 283 frontline employees who took The Breakroom Quiz
641st of 887 rated healthcare providers
We are seeking a Utilization Review Technician II, sometimes referred to as Utilization Management Technician II or Utilization Review Coordinator II. The Utilization Review Technician II supports the utilization review, appeals, and denial management process by coordinating communication and tracking payer-related activity. This role works closely with insurance providers, health plans, Utilization Review teams, the Business Office, and Case Managers to help ensure timely follow-up on authorizations, reviews, appeals, and denials. The position also assists with payer audits, Release of Information, discharge coordination, and other departmental needs.
ResponsibilitiesHere are some of the benefits of working at Prime Healthcare:
Full Time
ShiftDays
Equal Employment OpportunityCompany is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf
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Hospitals
10,000+ Employees
Ontario, CA, US
