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Behavioral Health Utilization Review Jobs in Alaska

Searhc

Crisis Behavioral Health Clinician

Sitka, AK

$29.82 - $41.60/hr

... utilization review staff, social work, discharge planners, etc. All services are documented within ... Behavioral health assessment and diagnostic evaluation criteria. * Treatment plan development and ...

CVS Health

Care Plan Reviewer- OhioRISE

Homer, AK · On-site

$60K - $129K/yr

... behavioral healthcare through review of assessment and care planning documentation and consultation with care coordinators to support psychosocial wraparound services to promote effective utilization ...

Searhc

Behavioral Health Clinician

Juneau, AK

$65K - $90K/yr

Develop individualized treatment plans and treatment reviews based upon the individual's needs ... Maximize access to care and effective utilization of care by focusing on improving coping ...

Searhc

Behavioral Health Clinician

Ketchikan, AK

$31.83 - $44.56/hr

Develop individualized treatment plans and treatment reviews based upon the individual's needs ... Maximize access to care and effective utilization of care by focusing on improving coping ...

Chugachmiut

Behavioral Health Aide

Homer, AK · On-site

Provide case management, case review, and referral to protective services for individuals and ... Behavioral Health Department and local human service providers, develop preparedness plans for ...

Searhc

Behavioral Health Clinician - Licensed

Sitka, AK

$41.66 - $58.69/hr

Develop individualized treatment plans and treatment reviews based upon the individual's needs ... Maximize access to care and effective utilization of care by focusing on improving coping ...

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Behavioral Health Utilization Review information

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

As of Aug 14, 2026, the average hourly pay for behavioral health utilization review in Alaska is $45.54, according to ZipRecruiter salary data. Most workers in this role earn between $35.96 and $52.31 per hour, depending on experience, location, and employer.

What is a behavioral health utilization review?

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.

What types of teams do behavioral health utilization review professionals typically work with, and how do they collaborate across departments?

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.

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

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.

What are the most commonly searched types of Behavioral Health Utilization Review jobs in Alaska?

The most popular types of Behavioral Health Utilization Review jobs in Alaska are:

What are popular job titles related to Behavioral Health Utilization Review jobs in Alaska?

For Behavioral Health Utilization Review jobs in Alaska, the most frequently searched job titles are:

What job categories do people searching Behavioral Health Utilization Review jobs in Alaska look for?

The top searched job categories for Behavioral Health Utilization Review jobs in Alaska are:

What cities in Alaska are hiring for Behavioral Health Utilization Review jobs?

Cities in Alaska with the most Behavioral Health Utilization Review job openings:

Behavioral Health Utilization Review jobs near you
Infographic showing various Behavioral Health Utilization Review job openings in Alaska as of August 2026, with employment types broken down into 86% Full Time, and 14% Part Time. Highlights an 93% In-person, and 7% Remote job distribution, with an average salary of $94,713 per year, or $45.5 per hour.

Utilization Review Nurse

Maniilaq Association

Kotzebue, AK • On-site

Other

Posted 11 days ago

Job description

Maniilaq Association is a P.L. 93-638 Native/Indian Preference/EEO Employer
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Utilization Review Nurse Job Code: 2026:OTZ-201 Location: Kotzebue, Alaska Program: Nursing Division FT/PT Status: Full Time Job Responsibilities:
MANIILAQ ASSOCIATION
5/2026
Title: Utilization Management Nurse Pay Grade: 31
Program: Nursing Status: Exempt
Housing Priority: 3 Covered: Yes
POSITION SUMMARY
The Utilization Management Nurse (UMN) is responsible for performing Utilization Review and managing risk, coordinates and facilitates with departmental staff on Durable Medical Equipment (DME), and pharmacy prior authorizations. THE UMN works with the medical treatment and case management team in the coordination of patient care including the development of new operational changes and new services to ensure compliance and risk mitigation. The UMN will use a process that includes screening and case finding, comprehensive multidimensional assessment, connection with available resources, implementation of the plan and ongoing monitoring and re-assessment/follow-up. The UMN assists with the Quality and Case Management programs and, coordinates the IPC4 program. This position reports directly to the Chief Nursing Officer or designee.
PRINCIPAL DUTIES AND RESPONSIBILITIES
  1. Coordinates the IPC4 process in Medicare/Medicaid and private insurances.
  2. Assists in revenue procurement by:making sure insurance approvals are completed correctly with no penalty; helping to identify alternate resources of funding such as VA, Denali Kid Care, Medicare, and Medicaid; and monitoring the appeal process when claims are denied.
  3. Chairs Quarterly Utilization Review Committee meetings to improve utilization of resources and improve patient care.
  4. Submits Quarterly reports to CMO and CNO for Board of Director meetings.
  5. Works closely with Coders and Billers to insure accurate, timely billing information.
  6. Completes Utilization Review processes as assigned.
  7. Oversees development and maintenance of a resource database of Federal, State, community, and institutional resources.
  8. Assists in arranging team conferences and networks for relationship building and resource development with village leaders, Community Health Aides/Practitioners, MHC Medical Staff, MHC Nursing Staff, private insurance contacts, Medicaid/Medicare contacts, ANMC Providers, and the CM/SC/UR Team.
  9. Participates on improvement projects as assigned.
  10. Participates in Medicaid Task Force committee through Alaska Native Health Board.
  11. Completes Quality Improvement, Quality Assurance and Performance Improvement projects and tasks as assigned.
  12. Utilizes team building, problem solving skills and lean principles in the on-going quality improvement initiatives.
  13. Identify, assess, and monitor potential clinical, operational, and compliance risks within the Utilization Review and Case Management programs.
  14. Report and document incidents, near-misses, and adverse events in accordance with organizational policy and regulatory standards.
  15. Participate in root cause analyses and collaborate with leadership to implement corrective action plans to mitigate future risks.
  16. Collaborate with the Risk Management team to review, update, and communicate policies and procedures relevant to utilization review and patient care coordination.
  17. Educate clinical and administrative staff on risk awareness, safety protocols, and compliance requirements.
  18. Coordinate and facilitate prior authorizations for DME by collaborating with patients, clinical staff and providers to ensure clients' needs are met.
  19. Collaborate with providers and pharmacist process prior authorizations for specialized high-cost medications; monitor appeal process if claims are denied.
Job Qualifications:
MINIMUM REQUIREMENTS
Current licensure as a RN with at least two years of Case Management, Utilization Review, Discharge Planning or Quality Improvement experience preferred. Knowledge of acute and chronic illnesses, specialty clinic procedures, and community health nursing. Must be able to pass the core competencies assigned to this position and maintain the educational requirements of the program. Ability to utilize various computer programs, including Cerner and Microsoft Office. Demonstrates a wide theory base in order to interact in an effective manner with physicians, health team members, community agencies, and clients/families with diverse opinions, values, and religious and cultural ideals. Ability to work autonomously with little direction and be directly accountable for practice. Knowledge of and experience working with all regulatory, state, and federal agencies.
Other Job Information (if applicable):
DISCLAIMER
The above statements are intended to describe the general nature and level of work being performed by people assigned to this job. They are not intended to be considered an exhaustive list of all responsibilities, duties and skills required of personnel in this job, and the employer reserves the right to revise or change this description. This description does not constitute a written or implied contract of employment. To perform this job successfully, an individual must be able to satisfactorily perform each of the above essential duties and meet physical demands. Reasonable accommodations may be made to enable individuals with disabilities to meet those conditions.

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