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Behavioral Health Utilization Review Jobs in Colorado

All Points North

Integrated Care Advisor

Edwards, CO · On-site

$60K - $75K/yr

Knowledge of behavioral health levels of care (RTC, PHP, IOP, OP) * Understanding of utilization review, medical necessity, and insurance processes * Ability to facilitate financial conversations ...

All Points North

Integrated Care Advisor

Edwards, CO · On-site

$60K - $75K/yr

Knowledge of behavioral health levels of care (RTC, PHP, IOP, OP) * Understanding of utilization review, medical necessity, and insurance processes * Ability to facilitate financial conversations ...

Sierra Vista

Intake Assessor - Night

Johnstown, CO

$34 - $43/hr

The Licensed Intake Assessor is responsible for conducting behavioral health assessments ... Verify insurance information and collaborate with utilization review when applicable. * Provide ...

DESERT COVE RECOVERY

$15.50 - $23/hr

Attend regular staff meetings, trainings, and reviews * Maintain compliance with company ... behavioral health (minimum), 3 years (preferred) * Valid driver's license or reliable ...

DOCS Health

Behavioral Health Specialist

Thornton, CO · On-site

Review Behavioral Health questionnaires. * Work with military providers on case-managed patients. Requirements: * Active Clinical Social Worker license or Master Social Worker license in the state

DOCS Health

Behavioral Health Specialist

Thornton, CO · On-site

Review Behavioral Health questionnaires. * Work with military providers on case-managed patients. Requirements * Active Clinical Social Worker license or Master Social Worker license in the state

Imh

Behavioral Health Provider

Grand Junction, CO · On-site

$35.60 - $54/hr

Credentialing through medical staff office and peer review requirements may apply if working in the behavioral health setting. * May provide support and debriefing, in conjunction with the Employee ...

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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 Colorado is $44.46, according to ZipRecruiter salary data. Most workers in this role earn between $35.14 and $51.06 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 Colorado?

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

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

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

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

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

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

Cities in Colorado 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 Colorado as of August 2026, with employment types broken down into 100% Full Time. Highlights an 89% In-person, and 11% Hybrid job distribution, with an average salary of $92,477 per year, or $44.5 per hour.

Utilization Review Registered Nurse : On Site Position

Pioneers Medical Center

Meeker, CO • On-site

$33.50 - $49/hr

Part-time

Re-posted 19 days ago

Job description

Reports To : Director of Nursing; Acute and Emergency Department
FLSA Classification: Part-Time, Non-Exempt, Hourly $33.50 - $49-53
Essential Functions:
The Part-Time Utilization Review Nurse is a Registered Nurse (RN) responsible for conducting utilization reviews to determine the medical necessity and appropriateness of patient admissions, continued hospital stays, and the level of care provided. This role ensures compliance with regulatory requirements and payer guidelines, proactively identifies potential barriers to discharge, and works to prevent claim denials, thereby supporting efficient patient throughput and optimal resource utilization within the hospital.
- Perform concurrent and retrospective utilization reviews for all patient admissions and continued stays, applying established medical necessity criteria (e.g. InterQual, Milliman Care Guidelines), and payer specific guidelines.
- Communicate effectively with attending physicians, residents, and other healthcare providers regarding medical necessity, documentation requirements, and alternative levels of care.
- Identify and address potential barriers to discharge, collaborating with the Case Management team to facilitate timely patient progression.
- Document all review activities, including approvals, denials, and appeals processes, accurately and thoroughly in the electronic health record (EHR) system.
- Assist in the preparation and submission of appeals for denied services, providing clinical rationale and supporting documentation.
- Stay current with Medicare, Medicaid, and commercial payer regulations, policies, and medical necessity criteria.
- Collaborate with the Case Management team to ensure seamless coordination between utilization review and discharge planning activities.
- Participate in interdisciplinary team meetings to discuss patient status, care progression, and discharge readiness.
- Provide education to physicians and other staff on documentation requirements for medical necessity.
- Monitor readmissions and avoidable days in Meditech for quality improvement initiatives.
- Coordinate in advance discharge planning for orthopedic surgical patients, ensuring timely referrals, equipment orders, and post-discharge services.
- Actively participate in the Utilization Review (UR) Committee.
- Perform other duties as assigned to support utilization management, case management, and hospital operations.
- Other duties as assigned.
Education and Experience:
- Previous experience in managing staff and schedules required.
- Active, unencumbered Registered Nurse (RN) license in Colorado or Compact-state license that includes Colorado.
- Two (2) to three (3) years' of recent clinical experience in an acute care setting required.
- One (1) year of experience in Utilization Review or Case Management preferred.
- Strong knowledge of Medicare, Medicaid, and commercial payer regulations, as well as medical necessity criteria (e.g., InterQual, Milliman Care Guidelines).
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

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