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Behavioral Health Utilization Review Jobs in Florida

Acrisure LLC

Utilization Review Nurse

Bradenton, FL · On-site

Acrisure is seeking a Utilization Review Nurse, LPN to evaluate treatment requests and help ensure ... Collaborate with physicians, healthcare providers, claims professionals, and internal team members ...

Acrisure

Utilization Review Nurse

Bradenton, FL

Acrisure is seeking a Utilization Review Nurse, LPN to evaluate treatment requests and help ensure ... Collaborate with physicians, healthcare providers, claims professionals, and internal team members ...

Acrisure

Utilization Review Nurse

Bradenton, FL · On-site

Acrisure is seeking a Utilization Review Nurse, LPN to evaluate treatment requests and help ensure ... Collaborate with physicians, healthcare providers, claims professionals, and internal team members ...

Oscar Health

Utilization Review Nurse

Miami, FL · 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 ...

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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 Sep 4, 2026, the average hourly pay for behavioral health utilization review in Florida is $31.60, according to ZipRecruiter salary data. Most workers in this role earn between $24.95 and $36.30 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 Florida?

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

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

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

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

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

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

Cities in Florida 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 Florida as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 14% Part Time, and 4% Contract. Highlights an 95% Physical, 1% Hybrid, and 4% Remote job distribution, with an average salary of $65,722 per year, or $31.6 per hour.

Utilization Review Coordinator (UR Coordinator)

Compassion Behavioral Health

Boynton Beach, FL • On-site

Full-time

This job post has expired today. Applications are no longer accepted.

Job description

POSITION PURPOSE:
The Utilization Review Coordinator (UR Coordinator) is responsible to perform the process of utilization review to ensure appropriate reimbursement by third party payers. This includes managing concurrent reviews for multiple locations and levels of care, the denial/appeals process, as well as the flow, organization, and reporting of information.


RESPONSIBILITIES:

This position reports to our Director of Utilization Review and will contribute to our overall efforts through the following responsibilities:

  • CLINICAL DATA REVIEW-Review clinical data, including medical records, patient charts and provider notes to understand patient history and to gain solid understanding of individual patient circumstances, needs and medical necessity for purposes of admission and or continued stay advocacy.
  • INSURANCE REVIEW CALLS -Communicate clinical information to insurance companies to obtain authorization to treat and or to facilitate continued stay. Utilize knowledge of billing process and clinical data to present viable arguments for insurance coverage.
  • APPEALS ADVOCACY -Speak with clinicians at insurance company upon denial of coverage to communicate relevant clinical information and bring light to individualized patient issues that necessitate coverage for prior treatment. Utilize facts to communicate in knowledgeable, persistent, passionate and or creative manner to achieve desired results for client base.


WORK SCHEDULE:

Monday through Friday from 9:00am to 5:00pm. This is not a remote position.


QUALIFICATIONS:

  • 4 + years prior experience in a utilization review capacity or equivalent experience. Must demonstrate prior experience, knowledge of insurance industry, and or aptitude for effective claim advocacy.
  • Understanding of the Utilization review process, prior patient care or related work experience in the substance abuse, behavioral and or mental health treatment field required.
  • Prior experience as a behavioral health technician, verification specialist or appeals specialist and/or other support staff in treatment facilities is highly desirable.
  • Strong computer skills and knowledge of MS Office products, including skills in MS Excel required. Ability to quickly navigate between platforms necessary.
  • Strong written and verbal communication skills are a must have.
  • College degree preferred but not required.
  • Medical and or clinical background/education is preferred but not required.

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