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Behavioral Health Utilization Review Jobs in Florida

Banyan

Utilization Review Specialist

Pompano Beach, FL · On-site

$50K - $65K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Utilization Review Specialist | Remote | Full-Time $50,000 - $65,000 Annually | Weekdays (Weekend ... Graduate degree in a health or behavioral health related field * Clinical licensure (LCSW, LMHC ...

Acrisure LLC

Utilization Review Nurse

Bradenton, FL · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

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

New

Acrisure

Utilization Review Nurse

Bradenton, FL · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

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 ...

New

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 Aug 16, 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 80% Full Time, and 20% Part Time. Highlights an 97% In-person, and 3% Remote job distribution, with an average salary of $65,722 per year, or $31.6 per hour.

Utilization Review Specialist (Remote) - Behavioral Health

Adolescent Wellness Academy

Davie, FL • Remote

Full-time

Posted 9 days ago

Job description

Remote Authorization Specialist

Remote | Full-Time | 9a-5p Monday-Friday | $24-$26/hour

About the Role
This role manages insurance authorization for clients across our PHP and IOP programs - completing pre-certifications, concurrent reviews, verifying benefits, obtaining Single Case Agreements, and managing appeals so that client access to treatment is never disrupted by a payer issue.

Backgrounds that translate well: Utilization Review Insurance Authorization/Precertification Behavioral Health Case Management

What You'll Do

  • Verify benefits and eligibility prior to admission and throughout treatment
  • Complete pre-certifications, concurrent reviews, and re-certifications for PHP/IOP levels of care
  • Obtain Single Case Agreements with out-of-network payers
  • Build the medical necessity case using ASAM, LOCUS, and CALOCUS criteria
  • Prepare and submit appeals on denied authorizations
  • Maintain accurate, audit-ready authorization, denial, and SCA records

What We're Looking For

Required

  • 2+ years of experience as a UR/authorization specialist at the PHP and IOP levels of care for a mental health or substance use facility
  • Working knowledge of ASAM, LOCUS, and CALOCUS criteria and medical necessity standards
  • Strong organizational skills with the ability to manage multiple authorizations and deadlines concurrently
  • Strong familiarity with EMR platforms and authorization software
  • Strong written and verbal communication skills, with the ability to advocate effectively with payers
  • Eligible for DCF and AHCA Level 2 Background Check

Preferred

  • CPT/ICD-10 and DSM-5 familiarity
  • Multi-payer SCA experience
  • Bilingual (English/Spanish)
  • Kipu or similar EMR experience

AWA and PRC are dual behavioral health organizations operating PHP and IOP programs across South Florida. We exist to serve clients and families at their most critical moments - and this role sits at the front door of that mission.


Learn More: Adolescent Wellness Academy Principles Recovery Center

Employment Type: FULL_TIME

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