Join a dedicated healthcare team in the Midwest region as a Registered Nurse Case Manager specializing in behavioral health utilization review. In this role, you will collaborate closely with health ...
Join a dedicated healthcare team in the Midwest region as a Registered Nurse Case Manager specializing in behavioral health utilization review. In this role, you will collaborate closely with health ...
Clinical Review : * Conduct comprehensive clinical reviews of prior authorization requests for behavioral health services to determine medical necessity. * Apply advanced evidence-based clinical ...
Clinical Review : * Conduct comprehensive clinical reviews of prior authorization requests for behavioral health services to determine medical necessity. * Apply advanced evidence-based clinical ...
Utilization Reviewer
Lawrence, KS · On-site
$65K - $70K/yr
... behavioral health services responsive to evolving needs and changing environments. We accomplish ... Provide chart review results to program directors or managers with both aggregate program data and ...
Utilization Reviewer
Lawrence, KS · On-site
$65K - $70K/yr
... behavioral health services responsive to evolving needs and changing environments. We accomplish ... Provide chart review results to program directors or managers with both aggregate program data and ...
Therapist - Behavioral Health
$58K - $77K/yr
Works well with the interdisciplinary team including physicians, utilization review and nursing ... behavioral health hospitals, and more than 170 additional sites of care across the healthcare ...
Therapist - Behavioral Health
$58K - $77K/yr
Works well with the interdisciplinary team including physicians, utilization review and nursing ... behavioral health hospitals, and more than 170 additional sites of care across the healthcare ...
Therapist - Behavioral Health
Olathe, KS · On-site
$58K - $77K/yr
Works well with the interdisciplinary team including physicians, utilization review and nursing ... behavioral health hospitals, and more than 170 additional sites of care across the healthcare ...
Therapist - Behavioral Health
Olathe, KS · On-site
$58K - $77K/yr
Works well with the interdisciplinary team including physicians, utilization review and nursing ... behavioral health hospitals, and more than 170 additional sites of care across the healthcare ...
Completing Utilization Review This is a small and very cohesive program with a supportive group and ... senior behavioral healthcare. #ZR * Master's level social work or counselor license (or license ...
Completing Utilization Review This is a small and very cohesive program with a supportive group and ... senior behavioral healthcare. #ZR * Master's level social work or counselor license (or license ...
Completing Utilization Review This is a small and very cohesive program with a supportive group and ... senior behavioral healthcare. #ZR Responsibilities * Master's level social work or counselor ...
Quick apply
Completing Utilization Review This is a small and very cohesive program with a supportive group and ... senior behavioral healthcare. #ZR Responsibilities * Master's level social work or counselor ...
Completing Utilization Review This is a small and very cohesive program with a supportive group and ... senior behavioral healthcare. #ZR Responsibilities * Master's level social work or counselor ...
Quick apply
Completing Utilization Review This is a small and very cohesive program with a supportive group and ... senior behavioral healthcare. #ZR Responsibilities * Master's level social work or counselor ...
Completing Utilization Review This is a small and very cohesive program with a supportive group and ... senior behavioral healthcare. #ZR Requirements/Qualifications * Master's level social work or ...
Completing Utilization Review This is a small and very cohesive program with a supportive group and ... senior behavioral healthcare. #ZR Requirements/Qualifications * Master's level social work or ...
Completing Utilization Review This is a small and very cohesive program with a supportive group and ... senior behavioral healthcare. #ZR Requirements/Qualifications * Master's level social work or ...
Completing Utilization Review This is a small and very cohesive program with a supportive group and ... senior behavioral healthcare. #ZR Requirements/Qualifications * Master's level social work or ...
Completing Utilization Review This is a small and very cohesive program with a supportive group and ... senior behavioral healthcare. #ZR Requirements/Qualifications * Master's level social work or ...
Completing Utilization Review This is a small and very cohesive program with a supportive group and ... senior behavioral healthcare. #ZR Requirements/Qualifications * Master's level social work or ...
Position Title Behavioral Health Intake Coordinator (Nights) Marillac Campus Position Summary ... and utilization review. * In conjunction with nursing and youth care managers, performs bed ...
Position Title Behavioral Health Intake Coordinator (Nights) Marillac Campus Position Summary ... and utilization review. * In conjunction with nursing and youth care managers, performs bed ...
Position Title Behavioral Health Intake Coordinator (Nights) Marillac Campus Position Summary ... and utilization review. * In conjunction with nursing and youth care managers, performs bed ...
Position Title Behavioral Health Intake Coordinator (Nights) Marillac Campus Position Summary ... and utilization review. * In conjunction with nursing and youth care managers, performs bed ...
Position Title Behavioral Health Intake Coordinator (Nights) Marillac Campus Position Summary ... and utilization review. * In conjunction with nursing and youth care managers, performs bed ...
Position Title Behavioral Health Intake Coordinator (Nights) Marillac Campus Position Summary ... and utilization review. * In conjunction with nursing and youth care managers, performs bed ...
Behavioral Health Intake Coordinator (Evenings)
Overland Park, KS · On-site
$37K - $42K/yr
Position Title Behavioral Health Intake Coordinator (Evenings) Marillac Campus Position Summary ... and utilization review. * In conjunction with nursing and youth care managers, performs bed ...
Behavioral Health Intake Coordinator (Evenings)
Overland Park, KS · On-site
$37K - $42K/yr
Position Title Behavioral Health Intake Coordinator (Evenings) Marillac Campus Position Summary ... and utilization review. * In conjunction with nursing and youth care managers, performs bed ...
Behavioral Health Intake Coordinator (Evenings)
Overland Park, KS · On-site
$37K - $42K/yr
Position Title Behavioral Health Intake Coordinator (Evenings) Marillac Campus Position Summary ... and utilization review. * In conjunction with nursing and youth care managers, performs bed ...
Behavioral Health Intake Coordinator (Evenings)
Overland Park, KS · On-site
$37K - $42K/yr
Position Title Behavioral Health Intake Coordinator (Evenings) Marillac Campus Position Summary ... and utilization review. * In conjunction with nursing and youth care managers, performs bed ...
Proficient knowledge, utilization, and/or familiarity of the DSM-5/ICD-10, ability to assess mental ... For further information, please review the Know Your Rights notice from the Department of Labor.
Proficient knowledge, utilization, and/or familiarity of the DSM-5/ICD-10, ability to assess mental ... For further information, please review the Know Your Rights notice from the Department of Labor.
Therapist - Behavioral Health - PT
Hutchinson, KS · On-site
$52K - $69K/yr
Employee assistance program Here is a look at the full Therapist - Behavioral Health - PT ESSENTIAL ... Develop a rudimentary knowledge of utilization review to serve as back up in the LBSW's absence.
Therapist - Behavioral Health - PT
Hutchinson, KS · On-site
$52K - $69K/yr
Employee assistance program Here is a look at the full Therapist - Behavioral Health - PT ESSENTIAL ... Develop a rudimentary knowledge of utilization review to serve as back up in the LBSW's absence.
Utilization Management Nurse Consultant (UM) - Work at Home CST Zone
Home, KS · On-site
$26.01 - $56.14/hr
... behavioral health or other specialty area) * Strong clinical assessment and decision‑making ... Utilization Review experience * 1+ year of Managed Care experience * Proficiency in Microsoft ...
Utilization Management Nurse Consultant (UM) - Work at Home CST Zone
Home, KS · On-site
$26.01 - $56.14/hr
... behavioral health or other specialty area) * Strong clinical assessment and decision‑making ... Utilization Review experience * 1+ year of Managed Care experience * Proficiency in Microsoft ...
Utilization Management Nurse Consultant
Home, KS · On-site
$26.01 - $56.14/hr
At CVS Health ® , you'll be surrounded by passionate colleagues who care deeply, innovate with ... Position Summary Utilization Management is a 24/7 operation and work schedules will include ...
Utilization Management Nurse Consultant
Home, KS · On-site
$26.01 - $56.14/hr
At CVS Health ® , you'll be surrounded by passionate colleagues who care deeply, innovate with ... Position Summary Utilization Management is a 24/7 operation and work schedules will include ...
Behavioral Health Utilization Review information
See Kansas salary details
$19.08 - $22.94
2% of jobs
$22.94 - $26.80
9% of jobs
$29.44 is the 25th percentile. Wages below this are outliers.
$26.80 - $30.66
21% of jobs
The median wage is $33.78 / hr.
$30.66 - $34.52
23% of jobs
$34.52 - $38.38
13% of jobs
$41.38 is the 75th percentile. Wages above this are outliers.
$38.38 - $42.23
10% of jobs
$42.23 - $46.09
8% of jobs
$46.09 - $49.95
5% of jobs
$49.95 - $53.81
5% of jobs
$53.81 - $57.67
2% of jobs
$57.67 - $61.53
2% of jobs
$19
$37
$61
How much do behavioral health utilization review jobs pay per hour?
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.
- Utilization Review Case Manager
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- Prior Authorization Utilization Review
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- Utilization Review Manager
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- Remote Aetna Utilization Review
- Weekend Utilization Review
- Utilization Review Nurse Compact License

Other
Re-posted 10 days ago
Job description
Join a dedicated healthcare team in the Midwest region as a Registered Nurse Case Manager specializing in behavioral health utilization review. In this role, you will collaborate closely with healthcare providers and members to evaluate patient needs and benefit requirements, ensuring optimal resource use. You will manage patient cases within the behavioral health unit, reviewing medical necessity for admissions, continued stays, and services.
Essential Responsibilities:
- Assess patient situations and conduct reviews to ensure compliance with eligibility, benefits, policies, and contracts.
- Manage appeals and coordinate comprehensive reviews of medical records to verify accurate admission and diagnosis information.
- Promote improved quality of care and support reduced hospital stays when safe and appropriate.
- Advise pre-certification staff and maintain records and reports related to non-clinical activities.
- Coordinate with insurance companies to secure authorizations for behavioral health services, ensuring adherence to payer requirements and facility standards.
- Maintain thorough documentation of utilization review activities, including clinical justifications and authorization requests.
- Assist with triage screenings for incoming behavioral health patients to determine immediate care needs and facilitate timely care delivery.
- Provide psychosocial support to patients and families, addressing emotional, social, and financial barriers.
- Serve as a liaison between healthcare teams and patients/families to ensure smooth care transitions.
- Support discharge planning processes when needed, ensuring safe and appropriate discharge plans.
- Conduct safety assessments and make protective reports for adults and children as indicated.
- Participate in ongoing professional development and mandatory training, including de-escalation techniques.
- Adhere to privacy and security regulations regarding Protected Health Information (PHI).
- Maintain effective communication and professional relationships with patients, team members, physicians, and external agencies.
- Graduate of a nursing or Bachelor of Social Work (BSW) program.
- Experience in behavioral health settings, particularly crisis management and inpatient care.
- Current licensure as a Registered Nurse (RN) or BSW in the relevant state.
- Current Basic Life Support (BLS) certification from American Heart Association or American Red Cross within 30 days of hire.
- De-escalation training required within six months of start date.
- Experience in utilization review, insurance coordination, and interdisciplinary team collaboration.
- Advanced degrees such as BSN or MSW are a plus.
- Strong collaboration skills with interdisciplinary teams to ensure high-quality care.
- Familiarity with community resources, mental health services, and post-acute care.
- Basic computer proficiency and experience documenting in electronic health records.
- Ability to multitask, prioritize, and communicate effectively.
Physical Requirements: Medium work involving occasional exertion up to 50 lbs and frequent standing or walking (26-50% of the day).
This position offers a competitive salary and benefits package, providing a meaningful opportunity to impact behavioral health care in a supportive regional healthcare environment.