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Behavioral Health Utilization Review Jobs in Tennessee

UHS

Full-time - UR Coordinator

Memphis, TN · On-site

Responsibilities Lakeside Behavioral Health System provides an excellent opportunity for those ... Oversees utilization review activities with other departments to ensure reimbursement for services ...

Summit BHC

Reviews application for client admission and approves admission or refers case to utilization ... work, behavioral or mental health, or other related health field preferred. * Two or more year ...

UHS

Full-time - UR Coordinator

Memphis, TN · On-site

Responsibilities Lakeside Behavioral Health System provides an excellent opportunity for those ... Oversees utilization review activities with other departments to ensure reimbursement for services ...

Harboroaks

Utilization Specialist (On-Site)

Burns, TN · On-site

$55 - $75/hr

Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Associate's, Bachelor's, or Master's degree in Social Work, Behavioral or Mental Health, Nursing ...

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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 Tennessee is $38.38, according to ZipRecruiter salary data. Most workers in this role earn between $30.34 and $44.09 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 Tennessee?

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

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

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

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

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

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

Cities in Tennessee 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 Tennessee as of August 2026, with employment types broken down into 10% As Needed, 70% Full Time, and 20% Part Time. Highlights an 80% In-person, and 20% Remote job distribution, with an average salary of $79,822 per year, or $38.4 per hour.

Utilization Specialist - Part Time

Acadia Healthcare

Nashville, TN • On-site

Part-time

This job post has expired 1 day ago. Applications are no longer accepted.

Acadia Healthcare rating

6.2

Company rating: 6.2 out of 10

Based on 191 frontline employees who took The Breakroom Quiz

698th of 898 rated healthcare providers

Job description

Overview

PURPOSE STATEMENT:

Proactively monitor utilization of services for patients to optimize reimbursement for the facility.

Responsibilities

ESSENTIAL FUNCTIONS:

  • Act as liaison between managed care organizations and the facility professional clinical staff.
  • Conduct reviews, in accordance with certification requirements, of insurance plans or other managed care organizations (MCOs) and coordinate the flow of communication concerning reimbursement requirements.
  • Monitor patient length of stay and extensions and inform clinical and medical staff on issues that may impact length of stay.
  • Gather and develop statistical and narrative information to report on utilization, non-certified days (including identified causes and appeal information), discharges and quality of services, as required by the facility leadership or corporate office.
  • Conduct quality reviews for medical necessity and services provided.
  • Facilitate peer review calls between facility and external organizations.
  • Initiate and complete the formal appeal process for denied admissions or continued stay.
  • Assist the admissions department with pre-certifications of care.
  • Provide ongoing support and training for staff on documentation or charting requirements, continued stay criteria and medical necessity updates.

OTHER FUNCTIONS:

  • Perform other functions and tasks as assigned.

Qualifications

EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:

  • Required Education: High school diploma or equivalent.
  • Preferred Education: Associate's, Bachelor's, or Master's degree in Social Work, Behavioral or Mental Health, Nursing, or a related health field.
  • Experience: Clinical experience is required, or two or more years' experience working with the facility's population. Previous experience in utilization management is preferred

LICENSES/DESIGNATIONS/CERTIFICATIONS:

  • Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides services; or current clinical professional license or certification, as required, within the state where the facility provides services.
  • CPR and de-escalation and restraint certification required (training available upon hire and offered by facility.
  • First aid may be required based on state or facility requirements.

ADDITIONAL REGULATORY REQUIREMENTS:

While this job description is intended to be an accurate reflection of the requirements of the job, management reserves the right to add or remove duties from particular jobs when circumstances
(e.g. emergencies, changes in workload, rush jobs or technological developments) dictate.

We are committed to providing equal employment opportunities to all applicants for employment regardless of an individual's characteristics protected by applicable state, federal and local laws.

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About Acadia Healthcare

Sourced by ZipRecruiter

Acadia Healthcare is a leading provider in the healthcare and hospital industry, based in Franklin, Tennessee, United States. The company is recognised for its commitment to creating a behavioural health network that provides accessible, high-quality treatment options for individuals suffering from mental health issues, addiction, eating disorders, and PTSD. Acadia Healthcare was founded in 2005, with the mission to create a world-class organization that sets the standard of excellence in the treatment of specialty behavioural health and addiction disorders.

Industry

Hospitals

Company size

10,000+ Employees

Headquarters location

Franklin, TN, US

Year founded

2005

Social media

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