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Behavioral Health Utilization Review Jobs in Virginia

Summit BHC

Utilization Specialist

Williamsburg, VA · On-site

The Utilization Specialist is responsible for reviewing of assigned admissions, continued stays ... behavioral or mental health, or other related health field required. • Two or more years of ...

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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 Virginia is $41.92, according to ZipRecruiter salary data. Most workers in this role earn between $33.12 and $48.12 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 Virginia?

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

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

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

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

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

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

Cities in Virginia 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 Virginia as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 15% Part Time, and 4% Contract. Highlights an 96% Physical, 1% Hybrid, and 3% Remote job distribution, with an average salary of $87,192 per year, or $41.9 per hour.

Clinical Coordinator - Utilization Review

Hampton-Newport News Community Services Board

Hampton, VA • On-site

$62K - $66K/yr

Full-time

Medical, Dental, Vision, Life, Retirement

Re-posted 4 days ago

Job description

Clinical Coordinator - Utilization Review
Annual Salary: $62,406 - $66,000
Work Schedule: Monday - Friday 8:30 am - 5:00 pm
The Hampton-Newport News Community Services Board (CSB) is seeking a Clinical Coordinator - Utilization Review to join the Region 5 Reinvestment Initiative. This full-time position plays an important role in ensuring individuals receive timely, appropriate, and effective behavioral health services while supporting regional efforts to improve access to care and coordinate treatment placements.
The Clinical Coordinator - Utilization Review conducts utilization reviews of acute and intermediate levels of care, evaluates medical necessity and appropriateness of services, and manages behavioral health bed utilization on a daily basis. This position works closely with hospitals, treatment facilities, CSB staff, and regional partners to support timely movement to the most appropriate level of care.
Minimum Qualifications
To qualify for this position, candidates must have:
  • Master's degree in Human Services or a related field.
  • Three (3) years of experience in behavioral health, including utilization management.
Key Responsibilities
  • Conduct utilization reviews of acute and intermediate levels of care to assess medical necessity, appropriateness of treatment, and continued stay criteria.
  • Manage and monitor acute care bed availability and placements to support timely and appropriate transitions in care.
  • Conduct face-to-face assessments and gather information regarding an individual's treatment needs, progress, and current level of functioning.
  • Review treatment progress and outcomes and make recommendations regarding the most appropriate level of care.
  • Coordinate communication among hospitals, facilities, CSB staff, and regional partners regarding admissions, continued stays, discharges, and placements.
  • Provide guidance and recommendations related to acute, sub-acute, crisis stabilization, and community-based services.
  • Monitor consumer placements and assist with identifying appropriate and least restrictive treatment options.
  • Communicate findings, recommendations, and utilization concerns to appropriate stakeholders.
  • Prepare utilization reports and provide data-driven recommendations to support regional behavioral health planning and resource management.
  • Promote quality, cost-effective care while supporting timely access to appropriate services.
  • Participate in regional initiatives and activities designed to improve behavioral health system coordination and outcomes.

BENEFITS
  • Health, Vision, and Dental Insurance
  • Virginia Retirement System
  • Flexible Spending Account (FSA)
  • Life Insurance
  • 11 Paid Holidays

The selected candidate must successfully pass a criminal history fingerprint background investigation, DMV record check, Child Registry search, drug screening test and employment reference checks.

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