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$43

$70

How much do behavioral health utilization review jobs pay per hour?

As of Aug 30, 2026, the average hourly pay for behavioral health utilization review in Prospect, CT is $43.16, according to ZipRecruiter salary data. Most workers in this role earn between $34.09 and $49.57 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 cities near Prospect, CT are hiring for Behavioral Health Utilization Review jobs?

Cities near Prospect, CT 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 Prospect, CT as of August 2026, with employment types broken down into 1% As Needed, 76% Full Time, 17% Part Time, and 6% Contract. Highlights an 92% Physical, 1% Hybrid, and 7% Remote job distribution, with an average salary of $89,764 per year, or $43.2 per hour.

Utilization Management Representative I - Backoffice Support

Elevance Health

Wallingford, CT • On-site

$17 - $21.75/hr

Other

Posted 10 days ago

Elevance Health rating

7.6

Company rating: 7.6 out of 10

Based on 353 frontline employees who took The Breakroom Quiz

215th of 315 rated insurance

Job description

Utilization Management Representative I – Backoffice Support

Location: This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law.

Hours: Monday through Friday. Candidates must be available to work an assigned shift between 8:00 a.m. and 8:00 p.m. Eastern Time, based on business needs.

The Behavioral Health Utilization Management Representative I – Backoffice Support is responsible for processing precertification, prior authorization, and post-service requests for governmental and commercial lines of business. This is primarily a back of office role with no inbound call responsibilities. Limited outbound calls may be required to obtain information or support case resolution.

How you will make an impact:

  • Reviews and processes utilization management requests received through fax, electronic queues, and other approved channels.
  • Accurately enters referral and authorization information into utilization management systems.
  • Prepares and sends clear, complete, and accurate fax correspondence to providers, facilities, members, and internal partners.
  • Meets departmental productivity, quality, accuracy, and turnaround-time standards while maintaining a low error rate.
  • Reviews documentation for completeness and refers cases requiring clinical review to the appropriate clinical reviewer.
  • Verifies benefits and administrative requirements within the scope of the role.
  • Documents all actions and correspondence accurately and completely.
  • Demonstrates accountability and ownership of assigned workload by monitoring queues, prioritizing tasks, following work through completion, and escalating barriers promptly.
  • Protects confidential information and complies with HIPAA, privacy and security requirements, company policies, accreditation standards, contractual obligations, and applicable federal and state regulations.
  • Identifies and reports potential quality, privacy, compliance, or regulatory concerns through established escalation processes.
  • Performs other duties as assigned.

Minimum Qualifications:

  • Requires HS diploma or GED and a minimum of 1 year of customer service or call-center experience; or any combination of education and experience which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences:

  • Administrative support, healthcare operations, data entry, document processing, or back-office experience strongly preferred
  • Medical terminology training and experience in medical or insurance field preferred
  • For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
  • Ability to meet established productivity, quality, accuracy, compliance, and turnaround-time expectations preferred
  • Ability to manage assigned work independently, maintain confidentiality, and follow detailed policies and procedures preferred
  • Proficiency with computers, electronic work queues, email, and document-management systems preferred
  • Experience processing faxes, referrals, authorizations, claims, medical records, or healthcare correspondence preferred
  • Knowledge of HIPAA and healthcare privacy requirements preferred
  • Experience working in a high-volume, production-based, compliance-focused environment preferred

Job Level: Non-Management Non-Exempt

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About Elevance Health

Sourced by ZipRecruiter

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. A Fortune 20 company with a longstanding history in the healthcare industry, we are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Indianapolis, IN, US

Year founded

2004

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