Utilization Review Nurse
Oxford, NC · On-site
One year utilization and review experience. Experience with MCG authorization criteria preferred. Knowledge of current nursing principles, techniques, procedures; knowledge of current utilization ...
Utilization Review Nurse
Oxford, NC · On-site
One year utilization and review experience. Experience with MCG authorization criteria preferred. Knowledge of current nursing principles, techniques, procedures; knowledge of current utilization ...
One year utilization and review experience. Experience with MCG authorization criteria preferred. Knowledge of current nursing principles, techniques, procedures; knowledge of current utilization ...
One year utilization and review experience. Experience with MCG authorization criteria preferred. Knowledge of current nursing principles, techniques, procedures; knowledge of current utilization ...
RN - Utilization Review & Care Coordination Join a dedicated healthcare team as a Registered Nurse specializing in Utilization Review and Coordination of Care. This role involves evaluating patient ...
RN - Utilization Review & Care Coordination Join a dedicated healthcare team as a Registered Nurse specializing in Utilization Review and Coordination of Care. This role involves evaluating patient ...
Join a dedicated healthcare team as a Registered Nurse specializing in Utilization Review and Coordination of Care. This role involves evaluating patient admissions and ongoing care to ensure medical ...
Join a dedicated healthcare team as a Registered Nurse specializing in Utilization Review and Coordination of Care. This role involves evaluating patient admissions and ongoing care to ensure medical ...
Drug Utilization Review Pharmacist
Raleigh, NC · On-site +1
Drug Utilization Review Pharmacist - Ensure Safe and Effective Use of Medications A confidential ... Document reviews and ensure compliance with state, federal, and health plan requirements.
Drug Utilization Review Pharmacist
Raleigh, NC · On-site +1
Drug Utilization Review Pharmacist - Ensure Safe and Effective Use of Medications A confidential ... Document reviews and ensure compliance with state, federal, and health plan requirements.
Utilization and Quality Management/Outcomes experience preferred. Previous work experience with a ... Prior experience in case management, home health, discharge planning, or Concurrent review.
Utilization and Quality Management/Outcomes experience preferred. Previous work experience with a ... Prior experience in case management, home health, discharge planning, or Concurrent review.
Review crisis assessments and evaluations to determine service eligibility and treatment placement. Assist in reviewing behavioral healthcare/person-centered plans as part of Utilization Review to ...
Review crisis assessments and evaluations to determine service eligibility and treatment placement. Assist in reviewing behavioral healthcare/person-centered plans as part of Utilization Review to ...
Review crisis assessments and evaluations to determine service eligibility and treatment placement. Assist in reviewing behavioral healthcare/person-centered plans as part of Utilization Review to ...
Review crisis assessments and evaluations to determine service eligibility and treatment placement. Assist in reviewing behavioral healthcare/person-centered plans as part of Utilization Review to ...
Provides formal and informal education to physicians and the healthcare team to improve processes and outcomes related to utilization review and compliance with utilization management plan. * Gives ...
Provides formal and informal education to physicians and the healthcare team to improve processes and outcomes related to utilization review and compliance with utilization management plan. * Gives ...
Provides formal and informal education to physicians and the healthcare team to improve processes and outcomes related to utilization review and compliance with utilization management plan. * Gives ...
Provides formal and informal education to physicians and the healthcare team to improve processes and outcomes related to utilization review and compliance with utilization management plan. * Gives ...
Our values and behaviors are the root of our culture. They are how we achieve our strategy, power ... review the education and awareness resources at HB531 | Florida Agency for Health Care ...
Our values and behaviors are the root of our culture. They are how we achieve our strategy, power ... review the education and awareness resources at HB531 | Florida Agency for Health Care ...
Behavioral Health Case Manager
Durham, NC · On-site
Ensure optimum utilization of the patient's and the Health System's resources and perform these ... review agencies. Duties and Responsibilities * Monitor daily census and assignment to assure all ...
Behavioral Health Case Manager
Durham, NC · On-site
Ensure optimum utilization of the patient's and the Health System's resources and perform these ... review agencies. Duties and Responsibilities * Monitor daily census and assignment to assure all ...
Behavioral Health Case Manager
Durham, NC · On-site
Ensure optimum utilization of the patient's and the Health System's resources and perform these ... review agencies. Duties and Responsibilities * Monitor daily census and assignment to assure all ...
Behavioral Health Case Manager
Durham, NC · On-site
Ensure optimum utilization of the patient's and the Health System's resources and perform these ... review agencies. Duties and Responsibilities * Monitor daily census and assignment to assure all ...
Behavioral Health Case Manager
Durham, NC · On-site
Ensure optimum utilization of the patient's and the Health System's resources and perform these ... review agencies. Duties and Responsibilities * Monitor daily census and assignment to assure all ...
Behavioral Health Case Manager
Durham, NC · On-site
Ensure optimum utilization of the patient's and the Health System's resources and perform these ... review agencies. Duties and Responsibilities * Monitor daily census and assignment to assure all ...
Ensure optimum utilization of the patient's and the Health System's resources and perform these ... review agencies. Duties and Responsibilities * Monitor daily census and assignment to assure all ...
Ensure optimum utilization of the patient's and the Health System's resources and perform these ... review agencies. Duties and Responsibilities * Monitor daily census and assignment to assure all ...
... review progress and adjust strategies as needed for consistency across environments. • ... Behavioral Health Technician (BHT) Qualifications: • Ability to follow instructions, implement ...
Quick apply
... review progress and adjust strategies as needed for consistency across environments. • ... Behavioral Health Technician (BHT) Qualifications: • Ability to follow instructions, implement ...
Community Outreach Liaison
Cary, NC · On-site
We are a part of Odyssey Behavioral Healthcare Network which offers a continuum of care within our ... Coordinates with the business office and Utilization Review to determine financing options for ...
Community Outreach Liaison
Cary, NC · On-site
We are a part of Odyssey Behavioral Healthcare Network which offers a continuum of care within our ... Coordinates with the business office and Utilization Review to determine financing options for ...
We are a part of Odyssey Behavioral Healthcare Network which offers a continuum of care within our ... Coordinates with the business office and Utilization Review to determine financing options for ...
We are a part of Odyssey Behavioral Healthcare Network which offers a continuum of care within our ... Coordinates with the business office and Utilization Review to determine financing options for ...
Behavioral Health Counselor I
Raleigh, NC · On-site
Tracks patients using a registry, prioritizes cases for review, and provides treatment ... Bilingual (English/Spanish) skills and behavioral health care management experience preferred.
Behavioral Health Counselor I
Raleigh, NC · On-site
Tracks patients using a registry, prioritizes cases for review, and provides treatment ... Bilingual (English/Spanish) skills and behavioral health care management experience preferred.
Director of Psychiatry CPHC
Raleigh, NC · On-site
$340K/yr
... utilization review efforts. * Serves as a key liaison across custody, nursing, administrative, and behavioral health teams to align services, address grievances, manage referrals, and support ...
Director of Psychiatry CPHC
Raleigh, NC · On-site
$340K/yr
... utilization review efforts. * Serves as a key liaison across custody, nursing, administrative, and behavioral health teams to align services, address grievances, manage referrals, and support ...
Behavioral Health Utilization Review information
See Raleigh, NC salary details
$20.80 - $25
2% of jobs
$25 - $29.21
9% of jobs
$32.09 is the 25th percentile. Wages below this are outliers.
$29.21 - $33.42
21% of jobs
The median wage is $36.82 / hr.
$33.42 - $37.62
23% of jobs
$37.62 - $41.83
13% of jobs
$45.10 is the 75th percentile. Wages above this are outliers.
$41.83 - $46.03
10% of jobs
$46.03 - $50.24
8% of jobs
$50.24 - $54.45
5% of jobs
$54.45 - $58.65
5% of jobs
$58.65 - $62.86
2% of jobs
$62.86 - $67.06
2% of jobs
$20
$41
$67
How much do behavioral health utilization review jobs pay per hour?
As of Jun 13, 2026, the average hourly pay for behavioral health utilization review in Raleigh, NC is $41.10, according to ZipRecruiter salary data. Most workers in this role earn between $32.50 and $47.21 per hour, depending on experience, location, and employer.
What is a Behavioral Health Utilization Review job?
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 the Behavioral Health Utilization Review position, 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 Raleigh, NC? The most popular types of Behavioral Health Utilization Review jobs in Raleigh, NC are:
What are popular job titles related to Behavioral Health Utilization Review jobs in Raleigh, NC? For Behavioral Health Utilization Review jobs in Raleigh, NC, the most frequently searched job titles are:
- Behavioral Health Consultant
- Remote Behavioral Health Utilization Review
- Behavioral Health Case Manager
- Remote Behavioral Health Consultant
- Behavioral Health Technician Full Time
- Crf Behavioral Healthcare
- Vital Behavioral Care
- Senior Behavioral Health Utilization Review
- Night Shift River Point Behavioral Health
- Manager Kaiser Permanente Behavioral Health
What job categories do people searching Behavioral Health Utilization Review jobs in Raleigh, NC look for? The top searched job categories for Behavioral Health Utilization Review jobs in Raleigh, NC are:
What cities near Raleigh, NC are hiring for Behavioral Health Utilization Review jobs? Cities near Raleigh, NC with the most Behavioral Health Utilization Review job openings:
Job description
Position Summary:
Conducts patient reviews as specified in review plan using screening criteria; identifies and documents actual and potential delays in services or treatment and works with departments and other providers to resolve problems; communicates to attending physician need for documentation for admission or continuation of hospitalization; refers cases that do not meet criteria to Director when needed. Screens all cases against high risk screens for discharge planning; conduct concurrent and retrospective reviews.
Qualifications:
North Carolina License as a Registered Nurse. Three years clinical nursing experience. One year utilization and review experience. Experience with MCG authorization criteria preferred. Knowledge of current nursing principles, techniques, procedures; knowledge of current utilization management criteria and standards. Excellent communication skills. Ability to work with physicians and hospital staff. Maintains professional knowledge and skills related to areas of responsibility. Self direction with the ability to work with minimal supervision and manage multiple tasks. Demonstrates understanding of variations in care of the following age groups - newborn, infant, child, adolescent, adult and geriatric.
Conducts patient reviews as specified in review plan using screening criteria; identifies and documents actual and potential delays in services or treatment and works with departments and other providers to resolve problems; communicates to attending physician need for documentation for admission or continuation of hospitalization; refers cases that do not meet criteria to Director when needed. Screens all cases against high risk screens for discharge planning; conduct concurrent and retrospective reviews.
Qualifications:
North Carolina License as a Registered Nurse. Three years clinical nursing experience. One year utilization and review experience. Experience with MCG authorization criteria preferred. Knowledge of current nursing principles, techniques, procedures; knowledge of current utilization management criteria and standards. Excellent communication skills. Ability to work with physicians and hospital staff. Maintains professional knowledge and skills related to areas of responsibility. Self direction with the ability to work with minimal supervision and manage multiple tasks. Demonstrates understanding of variations in care of the following age groups - newborn, infant, child, adolescent, adult and geriatric.