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Behavioral Health Utilization Review Jobs in Silver Spring, MD

Ascension

Registered Nurse Utilization Review

Baltimore, MD

$81K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Comprehensive health coverage: medical, dental, vision, prescription coverage and HSA/FSA options * Financial security & retirement: employer-matched 403(b), planning and hardship resources ...

Vivian Health

Utilization Review RN in Baltimore, MD

Baltimore, MD · On-site

$40.12 - $62.19/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Utilization Review Nurse RN Summary: The Utilization Review Nurse RN conducts initial, concurrent ... As part of LifeBridge Health - one of the region's most comprehensive healthcare systems ...

New

Ampcus

Spec, Utilization Management

Baltimore, MD · On-site

... behavioral health. ESSENTIAL FUNCTIONS * Abstractor Primary functions: * 50% Determines medical ... Applies sound clinical knowledge and judgment throughout the review process. Coordinates non-par ...

System One

Utilization Management Specialist

Baltimore, MD · Remote

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

Perform prospective, concurrent, and retrospective utilization reviews (medical + behavioral health). * Make medical necessity / appropriateness determinations and support prior authorizations

System One

Utilization Management Specialist

Baltimore, MD · Remote

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

Perform prospective, concurrent, and retrospective utilization reviews (medical + behavioral health). * Make medical necessity / appropriateness determinations and support prior authorizations

System One

Utilization Management Specialist

Baltimore, MD · Remote

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

Perform prospective, concurrent, and retrospective utilization reviews (medical + behavioral health). * Make medical necessity / appropriateness determinations and support prior authorizations

System One

Utilization Management Specialist

Baltimore, MD · Remote

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

Perform prospective, concurrent, and retrospective utilization reviews (medical + behavioral health). * Make medical necessity / appropriateness determinations and support prior authorizations

System One

Utilization Management Specialist

Baltimore, MD · Remote

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

Perform prospective, concurrent, and retrospective utilization reviews (medical + behavioral health). * Make medical necessity / appropriateness determinations and support prior authorizations

System One

Utilization Management Specialist

Baltimore, MD · Remote

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

Perform prospective, concurrent, and retrospective utilization reviews (medical + behavioral health). * Make medical necessity / appropriateness determinations and support prior authorizations

System One

Utilization Management Specialist

Baltimore, MD · Remote

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

Perform prospective, concurrent, and retrospective utilization reviews (medical + behavioral health). * Make medical necessity / appropriateness determinations and support prior authorizations

System One

Utilization Management Specialist

Baltimore, MD · Remote

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

Perform prospective, concurrent, and retrospective utilization reviews (medical + behavioral health). * Make medical necessity / appropriateness determinations and support prior authorizations

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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 Aug 17, 2026, the average hourly pay for behavioral health utilization review in Silver Spring, MD is $43.71, according to ZipRecruiter salary data. Most workers in this role earn between $34.52 and $50.19 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 popular job titles related to Behavioral Health Utilization Review jobs in Silver Spring, MD?

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

What job categories do people searching Behavioral Health Utilization Review jobs in Silver Spring, MD look for?

The top searched job categories for Behavioral Health Utilization Review jobs in Silver Spring, MD are:

What cities near Silver Spring, MD are hiring for Behavioral Health Utilization Review jobs?

Cities near Silver Spring, MD 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 Silver Spring, MD as of August 2026, with employment types broken down into 1% As Needed, 75% Full Time, 19% Part Time, and 5% Contract. Highlights an 96% Physical, 1% Hybrid, and 3% Remote job distribution, with an average salary of $90,917 per year, or $43.7 per hour.

Utilization Review Nurse RN

LifeBridge Health, Inc.

Randallstown, MD • On-site

$40.12 - $62.19/hr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 13 days ago

LifeBridge Health rating

6.3

Company rating: 6.3 out of 10

Based on 80 frontline employees who took The Breakroom Quiz

670th of 887 rated healthcare providers

Job description

Summary:

The Utilization Review Nurse RN conducts initial, concurrent and retrospective chart review for clinical, financial and resource utilization information. Provides intervention and coordination to decrease avoidable delays and denial of payment. Interfaces with 3rd party payers by providing pertinent, relevant clinical information.

Responsibilities Include:

Reviews the medical record by applying utilization review criteria, to assess clinical, financial, and resource consumption. Enters clinical reviews into the software program. Maintains close communication with external reviewers/internal financial counselors/patient access personnel and performs certification activities as required by payor.

Monitors and identifies patterns or trends in utilization management. Monitors potential and actual denials and coordinates with nurse Care Manager and/or Social Worker for any follow up necessary. Documents in software program the actions taken to coordinate care and avoid denials. Assists nurse Care Managers in communicating with the patient denied hospital days as well as the issuance of Medicare forms including HINN, Detailed Notice of Discharge to patients/family/significant other when they are in disagreement with the discharge plan arranged by attending and Care Management personnel.

Coordinates with the Care Manager to achieve optimal and efficient patient outcomes, while decreasing length of stay and avoid delays and denied days. Utilizes Physician Advisor and administrative personnel for unresolved issues. Identifies opportunities for expedited appeals and collaborates with the Care Manager and Physician Advisor to resolve payer issues. Other tasks as assigned.

Sends appropriate referrals/escalations to the physician advisors to review cases not met with criteria

REQUIREMENTS:

Registered Nurse License - Current Maryland license or eligibility to obtain Maryland license

Associate's Degree in Nursing required; BSN or higher preferred

Minimum of 3 years of related experience

Pay Range: $40.12 to $62.19 Based On Experience

Benefits:

Medical, dental, and vision coverage starting the first of the month after hire, plus wellness programs and mental health support

403(b) retirement plan with employer match, pension, and life and disability insurance

Tuition reimbursement toward advanced degrees and specialty certifications

Generous paid time off, fitness discounts, and free on-site parking

About Northwest Hospital

Northwest Hospital is a full-service community hospital in Baltimore County serving Randallstown, Pikesville, Owings Mills, and beyond. As part of LifeBridge Health - one of the region's most comprehensive healthcare systems - Northwest delivers compassionate, high-quality care close to home, with a mission to improve the health of the communities we serve, and to take care of the people who take care of patients.

About LifeBridge Health

LifeBridge Health is a dynamic, purpose-driven health system redefining care delivery across the mid-Atlantic and beyond, anchored by our mission to "improve the health of people in the communities we serve." Join us to advance health access, elevate patient experiences, and contribute to a system that values bold ideas and community-centered care.

With over 14,000 employees, 130 care locations, and two million annual patient encounters, we combine strategic growth, innovation, and deep community commitment to deliver exceptional care anchored by five leading centers in Maryland.

Our organization thrives on a culture of CARE BRAVELY-where compassion, courage, and urgency drive every decision, empowering teams to shape the future of healthcare.

LifeBridge Health complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex or sexual orientation and gender identity/expression. LifeBridge Health does not exclude people or treat them differently because of race, color, national origin, age, disability, sex or sexual orientation and gender identity/expression.

What LifeBridge Health employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

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About LifeBridge Health

Sourced by ZipRecruiter

LifeBridge Health is a $2B, 13,000 team member healthcare system that Cares Bravely for over 1 million patients annually throughout Maryland. We are comprised of 5 main healthcare centers: Sinai Hospital, Northwest Hospital, Carroll Hospital, Levindale Hebrew Geriatric Center and Hospital, and Grace Medical Center as well as several specialty and primary care locations throughout Baltimore.

Industry

Health care and social assistance

Company size

5,001 - 10,000 Employees

Headquarters location

Baltimore, MD, US

Year founded

1988

Social media

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