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Behavioral Utilization Review Jobs in California

GLC On-The-Go

Travel Utilization Review RN

Torrance, CA · On-site

$1.7K - $1.8K/day

Utilization Review * Discipline: RN * Start Date: 09/28/2026 * Duration: 13 weeks * 40 hours per ... behavioral health, and allied fields across the U.S. Our attentive and friendly recruiters are ...

Harboroaks

Utilization Specialist - Full Time

San Jose, CA · On-site

$45 - $83/hr

ONSITE ONLY San Jose Behavioral Health is currently seeking a Utilization Review Specialist - Full Time to assist the Utilization Department staff with comprehensive inpatient care and treatment ...

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Acadia Healthcare

Utilization Specialist PRN

Riverside, CA · On-site

$31 - $50/hr

Pacific Grove Hospital in Riverside, CA., is a leader in behavioral healthcare, providing superior ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...

Pacific Grove

Utilization Specialist PRN

Riverside, CA · On-site

$31 - $50/hr

Overview Pacific Grove Hospital in Riverside, CA., is a leader in behavioral healthcare, providing ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...

Acadia Healthcare

Utilization Specialist PRN

Riverside, CA · On-site

$31 - $50/hr

Overview Pacific Grove Hospital in Riverside, CA., is a leader in behavioral healthcare, providing ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...

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Behavioral Utilization Review information

What is the difference between Behavioral Utilization Review vs Behavioral Case Manager?

AspectBehavioral Utilization ReviewBehavioral Case Manager
CredentialsLicensed mental health professionals, certifications varyLicensed clinical social workers, counselors, or therapists
Work EnvironmentReview settings, insurance companies, healthcare facilitiesDirect patient interaction, hospitals, outpatient clinics
Employer & IndustryInsurance companies, healthcare organizationsHospitals, mental health agencies, managed care
Primary FocusAssessing medical necessity, reviewing treatment plansCoordinating care, supporting treatment adherence

Behavioral Utilization Review primarily involves evaluating the necessity of mental health services through review processes, while Behavioral Case Managers focus on coordinating patient care and supporting treatment plans. Both roles require mental health credentials but differ in daily tasks and work settings.

How to become a behavioral utilization review?

To become a behavioral utilization review specialist, candidates typically need a bachelor's degree in psychology, social work, nursing, or a related field. Relevant experience in mental health or healthcare settings, along with knowledge of insurance policies and utilization review processes, is important; some roles may require certification such as the Certified Professional in Utilization Review (CPUR).

Is behavioral utilization review a stressful job?

Behavioral utilization review can be stressful due to the need to evaluate complex mental health cases, meet strict deadlines, and handle sensitive patient information. The role often requires strong attention to detail, critical thinking, and emotional resilience, which can contribute to job-related stress.

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

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

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

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

What cities in California are hiring for Behavioral Utilization Review jobs?

Cities in California with the most Behavioral Utilization Review job openings:

Behavioral Utilization Review jobs near you
Infographic showing various Behavioral Utilization Review job openings in California as of August 2026, with employment types broken down into 90% Full Time, and 10% Part Time. Highlights an 100% In-person job distribution.

Utilization Review Tech

St. Francis Medical Center

Lynwood, CA • On-site

$23 - $24.45/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

This job post has expired today. Applications are no longer accepted.

Job description

Overview

St. Francis Medical Center is one of the leading comprehensive healthcare institutions in Los Angeles. St. Francis provides vital healthcare services for the 700,000 adults and 300,000 children in our community who count on the hospital for high quality and compassionate medical care. St. Francis is recognized for its full range of diagnostic and treatment services in specialties including Cardiovascular, Surgical, Orthopedics, Obstetrics, Pediatrics, Behavioral Health, and Emergency and Trauma Care. In addition, the hospital offers a broad array of education and outreach programs that advance community health. St. Francis Medical Center is a Comprehensive Stroke Center, STEMI Receiving Center, ED Approved for Pediatrics, Geriatric ED, Level III Neonatal ICU, and Level II Trauma Center. Please visit www.stfrancismedicalcenter.com for more information. Join an award-winning team of dedicated professionals committed to compassion, quality, and service!

Responsibilities

The Utilization review tech essentially works to coordinate the utilization review and appeals process as part of the denial management initiatives. Utilization review tech is responsible for coordinating phone calls, data entry and tracking data from various insurance providers and health plans regarding authorization, expedited reviews and appeals. Document and track all communication attempts with insurance providers and health plans. Utilization review tech will follow up on all denials while working closely with the Corporate/Facility Utilization review teams, Business Office and Case Managers. The Utilization review tech will also serve as the primary contact and coordinate the work to maintain integrity of tracking government review audits (RAC, MAC, CERT, ADR, Pre/Post Probes, QIO/Medicaid) and other payer audits as assigned.  The Utilization review tech will further support the department needs for Release of Information, discharge coordination or other duties as assigned.

Qualifications

Education and Work Experience

  • Minimum one year denials management experience in acute care setting highly preferred.
  • High School Diploma or equivalent required.
  • Accurate alphabetic, numeric, and/or terminal-digit filing skills.
  • Computer data entry with 10-key, with accurate typing speed of 35 wpm required. Excel skills highly preferred.
  • Knowledge of terminal digit filing and medical terminology; preferred.
  • Knowledge of State and Federal regulatory requirements for medical staff documentation; preferred.
  • Completion of a medical terminology course; preferred.
  • Background in business and office training; preferred.
    • Pay Transparency

    St. Francis Medical Center offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. Benefits may vary based on collective bargaining agreement requirements and/or the employment status, i.e. full-time or part-time. The current compensation range for this role is $23.00 to $24.45. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.

    Employment StatusFull TimeShiftDaysEqual Employment Opportunity

    Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf

    Privacy Notice

    Privacy Notice for California Applicants: https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf

    Employment Type: FULL_TIME

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