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Behavioral Utilization Review Jobs in Ohio (NOW HIRING)

Sevita

Utilization Review Specialist

Akron, OH · On-site

$40K/yr

SUMMARY The Utilization Review Specialist is responsible for proactive planning measures, accurate ... or behavioral challenges they face. We've made this our mission for more than 50 years. And today ...

syfs

UR Manager

Columbus, OH

For billing and hospitalization utilization review purposes, the reviewer will identify and certify ... behavioral health field. Benefits DailyPay Educational Assistance Program Medical, Dental, and ...

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Behavioral Utilization Review information

What jobs make $3,000 a month without a degree?

Behavioral Utilization Review roles typically require specialized training or certifications but may offer salaries around $3,000 or more per month, especially with experience. Other jobs that can pay this amount without a degree include sales positions, certain administrative roles, and skilled trades like HVAC or plumbing, which often prioritize skills and certifications over formal education.

Is being a BHT a stressful job?

Behavioral Utilization Review (BHT) roles can be stressful due to the need to assess and monitor patient care, often involving high caseloads and emotional situations. The job requires strong communication skills, attention to detail, and adherence to healthcare regulations, which can contribute to work-related stress. However, stress levels vary depending on the work environment and individual coping strategies.

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 utilization reviewer?

To become a utilization reviewer, typically one needs a bachelor's degree in healthcare, nursing, or a related field, along with experience in clinical or medical review processes. Certification such as the Certified Professional in Healthcare Quality (CPHQ) or relevant state licensure can enhance job prospects, and strong analytical and communication skills are essential for reviewing medical records and determining appropriate care utilization.

What skills do you need to be a BHT?

A Behavioral Utilization Review (BHT) typically requires strong communication, critical thinking, and knowledge of mental health or behavioral health principles. Skills in documentation, assessment, and familiarity with healthcare or insurance systems are also important. Certification or training in behavioral health or related fields may be required depending on the employer.
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Behavioral Utilization Review jobs near you
Utilization Review Coordinator

Utilization Review Coordinator

Neuropsychiatric Hospitals

Huber Heights, OH • On-site

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 15 days ago

Job description

About Us
Healing Body and Mind.
NeuroPsychiatric Hospitals is a national leader in behavioral healthcare, specializing in patients with acute psychiatric and complex medical needs. Our hospitals use an interdisciplinary, multi-specialty approach that delivers high-quality, patient-centered care when it's needed most.
With locations in Indiana, Michigan, Texas, and Arizona, we're expanding access to our unique model of care across the United States. Join us and be part of a team dedicated to making a lasting difference in the lives of patients and families every day
Overview
North Valley Behavioral Hospital, a brand new psychiatric hospital within the NeuroPsychiatric Hospitals network, is looking for a Utilization Review Coordinator to coordinate patients' services across the continuum of care by promoting effective utilization, monitoring health resources and elaborating with multidisciplinary teams.
Benefits of joining NPH
  • Competitive pay rates
  • Medical, Dental, and Vision Insurance
  • NPH 401(k) plan with up to 4% Company match
  • Employee Assistance Program (EAP) Programs
  • Generous PTO and Time Off Policy
  • Special tuition offers through Capella University
  • Work/life balance with great professional growth opportunities
  • Employee Discounts through LifeMart

Responsibilities
  • Filing documents as needed.
  • Initial Precertification with payors.
  • Concurrent Clinical review with payors.
  • Document in the electronic system daily in real time.
  • Admission audit.
  • Ensures that CON's/RON's and CMS certifications are completed by provider.
  • Consistently demonstrates professionalism with all internal and external customers as evidenced by positive customer and peer Communicates effectively with all staff and patients as evidenced by the establishment and maintenance of productive working relationships.
  • Maintains knowledge of current trends and developments in the field by reading appropriate books; journals and other literature and attending related seminars or conferences.
  • Maintains a professional approach with Assures protection and privacy of health information as attained through written, electronic or oral disclosures.
  • Cooperates and maintains good rapport with nursing staff, medical staff, and other departments.
  • Seeks guidance and remains knowledgeable of, and complies with, all applicable federal and state laws, as well as hospital polices that apply.
  • Complies with hospital expectations regarding ethical behavior and standards of conduct.
  • Complies with federal and hospital requirements in the areas of protected health information and patient information.
  • Reconsiderations, assists with appeals as needed, arrange peer to peer level reviews, and report the outcomes to the VP of Care Management and Team.
  • Provides education to nursing staff. leadership team, and providers regarding documentation.
  • Actively works with the business office regarding resolution of appeals/denials and retrospective reviews.

Qualifications
Education: Bachelor's in Behavioral Health, Social Work, Counseling, Nursing or Psychology required. Master's degree preferred.
Experience: Minimum of 2 years of utilization review experience in a hospital setting required. Minimum of 2 years of case management experience, including discharge planning in a hospital setting required.
Licensure: Certified Case Manager (CCM) or Accredited Case Manager (ACM) preferred. Basic Life Support (BLS) and Handle with Care (HWC) obtained during orientation, if applicable.
Skills: Must have strong knowledge of medications and demonstrate exceptional time management, data entry, and communication skills. Must be detail oriented.#INDEEDLOW

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