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Behavioral Utilization Review Jobs in Topsfield, MA

Acadia Healthcare

Registered Nurse (RN)

Malden, MA · On-site

$42.95 - $51.28/hr

... behavioral health services in the region. Our RNs are clinical professionals responsible for facilitating admissions, clinical intake assessments, and utilization review processes to assure ...

Acadia Healthcare

Registered Nurse (RN)

Malden, MA · On-site

$42.95 - $51.28/hr

... behavioral health services in the region. Our RNs are clinical professionals responsible for facilitating admissions, clinical intake assessments, and utilization review processes to assure ...

Pyramid Healthcare

Intake Coordinator

Concord, MA · On-site

$22/hr

... leader in behavioral healthcare, providing compassionate and evidence-based treatment for ... Manage insurance-related processes, including precertifications and utilization review (UR) notes ...

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Showing results 21-40

All JobsBehavioral Utilization Review JobsBehavioral Utilization Review Jobs in Topsfield, MA

Behavioral Utilization Review information

See Topsfield, MA salary details

$23

$45

$74

How much do behavioral utilization review jobs pay per hour?

As of Sep 3, 2026, the average hourly pay for behavioral utilization review in Topsfield, MA is $45.79, according to ZipRecruiter salary data. Most workers in this role earn between $36.20 and $52.60 per hour, depending on experience, location, and employer.

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 cities near Topsfield, MA are hiring for Behavioral Utilization Review jobs?

Cities near Topsfield, MA with the most Behavioral Utilization Review job openings:

Behavioral Utilization Review jobs near you

Patient Care Technicians - Behavioral Health Tech

Well Sense Health Plan

Charlestown, MA • On-site

Other

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

Job description

Behavioral Health Utilization Manager

The Behavioral Health Utilization Manager plays a critical role in ensuring the appropriate and effective delivery of mental health and substance use disorder services. This role serves as a key clinical decision-maker, exercising independent judgment and critical thinking in the evaluation of behavioral health service requests. The position is responsible for managing complex outpatient and non-24-hour diversionary cases. The role requires a proactive and analytical approach to service delivery, with a focus on clinical quality and compliance.

Responsibilities include using advanced clinical judgment to evaluate outpatient and non-24-hour behavioral health services. The manager determines the appropriateness of care based on individual member needs, clinical presentations, and professional standards. Collaboration with Medical Directors is required when clinical complexity necessitates further review. Identification of members who may benefit from enhanced care coordination or specialized interventions is essential. The manager must ensure accurate, timely documentation of clinical decisions per operational standards. Clear communication with internal and external stakeholders is vital to resolve questions or concerns. Participation in clinical rounds and interdisciplinary case discussions supports collaborative care planning and cross-functional learning. The role entails representing the organization with external partners and ensuring compliance with regulations. Monitoring clinical trends for potential indicators of Fraud, Waste, and Abuse is a key responsibility. Partnership with leadership will be necessary to evaluate existing processes and support initiatives aimed at improving quality. Crisis intervention support using clinical judgment to de-escalate situations is a required function of the role. The manager must uphold all organizational policies, professional standards, and compliance requirements. Opportunities to contribute to special projects and initiatives will arise as assigned by senior leadership. Providing Network Management in collaboration with other organizations may require some travel within designated areas.

Must-Have: Master's degree in Social Work, Psychology, Counseling, or a related Behavioral Health field. Expertise in utilization management and medical necessity determinations. Experience with Child and Adolescent Behavioral Health Services and/or Substance Use Disorder Services is preferred. Proficiency in Microsoft Office applications, particularly Outlook, Word, and Excel.

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