ZipRecruiter

Log In

2

Entry Level Behavioral Health Utilization Review Jobs in Virginia

Summit BHC

Utilization Specialist

Williamsburg, VA · On-site

The Utilization Specialist is responsible for reviewing of assigned admissions, continued stays ... behavioral or mental health, or other related health field required. • Two or more years of ...

next page

Showing results 1-20

All JobsBehavioral Health Utilization Review JobsEntry Level Behavioral Health Utilization Review JobsEntry Level Behavioral Health Utilization Review Jobs in Virginia

Entry Level Behavioral Health Utilization Review information

What are some common challenges faced by entry level behavioral health utilization review professionals, and how can they be managed?

Entry-level Behavioral Health Utilization Review professionals often encounter challenges such as learning to interpret clinical documentation accurately, balancing productivity with thoroughness, and effectively communicating with providers about coverage determinations. Adjusting to the fast-paced environment and understanding complex insurance guidelines can also be demanding. Seeking mentorship from experienced colleagues, participating in ongoing training, and developing strong organizational skills are effective ways to overcome these challenges and grow within the role.

What are the key skills and qualifications needed to thrive as an entry level behavioral health utilization review specialist?

To thrive as an Entry Level Behavioral Health Utilization Review Specialist, you need foundational knowledge in behavioral health, familiarity with insurance processes, and often a relevant bachelor's degree in psychology, social work, or a related field. Proficiency with medical management software, electronic health records (EHRs), and familiarity with ICD-10 and DSM-5 coding systems are typically required. Strong analytical skills, attention to detail, and effective communication help you excel in reviewing clinical documentation and collaborating with providers. These skills ensure accurate, timely authorization decisions and support quality patient care while adhering to regulatory and payer guidelines.

What is an entry level behavioral health utilization review?

Entry level behavioral health utilization review jobs involve assessing mental health and substance abuse treatment services to ensure they are appropriate, necessary, and covered by insurance plans. Individuals in these roles typically review clinical documentation, compare it to established criteria, and collaborate with healthcare providers to determine coverage. These positions are a starting point for those interested in behavioral health or healthcare administration, and often require strong communication, analytical skills, and a background in mental health or social services.
What are the most commonly searched types of Behavioral Health Utilization Review jobs in Virginia? The most popular types of Behavioral Health Utilization Review jobs in Virginia are:
What are popular job titles related to Entry Level Behavioral Health Utilization Review jobs in Virginia? For Entry Level Behavioral Health Utilization Review jobs in Virginia, the most frequently searched job titles are:
What job categories do people searching Entry Level Behavioral Health Utilization Review jobs in Virginia look for? The top searched job categories for Entry Level Behavioral Health Utilization Review jobs in Virginia are:
Entry Level Behavioral Health Utilization Review jobs near you
Infographic showing various Entry Level Behavioral Health Utilization Review job openings in Virginia as of August 2026, with employment types broken down into 68% Full Time, 27% Part Time, and 5% Contract. Highlights an 90% In-person, 5% Hybrid, and 5% Remote job distribution.

Behavioral Healthcare Utilization Review Spec

Horizon Behavioral Heal

Lynchburg, VA • On-site

$46K - $74K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 14 days ago

Job description

Hours: full-time (37.5 hours per week)

Location: Lynchburg VA, 24501

Compensation dependent on experience


Position Summary

The Behavioral Healthcare Utilization Review Specialist works on-site, and will proactively monitor utilization of services for clients, reviewing for quality of services and medical necessity. The employee will review clients’ medical records to ensure appropriate utilization of treatment resources, medical necessity, proper documentation, and compliance with federal and state regulations, and certification requirements of insurance plans or other managed care organizations (MCOs). This position will report to the CQI Manager.

Education Requirements

  • Bachelor's degree from an accredited college/university in an applicable human services field. Preferred: Master’s degree in social work, Mental Health Counseling, or related health field preferred.

Types of Experience

  • (2) Two years of continuous quality improvement and/or utilization review experience. Preference will be given to individual with at least one year of managed care experience. Behavioral Health experience is desirable.
  • An equivalent combination of education and experience that provides the candidate with the required knowledge, skills and abilities may be considered.

Related Knowledge, Skills and Abilities

  • Knowledge of behavioral healthcare terminology, the course and progress of substance abuse treatment and medical terminology;
  • Knowledge of Medicaid and MCO regulations and policies, relevant to behavioral healthcare and substance use;
  • Knowledge of Utilization Review protocols and auditing skills;
  • Knowledge of DSM 5, CPT Codes and ICD 10;
  • Knowledge of levels of care and medical necessity;
  • Ability to review and understand medical records, treatment plans and progress notes;
  • Proficiency in MS Office software and EMR systems;
  • Ability to extract and analyze data;
  • Ability to develop and present statistical and narrative reports;
  • Must be proficient in MS Office software and EMR systems.
  • Able to collaborate with all members of clinical team/medical providers;
  • Excellent verbal and written communication skills;
  • Ability to work independently as well as with a team;
  • Excellent organizational and time management skills;
  • Willing and available to work modified schedules (weekends, holiday, etc.) as required;
  • Ability to drive and must possess a valid driver's license. May be required to travel to different Horizon worksites during the day based on operational needs or provide admin support at other locations. Regular attendance at trainings and Horizon meetings may require travel to a variety of Horizon sites.

THE BEST BENEFITS FOR THOSE WHO TAKE CARE OF THE COMMUNITY

We’re proud to offer some of the best benefits options in Central Virginia. Participation in the Virginia Retirement System (VRS) is exclusively for public service workers in Virginia, while several options exist for life, health, dental, and vision insurance. Emphasis on work-life balance means a generous annual leave policy ensuring time for wellness with separate time allocated for sick leave and additionally for paid holidays. Stay active with Horizon’s annual wellness programs and various opportunities to interact with the community through the year. Horizon’s clinical sites are NHSC/HRSA approved for clinical student loan repayment and qualify for both the Public Service Loan Forgiveness (PSLF) and the Behavioral Health State Loan Repayment (BHLRP) programs. If you are interested in continuing your education, working at Horizon qualifies you to receive discounts at some local universities.

To Apply – Please visit our online career center at https://www.horizonbh.org/careers/

Horizon Behavioral Health is an Equal Opportunity Employer (EOE).