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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 ...

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Entry Level Behavioral Health Utilization Review information

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 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 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 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.

Clinical Coordinator - Utilization Review

Hampton, VA • On-site

Hampton-Newport News Community Services Board
Offices of Mental Health Practitioners • 501 - 1,000 employees
Learn more about Hampton-Newport News Community Services Boardexternal

$62K - $66K/yr

Full-time

Medical, Dental, Vision, Life, Retirement

Re-posted 15 days ago

Job description

Clinical Coordinator - Utilization Review
Annual Salary: $62,406 - $66,000
Work Schedule: Monday - Friday 8:30 am - 5:00 pm
The Hampton-Newport News Community Services Board (CSB) is seeking a Clinical Coordinator - Utilization Review to join the Region 5 Reinvestment Initiative. This full-time position plays an important role in ensuring individuals receive timely, appropriate, and effective behavioral health services while supporting regional efforts to improve access to care and coordinate treatment placements.
The Clinical Coordinator - Utilization Review conducts utilization reviews of acute and intermediate levels of care, evaluates medical necessity and appropriateness of services, and manages behavioral health bed utilization on a daily basis. This position works closely with hospitals, treatment facilities, CSB staff, and regional partners to support timely movement to the most appropriate level of care.
Minimum Qualifications
To qualify for this position, candidates must have:
  • Master's degree in Human Services or a related field.
  • Three (3) years of experience in behavioral health, including utilization management.
Key Responsibilities
  • Conduct utilization reviews of acute and intermediate levels of care to assess medical necessity, appropriateness of treatment, and continued stay criteria.
  • Manage and monitor acute care bed availability and placements to support timely and appropriate transitions in care.
  • Conduct face-to-face assessments and gather information regarding an individual's treatment needs, progress, and current level of functioning.
  • Review treatment progress and outcomes and make recommendations regarding the most appropriate level of care.
  • Coordinate communication among hospitals, facilities, CSB staff, and regional partners regarding admissions, continued stays, discharges, and placements.
  • Provide guidance and recommendations related to acute, sub-acute, crisis stabilization, and community-based services.
  • Monitor consumer placements and assist with identifying appropriate and least restrictive treatment options.
  • Communicate findings, recommendations, and utilization concerns to appropriate stakeholders.
  • Prepare utilization reports and provide data-driven recommendations to support regional behavioral health planning and resource management.
  • Promote quality, cost-effective care while supporting timely access to appropriate services.
  • Participate in regional initiatives and activities designed to improve behavioral health system coordination and outcomes.

BENEFITS
  • Health, Vision, and Dental Insurance
  • Virginia Retirement System
  • Flexible Spending Account (FSA)
  • Life Insurance
  • 11 Paid Holidays

The selected candidate must successfully pass a criminal history fingerprint background investigation, DMV record check, Child Registry search, drug screening test and employment reference checks.

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