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Entry Level Behavioral Health Utilization Review Jobs

UHS

Utilization Reviewer -Behavioral Health

Conway, SC · On-site

Responsibilities Utilization Reviewer Opportunity! Lighthouse Behavioral Health Hospital, located ... Review clinical content of medical records, participate in treatment team meetings, and collaborate ...

UHS

Utilization Reviewer -Behavioral Health

Conway, SC · On-site

Responsibilities Utilization Reviewer Opportunity! Lighthouse Behavioral Health Hospital, located ... Review clinical content of medical records, participate in treatment team meetings, and collaborate ...

Mindful Health

Utilization Review Specialist

$25 - $30/hr

Utilization Review Specialist Mindful Health is a fast-growing company with the goal of providing an intentionally different approach to mental health and well-being. We are a combination of bricks ...

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How much do entry level behavioral health utilization review jobs pay per hour?

As of Jun 14, 2026, the average hourly pay for entry level behavioral health utilization review in the United States is $42.28, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 per hour, depending on experience, location, and employer.

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, and why are they important?

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 entry level behavioral health utilization review jobs?

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? The most popular types of Behavioral Health Utilization Review jobs are:
What states have the most Entry Level Behavioral Health Utilization Review jobs? States with the most job openings for Entry Level Behavioral Health Utilization Review jobs include:
What job categories do people searching Entry Level Behavioral Health Utilization Review jobs look for? The top searched job categories for Entry Level Behavioral Health Utilization Review jobs are:
Entry Level Behavioral Health Utilization Review jobs near you
Infographic showing various Entry Level Behavioral Health Utilization Review job openings in the United States as of June 2026, with employment types broken down into 1% Locum Tenens, 1% As Needed, 21% Full Time, 57% Part Time, 19% Contract, and 1% Nights. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

RN Case Manager - Behavioral Health Utilization Review

MLee Medical Employment

Goddard, KS

Other

Posted 13 days ago

Job description

Join a dedicated healthcare team in the Midwest region as a Registered Nurse Case Manager specializing in behavioral health utilization review. In this role, you will collaborate closely with healthcare providers and members to evaluate patient needs and benefit requirements, ensuring optimal resource use. You will manage patient cases within the behavioral health unit, reviewing medical necessity for admissions, continued stays, and services.
Essential Responsibilities:

  • Assess patient situations and conduct reviews to ensure compliance with eligibility, benefits, policies, and contracts.
  • Manage appeals and coordinate comprehensive reviews of medical records to verify accurate admission and diagnosis information.
  • Promote improved quality of care and support reduced hospital stays when safe and appropriate.
  • Advise pre-certification staff and maintain records and reports related to non-clinical activities.
  • Coordinate with insurance companies to secure authorizations for behavioral health services, ensuring adherence to payer requirements and facility standards.
  • Maintain thorough documentation of utilization review activities, including clinical justifications and authorization requests.
  • Assist with triage screenings for incoming behavioral health patients to determine immediate care needs and facilitate timely care delivery.
  • Provide psychosocial support to patients and families, addressing emotional, social, and financial barriers.
  • Serve as a liaison between healthcare teams and patients/families to ensure smooth care transitions.
  • Support discharge planning processes when needed, ensuring safe and appropriate discharge plans.
  • Conduct safety assessments and make protective reports for adults and children as indicated.
  • Participate in ongoing professional development and mandatory training, including de-escalation techniques.
  • Adhere to privacy and security regulations regarding Protected Health Information (PHI).
  • Maintain effective communication and professional relationships with patients, team members, physicians, and external agencies.
Education and Experience:
  • Graduate of a nursing or Bachelor of Social Work (BSW) program.
  • Experience in behavioral health settings, particularly crisis management and inpatient care.
Licenses and Certifications:
  • Current licensure as a Registered Nurse (RN) or BSW in the relevant state.
  • Current Basic Life Support (BLS) certification from American Heart Association or American Red Cross within 30 days of hire.
  • De-escalation training required within six months of start date.
Preferred Qualifications:
  • Experience in utilization review, insurance coordination, and interdisciplinary team collaboration.
  • Advanced degrees such as BSN or MSW are a plus.
Skills and Abilities:
  • Strong collaboration skills with interdisciplinary teams to ensure high-quality care.
  • Familiarity with community resources, mental health services, and post-acute care.
  • Basic computer proficiency and experience documenting in electronic health records.
  • Ability to multitask, prioritize, and communicate effectively.

Physical Requirements: Medium work involving occasional exertion up to 50 lbs and frequent standing or walking (26-50% of the day).
This position offers a competitive salary and benefits package, providing a meaningful opportunity to impact behavioral health care in a supportive regional healthcare environment.

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