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How much do full time behavioral health utilization review jobs pay per hour?

As of Jun 14, 2026, the average hourly pay for full time 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 Behavioral Health Utilization Review professionals, and how can they be addressed?

Behavioral Health Utilization Review professionals often encounter challenges such as managing high caseloads, staying current with changing insurance policies, and effectively communicating clinical needs to payers. Balancing administrative requirements with patient advocacy can be demanding, especially when there is pressure to ensure timely reviews and approvals. To address these challenges, strong organizational skills, ongoing professional development, and collaboration with interdisciplinary teams are essential. Utilizing up-to-date technology and participating in regular training can also help streamline processes and improve outcomes.

What is a Full Time Behavioral Health Utilization Review?

A Full Time Behavioral Health Utilization Review professional evaluates mental health and substance use treatment plans to ensure they meet clinical guidelines and are medically necessary. They review patient records, coordinate with healthcare providers, and make recommendations regarding the approval or denial of services. These professionals help manage healthcare costs while ensuring patients receive appropriate care. Their expertise is essential in maintaining compliance with insurance and regulatory requirements, and they often serve as a bridge between treatment providers and insurance companies.

What are the key skills and qualifications needed to thrive as a Full Time Behavioral Health Utilization Review Specialist, and why are they important?

To thrive as a Full Time Behavioral Health Utilization Review Specialist, you need clinical expertise in behavioral health, knowledge of insurance guidelines, and typically a degree in nursing, social work, or a related field with relevant licensure. Familiarity with utilization management software, electronic health records (EHRs), and standardized assessment tools is essential. Strong analytical skills, attention to detail, and effective communication are vital soft skills for collaborating with providers and advocating for patients. These competencies ensure appropriate care authorization, regulatory compliance, and quality outcomes for both patients and healthcare organizations.
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What cities are hiring for Full Time Behavioral Health Utilization Review jobs? Cities with the most Full Time Behavioral Health Utilization Review job openings:
What are the most commonly searched types of Behavioral Health Utilization Review jobs? The most popular types of Behavioral Health Utilization Review jobs are:
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Full Time Behavioral Health Utilization Review jobs near you
Infographic showing various Full Time Behavioral Health Utilization Review job openings in the United States as of June 2026, with employment types broken down into 8% Locum Tenens, 53% Full Time, 23% Part Time, 8% Temporary, and 8% Contract. 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.
Utilization Review Specialist

Utilization Review Specialist

Northlake Behavioral Health System

Mandeville, LA

Full-time

Posted 2 days ago

Job description

Position: Utilization Review Specialist

Status: Full Time, Days

Schedule: Mon-Fri, Days. New hire will have the option to choose a schedule of either 7:30am to 4:00pm or 8:00am to 4:30pm.
Are you experienced in navigating medical insurance authorizations? We're looking for a Utilization Review Specialist to ensure our inpatient psychiatric patients receive timely access to the care they need — and that our facility is appropriately reimbursed for the services we provide.

In this role, you'll conduct admission, concurrent, and continued stay reviews with managed care organizations, commercial insurers, and government payers. You'll work closely with psychiatrists, nurses, therapists, and case managers to make sure clinical documentation supports medical necessity, and you'll manage denials and appeals to protect both patient access and reimbursement.

What You'll Do

Utilization Review & Authorizations

  • Conduct admission, concurrent, and continued stay reviews for inpatient behavioral health patients

  • Evaluate patient records against payer medical necessity and level-of-care criteria

  • Complete telephonic and electronic reviews with managed care organizations and third-party payers

  • Secure initial and continued stay authorizations; track authorization periods and obtain extensions

  • Submit clinical information on time to prevent authorization lapses and reimbursement delays

Denials & Appeals

  • Review denials and coordinate reconsiderations, peer-to-peer reviews, and appeals

  • Prepare appeal packets with supporting clinical documentation

  • Monitor denial trends and identify ways to improve authorization outcomes

Clinical Documentation & Team Collaboration

  • Review psychiatric, nursing, and therapy documentation for accuracy and medical necessity support

  • Coach providers and clinical staff on documentation improvements

  • Participate in treatment team discussions to support medical necessity and discharge planning

  • Serve as the go-to resource on behavioral health payer criteria and UR processes

Data & Compliance

  • Maintain authorization, denial, and appeal tracking logs with timely, accurate data entry

  • Assist with audits, reporting, and performance improvement initiatives

  • Maintain compliance with federal/state regulations, accreditation standards, and HIPAA

What We're Looking For

Required:

  • Associate's degree in healthcare related field — OR a high school diploma/GED with at least 4 years of psychiatric, behavioral health, utilization review, case management, admissions, or related healthcare experience

  • Min 2 years of experience in a psychiatric, behavioral health, or healthcare setting

  • Knowledge of managed care, medical necessity criteria, utilization review, third-party reimbursement, and clinical documentation review

  • Strong organization and time management — you'll juggle multiple payer reviews and deadlines

Ready to apply? Submit your resume today

Northlake Behavioral Health is an equal opportunity/affirmative action employer. All qualified applicants are encouraged to apply and will receive consideration for all employment; free from discrimination based on race, creed, color, national origin, age, sex, pregnancy, sexual orientation, gender identity, genetic information, religion, associational preferences, status as a qualified individual with a disability, or status as a protected veteran.