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Home Based Behavioral Health Utilization Review Jobs

CareSource

Behavioral Health Medical Director

Bronx, NY · On-site

... utilization review, quality improvement initiatives, and clinical policy development. Partners with interdisciplinary teams to ensure the delivery of high-quality, evidence-based behavioral health ...

Umpqua Health

Utilization Review Clinician

Evaluate behavioral health and substance use disorder services to determine medical necessity ... Apply clinical judgment and evidence-based criteria to make utilization decisions and identify ...

Axiom Care

Utilization Review Coordinator

Phoenix, AZ · On-site

Founded in 2012, Axiom Care is a Phoenix-based behavioral health organization that aims to ensure every Arizonan has access to compassionate, effective substance use treatment. With facilities in ...

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How much do home based behavioral health utilization review jobs pay per hour?

As of Aug 20, 2026, the average hourly pay for home based 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 is a home based behavioral health utilization review?

A Home Based Behavioral Health Utilization Review is the process of evaluating the necessity, appropriateness, and efficiency of behavioral health services provided to patients in their home environments. Professionals in this role review clinical documentation, treatment plans, and service utilization to ensure compliance with insurance policies and regulatory standards. Their goal is to help ensure that patients receive the right care at the right time, while also managing healthcare costs and preventing unnecessary services. This position often involves collaboration with healthcare providers, insurance companies, and patients’ families.

What are the key skills and qualifications needed to thrive as a home based behavioral health utilization review specialist?

To thrive as a Home Based Behavioral Health Utilization Review Specialist, you need a background in behavioral health or social work, typically with relevant licensure (e.g., LCSW, LMHC, RN) and experience in case management or utilization review. Familiarity with utilization management software, electronic health record (EHR) systems, and knowledge of insurance guidelines and regulatory standards are essential. Strong analytical thinking, attention to detail, and clear communication skills help professionals effectively assess cases and advocate for appropriate care. These competencies ensure accurate service authorization, compliance with regulations, and improved patient outcomes in a remote setting.

What are some common challenges faced in a home based behavioral health utilization review role, and how can they be managed?

One common challenge in a home-based behavioral health utilization review role is maintaining effective communication with providers and care teams remotely. Since much of the work is done virtually, it requires strong organizational skills and proficiency with digital tools to ensure timely, accurate reviews and documentation. Additionally, staying updated with constantly changing insurance policies and clinical guidelines can be demanding. Regular training, leveraging collaborative platforms, and setting up structured routines can help professionals manage these challenges successfully.

What is the difference between Home Based Behavioral Health Utilization Review vs Outpatient Behavioral Health Clinician?

AspectHome Based Behavioral Health Utilization ReviewOutpatient Behavioral Health Clinician
CredentialsLicenses in mental health or social work, certifications in utilization reviewLicenses in mental health or social work, clinical certifications
Work EnvironmentRemote, reviewing cases from home or officeClinic or outpatient setting, direct patient interaction
Employer & Industry UsageHealth plans, managed care organizationsHospitals, outpatient clinics, private practices
Primary FocusReviewing treatment necessity, authorization, and complianceProviding direct therapy and clinical assessments

Home Based Behavioral Health Utilization Review professionals focus on evaluating treatment plans and authorizations remotely, ensuring appropriate care. Outpatient Behavioral Health Clinicians provide direct patient care in clinical settings. Both roles require mental health licensure but differ mainly in job functions and work environment.

What cities are hiring for Home Based Behavioral Health Utilization Review jobs?

Cities with the most Home Based 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:

What states have the most Home Based Behavioral Health Utilization Review jobs?

States with the most job openings for Home Based Behavioral Health Utilization Review jobs include:

Home Based Behavioral Health Utilization Review jobs near you

Supervisor Behavioral Health Utilization Review

Saint Luke's Hospital System

Kansas City, MO • On-site

Full-time

Re-posted yesterday

Job description

Job Description

Saint Luke's Crittenton Children's Center in South Kansas City, MO is seeking a Supervisor of Behavioral Health Utilization Review to join our team.

This role facilitates and directs the Utilization Review Department, Case Management and Reception teams of a 24/7 inpatient residential and hospital program. Additionally, ensures compliance with all pertinent regulations, analyzes trends related to denials & authorizations, builds strong relationships with third party payers. Positive relationships with physicians, nursing supervisors and senior administration are required to ensure empathic and timely response to individual patient and community needs.

Job Details:

  • Monday - Friday, dayshift, 9am -5pm. Remote work not preferred, but occasional opportunity, must be primarily onsite. No weekend or holiday rotations.
  • Supervises and completes daily operations as assigned by Manager of Intake and Utilizations Review.
  • Oversees resources and functions related to utilization review and regulatory compliance adherence.
  • Responsible for training of staff, discipline and evaluations.
  • Monitors and maintains data to achieve quality outcomes and progression with the departmental strategic plan.
  • Collaborates and communicates with the multidisciplinary team to ensure communication of patient's treatment to the managed care provider.
  • Review clinical charts in order to file appeals on denied accounts.
  • Oversees scheduling and supervision needs for the Reception team.
  • Must have a master's degree and current clinical licensure for State of Missouri (LPC or LCSW)
  • 1-3 years in a leadership or team lead role preferred
Job Requirements

Applicable Experience:

2 yearsLicensed Professional Counselor - VariousMaster's DegreeJob DetailsFull TimeDay (United States of America)

The best place to get care. The best place to give care. Saint Luke's 12,000 employees strive toward that vision every day. Our employees are proud to work for the only faith-based, nonprofit, locally owned health system in Kansas City. Joining Saint Luke's means joining a team of exceptional professionals who strive for excellence in patient care. Do the best work of your career within a highly diverse and inclusive workspace where all voices matter.

Join the Kansas City region's premiere provider of health services. Equal Opportunity Employer.

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