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

As of Jun 14, 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 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 are the key skills and qualifications needed to thrive as a Home Based Behavioral Health Utilization Review Specialist, and why are they important?

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 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
Manager, Utilization Review (5052)

Manager, Utilization Review (5052)

REGIONAL ONE HEALTH

Memphis, TN • On-site

Full-time

Posted 2 days ago

Regional One Health rating

6.4

Company rating: 6.4 out of 10

Based on 33 frontline employees who took The Breakroom Quiz

633rd of 872 rated healthcare providers

Job description

Regional One Health is currently seeking a Manager, Utilization Review

A Brief Overview
The Manager, Utilization Review manages the daily operations of the Utilization Review Department and is responsible for overseeing and coordinating utilization review processes within Regional One Health. Utilization Review activities include inpatient, observation, outpatient in a bed, ambulatory surgery, and Point-of-Entry Utilization review/case management activities. This role is crucial in ensuring appropriate utilization of healthcare resources while maintaining high-quality patient care. The Utilization Review Manager works collaboratively with medical and hospital staff to efficiently support and integrate utilization review activities.
What you will do

  • Reports to the Sr. Director on department activities, market changes, and operational opportunities, presenting action plans as necessary.
  • Establishes and maintains an organizational structure and staffing to meet departmental and organizational goals.
  • Develops and implements utilization review policies and procedures in compliance with regulatory requirements and industry best practices.
  • Stay current on changes in healthcare regulations, laws, and policies affecting utilization review.
  • Supervises the utilization review staff, including case managers (Point of Entry) and the utilization review team.
  • Oversees the submission of utilization activities, including ensuring timely and accurate submission of medical necessity reviews, clinical documentation to providers for authorization and concurrent review, and planned surgery authorizations.
  • Conducts periodic reviews of medical records to assess the appropriateness of care and services provided.
  • Assists in developing and managing department budgets and implementing cost containment measures as needed.
  • Participates in quality improvement initiatives, including patient satisfaction surveys and process improvement projects.
  • Communicates utilization review findings and recommendations to hospital administration, medical staff, and other stakeholders.
  • Ensures compliance with best practices and standards related to utilization review metrics and data collection.
  • Oversees staff competencies, training, and development to maintain a highly skilled workforce.
  • Supports leadership in setting department goals, monitoring program effectiveness, and making necessary adjustments based on utilization statistics and cost-benefit analysis.
  • Leads quality improvement initiatives, including audits and mock inspections, to maintain compliance and operational excellence.
  • Ensures timely submission of departmental reports, highlighting findings, recommendations, and action plans.
  • Encourages professional growth and continuous education among team members.
  • Bachelor's Degree in Healthcare Administration or Management Preferred
  • Bachelor's Degree in Nursing (BSN) Preferred
  • Master's Degree Strongly preferred
  • Registered Nurse (RN) Required
  • Minimum 5 years experience Five (5) years’ progressively responsible related experience is required, preferably within a healthcare environment. Required


Physical Demands

  • Standing - Occasionally
  • Walking - Occasionally
  • Sitting - Constantly
  • Lifting - Rarely
  • Carrying - Rarely
  • Pushing - Rarely
  • Pulling - Rarely
  • Climbing - Rarely
  • Balancing - Rarely
  • Stooping - Rarely
  • Kneeling - Rarely
  • Crouching - Rarely
  • Crawling - Rarely
  • Reaching - Rarely
  • Handling - Occasionally
  • Grasping - Occasionally
  • Feeling - Rarely
  • Talking - Constantly
  • Hearing - Constantly
  • Repetitive Motions - Frequently
  • Eye/Hand/Foot Coordination - Frequently


Regional One Health is an equal opportunity employer.

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