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Home Based Behavioral Health Utilization Review Jobs

Lifepoint Health

Specialist, Utilization Review

Holyoke, MA · On-site

$33.22 - $44.85/hr

Lifepoint Health is a leader in community-based care and driven by a mission of Making Communities ... behavioral health hospitals, and more than 170 additional sites of care across the healthcare ...

Lifepoint Health

Specialist, Utilization Review

Holyoke, MA · On-site

$33.22 - $44.85/hr

About Us Lifepoint Health is a leader in community-based care and driven by a mission of Making ... behavioral health hospitals, and more than 170 additional sites of care across the healthcare ...

UHS

Utilization Review Clinician

Augusta, GA · On-site

... based systems, in addition to other job duties. Benefit Highlights: * Referral Bonus Program ... Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory ...

Umpqua Health

Utilization Review Nurse

Roseburg, OR · On-site +1

$85K - $105K/yr

We provide integrated, whole-person care through primary care, specialty care, behavioral health ... evidence-based care for members. This role conducts prior authorizations, facilitates care ...

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Home Based Behavioral Health Utilization Review information

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

As of Aug 21, 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

Utilization Review Coordinator

Neuropsychiatric Hospitals

Huber Heights, OH

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 17 days ago

Job description

Healing Body and Mind.

NeuroPsychiatric Hospitals is a national leader in behavioral healthcare, specializing in patients with acute psychiatric and complex medical needs. Our hospitals use an interdisciplinary, multi-specialty approach that delivers high-quality, patient-centered care when it’s needed most.

With locations in Indiana, Michigan, Texas, and Arizona, we’re expanding access to our unique model of care across the United States. Join us and be part of a team dedicated to making a lasting difference in the lives of patients and families every day


North Valley Behavioral Hospital, a brand new psychiatric hospital within the NeuroPsychiatric Hospitals network, is looking for a Utilization Review Coordinator to coordinate patients’ services across the continuum of care by promoting effective utilization, monitoring health resources and elaborating with multidisciplinary teams.

Benefits of joining NPH

  • Competitive pay rates
  • Medical, Dental, and Vision Insurance
  • NPH 401(k) plan with up to 4% Company match
  • Employee Assistance Program (EAP) Programs
  • Generous PTO and Time Off Policy
  • Special tuition offers through Capella University
  • Work/life balance with great professional growth opportunities
  • Employee Discounts through LifeMart

  • Filing documents as needed.
  • Initial Precertification with payors.
  • Concurrent Clinical review with payors.
  • Document in the electronic system daily in real time.
  • Admission audit.
  • Ensures that CON’s/RON’s and CMS certifications are completed by provider.
  • Consistently demonstrates professionalism with all internal and external customers as evidenced by positive customer and peer Communicates effectively with all staff and patients as evidenced by the establishment and maintenance of productive working relationships.
  • Maintains knowledge of current trends and developments in the field by reading appropriate books; journals and other literature and attending related seminars or conferences.
  • Maintains a professional approach with Assures protection and privacy of health information as attained through written, electronic or oral disclosures.
  • Cooperates and maintains good rapport with nursing staff, medical staff, and other departments.
  • Seeks guidance and remains knowledgeable of, and complies with, all applicable federal and state laws, as well as hospital polices that apply.
  • Complies with hospital expectations regarding ethical behavior and standards of conduct.
  • Complies with federal and hospital requirements in the areas of protected health information and patient information.
  • Reconsiderations, assists with appeals as needed, arrange peer to peer level reviews, and report the outcomes to the VP of Care Management and Team.
  • Provides education to nursing staff. leadership team, and providers regarding documentation.
  • Actively works with the business office regarding resolution of appeals/denials and retrospective reviews. 

Education: Bachelor's in Behavioral Health, Social Work, Counseling, Nursing or Psychology required. Master's degree preferred.

Experience: Minimum of 2 years of utilization review experience in a hospital setting required. Minimum of 2 years of case management experience, including discharge planning in a hospital setting required.

Licensure: Certified Case Manager (CCM) or Accredited Case Manager (ACM) preferred. Basic Life Support (BLS) and Handle with Care (HWC) obtained during orientation, if applicable.

Skills: Must have strong knowledge of medications and demonstrate exceptional time management, data entry, and communication skills. Must be detail oriented.#INDEEDLOW

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