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Remote Behavioral Health Utilization Review Jobs

Umpqua Health

Utilization Review Nurse

$85K - $105K/yr

UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR ... We provide integrated, whole-person care through primary care, specialty care, behavioral health ...

Umpqua Health

Utilization Review Nurse

$85K - $105K/yr

Utilization Review Nurse Remote Ability to travel on-site to 3031 NE Stephens St., Roseburg OR ... We provide integrated, whole-person care through primary care, specialty care, behavioral health ...

Oscar Health

Utilization Review Nurse

Miami, FL · Remote

$35 - $45.94/hr

This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois ... We're on a mission to change health care -- an experience made whole by our unique backgrounds and ...

Oscar Health

Utilization Review Nurse

Dallas, TX · Remote

$35 - $45.94/hr

This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois ... We're on a mission to change health care -- an experience made whole by our unique backgrounds and ...

Oscar Health

Utilization Review Nurse

Tempe, AZ · Remote

$35 - $45.94/hr

This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois ... We're on a mission to change health care -- an experience made whole by our unique backgrounds and ...

Oscar Health

Utilization Review Nurse

Atlanta, GA · Remote

$35 - $45.94/hr

This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois ... We're on a mission to change health care -- an experience made whole by our unique backgrounds and ...

Centene

Utilization Review Clinician - ABA

$27.02 - $48.55/hr

Performs reviews of member's care and health status of Applied Behavioral Analysis (ABA) services ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...

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

As of Aug 28, 2026, the average hourly pay for remote 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 remote behavioral health utilization review?

A Remote Behavioral Health Utilization Review job involves evaluating behavioral health treatment plans and services to ensure they meet insurance guidelines, medical necessity, and regulatory requirements. Professionals in this role review clinical documentation, assess patient needs, and collaborate with healthcare providers to determine appropriate levels of care. They work remotely, often for insurance companies or healthcare organizations, to authorize or deny coverage based on established criteria. Strong clinical knowledge, attention to detail, and communication skills are essential for success in this role.

What are the typical daily responsibilities for someone working in remote behavioral health utilization review?

In a Remote Behavioral Health Utilization Review role, your daily tasks often include reviewing clinical documentation, assessing medical necessity for behavioral health services, and making authorization or denial recommendations according to established guidelines. You’ll frequently interact with providers, case managers, and insurance representatives to gather information and clarify care requests. Additionally, your day may involve documenting decisions, participating in case review meetings, and staying updated on evolving policies. Working remotely, you'll communicate primarily via secure electronic systems, phone, and video conferencing. This structure typically offers flexibility but also requires strong self-motivation and organization.

What are the key skills and qualifications needed to thrive in remote behavioral health utilization review, and why are they important?

To excel in Remote Behavioral Health Utilization Review, candidates generally need a clinical background such as a nursing or social work license, strong analytical skills, and experience with behavioral health diagnoses and treatment planning. Familiarity with utilization management software, electronic health records (EHRs), and insurance coding systems is often required, along with certifications like CCM (Certified Case Manager) or URAC accreditation being valued. Excellent communication, critical thinking, and organizational skills help professionals handle complex cases and collaborate effectively in a virtual team environment. These competencies ensure accurate review of mental health services, compliance with payer requirements, and optimal patient outcomes.

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Remote Behavioral Health Utilization Review jobs near you
Infographic showing various Remote Behavioral Health Utilization Review job openings in the United States as of August 2026, with employment types broken down into 95% Full Time, and 5% Part Time. Highlights an 100% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

Remote Utilization Manager - Inpatient

Watkins, CO • On-site, Remote

AllHealth Network
Offices of Mental Health Practitioners • 501 - 1,000 employees
Learn more about AllHealth Networkexternal

$75K - $83K/yr

Full-time

Posted 22 days ago

Job description

Join Our Team as a Utilization Review Manager (RN or Social Worker)
Are you a compassionate nurse or social worker looking to make a real difference in behavioral health? AllHealth Network is seeking a dedicated Utilization Review Specialist to help ensure clients receive the care they need while collaborating with a team that values your expertise and commitment.
Why AllHealth Network?
  • Work in a supportive, interdisciplinary environment that values your professional judgment
  • Enjoy opportunities for ongoing learning, growth, and advancement
  • Make a tangible impact on client outcomes and community well-being
  • Be part of a mission-driven organization dedicated to high-quality, client-centered care

What You'll Do:
  • Advocate for clients by communicating clinical information to secure timely and appropriate care authorizations
  • Lead utilization reviews for clients in our Acute Treatment and Crisis Stabilization Units
  • Collaborate with nurses, social workers, case managers, and other healthcare professionals
  • Ensure quality care by coordinating with payers, treatment teams, and billing staff
  • Maintain accurate records and use your problem-solving skills to navigate challenging cases

What We're Looking For:
  • Registered Nurse (BSN/RN) or Master's in a human services field
  • Clinical license (LPC, LCSW) required
  • Minimum 2 years' experience in behavioral health utilization management, care coordination, or case management
  • Strong communication, organization, and advocacy skills
  • Experience with insurance processes, electronic records, and multidisciplinary teamwork

Ready to take your career to the next level with a team that cares as much as you do? Apply today and help us transform lives-one client at a time.
$75,000 - $83,000 annually
AllHealth Network also provides a 10% compensation differential for individuals who are bilingual in English and Spanish (language proficiency testing required).
The base salary range represents the low and high end of the AllHealth Network hiring range for this position. Actual salaries will vary and may be above or below the range based on various factors including but not limited to experience, education, training, merit, and the ability to embody the AllHealth Network mission and values. The range listed is just one component of AllHealth Networks' total compensation package for employees. Other rewards may include short-term and long-term incentives as well as a generous benefits package detailed below.
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

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