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How much do remote psychiatric utilization review jobs pay per hour?

As of Jun 12, 2026, the average hourly pay for remote psychiatric 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 professionals in Remote Psychiatric Utilization Review roles, and how can they be addressed?

Professionals in Remote Psychiatric Utilization Review often encounter challenges such as interpreting clinical documentation remotely, ensuring timely case reviews, and maintaining effective communication with providers and insurance companies. Staying organized and developing strong time-management skills are key to managing caseloads efficiently. Regularly participating in team meetings and leveraging secure digital communication tools can help bridge the gap between remote team members and facilitate collaboration. Continuous education on evolving mental health regulations and payer guidelines is also essential to remain effective in the role.

What is a Remote Psychiatric Utilization Review position?

A Remote Psychiatric Utilization Review position involves evaluating mental health treatment plans and services to ensure they are medically necessary and meet insurance or regulatory guidelines. Professionals in this role typically review clinical documentation, assess the appropriateness of care, and make recommendations regarding the coverage of psychiatric services, all while working remotely. They collaborate with healthcare providers, insurance companies, and sometimes patients, to facilitate quality care and manage costs. Strong knowledge of mental health diagnoses, treatment protocols, and insurance policies is essential for success in this position.

What is the difference between Remote Psychiatric Utilization Review vs Remote Mental Health Case Manager?

AspectRemote Psychiatric Utilization ReviewRemote Mental Health Case Manager
CredentialsLicensed Psychiatrist, Psychologist, or Certified Utilization Review ProfessionalLicensed Clinical Social Worker, Mental Health Counselor, or Case Management Certification
Work EnvironmentReviewing medical records, insurance documentation, and making utilization decisions remotelyCoordinating care, assessing client needs, and providing support remotely
Employer & Industry UsageInsurance companies, health plans, and utilization review organizationsHealthcare providers, community agencies, and insurance companies

Remote Psychiatric Utilization Review focuses on evaluating medical necessity for psychiatric services, often within insurance and healthcare organizations. In contrast, Remote Mental Health Case Managers actively coordinate and support patient care. Both roles require mental health credentials but differ in daily tasks and focus areas.

What are the key skills and qualifications needed to thrive as a Remote Psychiatric Utilization Review specialist, and why are they important?

To thrive as a Remote Psychiatric Utilization Review specialist, you need a clinical background in nursing, social work, or mental health counseling, typically with relevant licensure (such as RN, LCSW, or LPC) and experience in psychiatric care. Familiarity with utilization review platforms, electronic health records (EHRs), and managed care systems is essential, along with certifications like CCM (Certified Case Manager) being advantageous. Strong analytical thinking, attention to detail, and effective verbal and written communication skills are crucial for evaluating cases and coordinating with providers. These competencies ensure accurate assessments, compliance with regulations, and optimal patient outcomes while managing costs in a remote work environment.
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Remote Psychiatric Utilization Review jobs near you
Infographic showing various Remote Psychiatric Utilization Review job openings in the United States as of June 2026, with employment types broken down into 2% As Needed, 86% Full Time, 9% Part Time, and 3% 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.
Senior Utilization Review Specialist

Senior Utilization Review Specialist

Within Health

Remote

Full-time

Posted 3 days ago

Job description

Who We Are
Within Health is revolutionizing eating disorder treatment through our innovative telehealth platform. We provide remote clinical services at the Partial Hospitalization Program (PHP) and Intensive Outpatient Program (IOP) levels of care. Our mission is to transform lives by increasing access to quality eating disorder treatment, improving patient outcomes, and fostering healing in a compassionate, stigma-free environment. We combine clinical expertise with cutting-edge technology to address the complex needs of individuals with eating disorders, creating a future where effective treatment is accessible to all who need it.
Our Culture
Within is a purpose-driven physician-led healthcare organization committed to innovation, compassion, and integrity. We bring together clinicians, technologists, and eating disorder professionals to transform lives through exceptional care. In 2025 and 2026, we were named one of Forbes' Top Startup Employers in the U.S, a recognition based on performance and reputation.
The Role
The Senior Utilization Review Specialist (SURS) provides administrative support and management to Within and clients. Additionally, The URS works collaboratively with insurance companies, and clinical staff.
What You'll Do
  • Maintain efficient methods for ensuring the medical necessity and appropriateness of prescribed level of care.
  • Oversee the entire UR process for client journey from admission to discharge.
  • Complete precertification process and associated documentation.
  • Audit charts to ensure content reflects medical necessity guidelines.
  • Ensure continued stay reviews are completed, accurate, and timely.
  • Assist clinical staff with appeals when necessary.
  • Provide support to clinical staff around the UR process.
  • Train new clinical staff on UR process and procedures including documentation of medical necessity.
  • Provide ongoing training for existing staff on UR and documentation.
  • Submit initial assessments, continued stay assessments, and payer requested reviews following the established policies and governing regulations to ensure the payer receives notification and documentation that the client meets medical necessity for admission at the correct level of care.
  • Communicate with commercial payers per request of payer and Within policy.
  • Issue complete and concise communications, submitting the critical elements that establish medical necessity to ensure timely authorization and reduce the potential for denials.
  • Follow-up on approval/denial if no reply is received within 12-24 hours by telephone or payer portals.
  • Document all actions and activities in the case management and billing management systems, including but not limited to, initial submissions, escalations, avoidable days, payer contacts, authorization numbers, denials, etc. (Documentation must be clear and complete for billing and case review).
  • Will advise clinical staff on peer review and/or appeals process and provide oversight when necessary.
  • Communicate with Admissions Specialists and other members of the Clinical team to ensure effective collaboration between all disciplines.
  • Compiles reports and statistics for presentation to the Utilization Review Committee upon request.
  • Other duties assigned by the supervisor.

Qualifications
  • Experience in a business or health-related field or an equal combination of education and applicable experience within a higher level of care eating disorders setting.
  • Minimum of 1 year experience performing insurance verification, utilization review or intake assessments in a Residential Treatment Center (RTC), Partial Hospitalization Program (PHP) and/or Intensive Outpatient Program (IOP) environment, eating disorders setting preferred.
  • Ability to assist in the development and process improvement of obtaining payor authorization and concurrent appeals.
  • Manages time effectively, setting priorities, and consistently meeting deadlines.
  • Ability to effectively interact with insurance companies.
  • Demonstrates initiative and proactive approach to problem resolution.
  • Can perform well independently and on a team.
  • Assumes accountability for behaviors consistent with the customer service policy.
  • Competent in computer based charting, clinical, and non-clinical software programs.
  • Understands commercial coverage details.
  • Operates office equipment efficiently.
  • Demonstrates appropriate judgment and discretion in the UR Coordinator role.

Physical & Environmental Requirements
  • Must have reliable internet connection.
  • Must be comfortable operating a computer and smart-phone and navigate applications within macOS and iOS.
  • Must be comfortable communicating with colleagues via chat, telephone, and video calls.
  • Must be able to sit for the majority of the shift.
  • This is a work-from-home position. Work should be performed in a private, quiet space with minimal background noise.

What We Offer
  • Competitive compensation package including salary commensurate with experience
  • Remote work flexibility with a results-driven culture
  • Comprehensive health benefits that reflect our commitment to wellbeing
  • The chance to directly transform lives and makes treatment accessible
  • Collaborative and innovative work environment with a team passionate about our mission
  • Professional development opportunities and support for continued growth

Apply