Utilization Review Specialist
Raleigh, NC · On-site
Triangle Springs is a 77-bed behavioral health hospital located in Raleigh, North Carolina ... How you'll contribute Utilization Review Specialist facilitates clinical reviews on all patient ...
Raleigh, NC · On-site
Triangle Springs is a 77-bed behavioral health hospital located in Raleigh, North Carolina ... How you'll contribute Utilization Review Specialist facilitates clinical reviews on all patient ...
Raleigh, NC · On-site
Triangle Springs is a 77-bed behavioral health hospital located in Raleigh, North Carolina ... How you'll contribute Utilization Review Specialist facilitates clinical reviews on all patient ...
Raleigh, NC · On-site
$60 - $85/hr
Triangle Springs is a 77-bed behavioral health hospital located in Raleigh, North Carolina ... How you'll contribute Utilization Review Specialist facilitates clinical reviews on all patient ...
New
Raleigh, NC · On-site
$60 - $85/hr
Triangle Springs is a 77-bed behavioral health hospital located in Raleigh, North Carolina ... How you'll contribute Utilization Review Specialist facilitates clinical reviews on all patient ...
New
Oxford, NC · On-site
One year utilization and review experience. Experience with MCG authorization criteria preferred. Knowledge of current nursing principles, techniques, procedures; knowledge of current utilization ...
Oxford, NC · On-site
One year utilization and review experience. Experience with MCG authorization criteria preferred. Knowledge of current nursing principles, techniques, procedures; knowledge of current utilization ...
Oxford, NC · On-site
One year utilization and review experience. Experience with MCG authorization criteria preferred. Knowledge of current nursing principles, techniques, procedures; knowledge of current utilization ...
Oxford, NC · On-site
One year utilization and review experience. Experience with MCG authorization criteria preferred. Knowledge of current nursing principles, techniques, procedures; knowledge of current utilization ...
The Utilization Management Nurse performs medical necessity and benefit review requests in ... Experience with both inpatient and outpatient reviews including Behavioral Health, DME, Genetic ...
Quick apply
The Utilization Management Nurse performs medical necessity and benefit review requests in ... Experience with both inpatient and outpatient reviews including Behavioral Health, DME, Genetic ...
Case Manager - Utilization Review Location ... Granville Health System, Oxford NC About Granville Health System: For over a century, Granville ...
Case Manager - Utilization Review Location ... Granville Health System, Oxford NC About Granville Health System: For over a century, Granville ...
Case Manager - Utilization Review Location ... Granville Health System, Oxford NC About Granville Health System: For over a century, Granville ...
Case Manager - Utilization Review Location ... Granville Health System, Oxford NC About Granville Health System: For over a century, Granville ...
Raleigh, NC · On-site
Utilization and Quality Management/Outcomes experience preferred. Previous work experience with a ... Prior experience in case management, home health, discharge planning, or Concurrent review.
Raleigh, NC · On-site
Utilization and Quality Management/Outcomes experience preferred. Previous work experience with a ... Prior experience in case management, home health, discharge planning, or Concurrent review.
Chapel Hill, NC · On-site +1
The Utilization Management Nurse performs medical necessity and benefit review requests in ... reviews including Behavioral Health, DME, Genetic Testing, Clinical Trials, Oncology, and/or ...
Chapel Hill, NC · On-site +1
The Utilization Management Nurse performs medical necessity and benefit review requests in ... reviews including Behavioral Health, DME, Genetic Testing, Clinical Trials, Oncology, and/or ...
Our values and behaviors are the root of our culture. They are how we achieve our strategy, power ... review the education and awareness resources at HB531 | Florida Agency for Health Care ...
Our values and behaviors are the root of our culture. They are how we achieve our strategy, power ... review the education and awareness resources at HB531 | Florida Agency for Health Care ...
Provides formal and informal education to physicians and the healthcare team to improve processes and outcomes related to utilization review and compliance with utilization management plan. * Gives ...
Provides formal and informal education to physicians and the healthcare team to improve processes and outcomes related to utilization review and compliance with utilization management plan. * Gives ...
Durham, NC · On-site
Provides formal and informal education to physicians and the healthcare team to improve processes and outcomes related to utilization review and compliance with utilization management plan. * Gives ...
Durham, NC · On-site
Provides formal and informal education to physicians and the healthcare team to improve processes and outcomes related to utilization review and compliance with utilization management plan. * Gives ...
Our values and behaviors are the root of our culture. They are how we achieve our strategy, power ... review the education and awareness resources at HB531 | Florida Agency for Health Care ...
Our values and behaviors are the root of our culture. They are how we achieve our strategy, power ... review the education and awareness resources at HB531 | Florida Agency for Health Care ...
Durham, NC · On-site
Provides formal and informal education to physicians and the healthcare team to improve processes and outcomes related to utilization review and compliance with utilization management plan. * Gives ...
Durham, NC · On-site
Provides formal and informal education to physicians and the healthcare team to improve processes and outcomes related to utilization review and compliance with utilization management plan. * Gives ...
Durham, NC · On-site
Provides formal and informal education to physicians and the healthcare team to improve processes and outcomes related to utilization review and compliance with utilization management plan. * Gives ...
Durham, NC · On-site
Provides formal and informal education to physicians and the healthcare team to improve processes and outcomes related to utilization review and compliance with utilization management plan. * Gives ...
Durham, NC · On-site
$15.96 - $23.94/hr
The Behavioral Health Utilization Management Representative I - Backoffice Support is responsible ... Reviews documentation for completeness and refers cases requiring clinical review to the ...
Durham, NC · On-site
$15.96 - $23.94/hr
The Behavioral Health Utilization Management Representative I - Backoffice Support is responsible ... Reviews documentation for completeness and refers cases requiring clinical review to the ...
Durham, NC · On-site
$15.96 - $23.94/hr
The Behavioral Health Utilization Management Representative I - Backoffice Support is responsible ... Reviews documentation for completeness and refers cases requiring clinical review to the ...
Durham, NC · On-site
$15.96 - $23.94/hr
The Behavioral Health Utilization Management Representative I - Backoffice Support is responsible ... Reviews documentation for completeness and refers cases requiring clinical review to the ...
... utilization trends, and performance metrics to drive continuous improvement. * Serve as the senior ... For further information, please review the Know Your Rights notice from the Department of Labor.
... utilization trends, and performance metrics to drive continuous improvement. * Serve as the senior ... For further information, please review the Know Your Rights notice from the Department of Labor.
Provides formal and informal education to physicians and the healthcare team to improve processes and outcomes related to utilization review and compliance with utilization management plan. * Gives ...
Provides formal and informal education to physicians and the healthcare team to improve processes and outcomes related to utilization review and compliance with utilization management plan. * Gives ...
Provides formal and informal education to physicians and the healthcare team to improve processes and outcomes related to utilization review and compliance with utilization management plan. * Gives ...
Provides formal and informal education to physicians and the healthcare team to improve processes and outcomes related to utilization review and compliance with utilization management plan. * Gives ...
$30.1K - $37.7K
3% of jobs
$37.7K - $45.3K
11% of jobs
$48.8K is the 25th percentile. Wages below this are outliers.
$45.3K - $52.9K
23% of jobs
The median wage is $59.4K / yr.
$52.9K - $60.5K
15% of jobs
$60.5K - $68.1K
5% of jobs
$68.1K - $75.7K
3% of jobs
$75.7K - $83.3K
3% of jobs
$83.3K - $90.9K
2% of jobs
$90.9K - $98.5K
0% of jobs
$98.5K - $106.1K
0% of jobs
$108.2K is the 75th percentile. Wages above this are outliers.
$106.1K - $113.7K
34% of jobs
$30.1K
$77.5K
$113.7K
| Aspect | Senior Behavioral Health Utilization Review | Behavioral Health Case Manager |
|---|---|---|
| Credentials | Licenses (e.g., RN, LCSW), certifications in utilization review | Licenses (e.g., LCSW, LPC), case management certifications |
| Work Environment | Healthcare facilities, insurance companies, managed care organizations | Hospitals, community clinics, outpatient centers |
| Primary Focus | Reviewing medical necessity, authorizing services, ensuring appropriate utilization | Coordinating care, supporting patient needs, connecting clients with resources |
While both roles involve behavioral health, the Senior Behavioral Health Utilization Review focuses on evaluating and authorizing services based on medical necessity, often within insurance or managed care settings. In contrast, Behavioral Health Case Managers actively coordinate patient care and support recovery efforts. Understanding these differences helps clarify career paths and employer expectations in behavioral health services.
The most popular types of Behavioral Health Utilization Review jobs in Raleigh, NC are:
For Senior Behavioral Health Utilization Review jobs in Raleigh, NC, the most frequently searched job titles are:
The top searched job categories for Senior Behavioral Health Utilization Review jobs in Raleigh, NC are:
Cities near Raleigh, NC with the most Senior Behavioral Health Utilization Review job openings:

Full-time
Medical, Dental, Vision, Life, Retirement, PTO
Posted 16 days ago
5.9
Based on 273 frontline employees who took The Breakroom Quiz
766th of 898 rated healthcare providers
Your experience matters
Lifepoint Behavioral Health is part of Lifepoint Health, a diversified healthcare delivery network with facilities coast to coast. Triangle Springs is a 77-bed behavioral health hospital located in Raleigh, North Carolina, providing care for patients with mental health and substance use disorders. We are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. As a Registered Nurse (RN) joining our team, you're embracing a vital mission dedicated to making communities healthier. Join us on this meaningful journey where your skills, compassion, and dedication will make a remarkable difference in the lives of those we serve.
How you'll contribute
Utilization Review Specialist facilitates clinical reviews on all patient admissions and continued stays. UR analyzes patient records to determine legitimacy of admission, treatment, and length of stay and interfaces with managed care organizations, external reviewers and other payers. UR advocates on behalf of patients with substance abuse, dual diagnosis, psychiatric or emotional disorders to manage care providers for necessary treatment. UR contacts external case managers/managed care organizations for certification of insurance benefits throughout the patient's stay and assists the treatment team in understanding the insurance company's requirements for continued stay and discharge planning.
Job Responsibilities
What we're looking for
Education: Bachelor's degree required. Master's degree preferred.
Experience: Previous utilization review experience in a psychiatric healthcare facility preferred.
License: Current unencumbered clinical license strongly preferred.
Additional Requirements: CPR certification and Crisis Prevention Training (CPI) preferred.
Why join us
We believe that investing in our employees is the first step to providing excellent patient care. In addition to your base compensation, this position also offers:
Comprehensive Benefits: Multiple levels of medical, dental, and vision coverage for full-time and part-time employees
Financial Protection & PTO: Life, accident, critical illness, hospital indemnity insurance, short- and long-term disability, paid family leave, and paid time off
Financial & Career Growth: Tuition reimbursement and 401(k) retirement package with company match
Employee Well-being: Mental, physical, and financial wellness programs, including Employee Assistance Program and discount programs
Professional Development: Ongoing learning and career advancement opportunities
Additional Perks: Shift differentials and set schedules
EEOC Statement
Lifepoint Behavioral Health is an Equal Opportunity Employer. Lifepoint Behavioral Health is committed to Equal Employment Opportunity for all applicants and employees and complies with all applicable laws prohibiting discrimination and harassment in employment.
Lifepoint Health is a leader in community-based care and driven by a mission of Making Communities Healthier. Our diversified healthcare delivery network spans 29 states and includes 63 community hospital campuses, 32 rehabilitation and behavioral health hospitals, and more than 170 additional sites of care across the healthcare continuum, such as acute rehabilitation units, outpatient centers and post-acute care facilities. We believe that success is achieved through talented people. We want to create places where employees want to work, with opportunities to pursue meaningful and satisfying careers that truly make a difference in communities across the country.We employ and provide care to people from all walks of life. We are committed to promoting healing, providing hope, preserving dignity and producing value with an inclusive workforce in which diversity is leveraged, respected, and reflective of the patients, family members, customers and team members we serve.Get the full story on Breakroom
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Lifepoint Health serves patients, clinicians, communities and partners across the healthcare continuum. Our diversified healthcare delivery network extends from coast to coast, consisting of community hospitals, rehabilitation and behavioral health hospitals, and additional sites of care.
Health care and social assistance
10,000+ Employees
Brentwood, TN, US
1999