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Utilization Review Behavioral Health Rn Jobs (NOW HIRING)

Skyway Behavioral Health

IL · On-site

$60K - $70K/yr

... Utilization Review Department policies and procedures. * Maintain completion of all competencies associated with role and in accordance with Skyway Behavioral Health policies and subsequent Joint ...

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Raleigh Oaks Behavioral Health

Current licensure as an LPN or RN or current clinical professional license or certification, as ... Raleigh Oaks Behavioral Health offers a comprehensive benefit plan and a competitive salary ...

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Trinity Health

RN - Utilization Review

Elmhurst, NY · On-site

$2.8K/wk

Details Client Name New York City Health and Hospitals Corporation-Rikers Island Job Type Travel Offering Nursing Profession RN Specialty Utilization Review Job ID 19030015 Job Title RN - Utilization ...

CommonSpirit Health

Utilization Review RN

Centennial, CO · On-site

Job Summary and Responsibilities As our Utilization Review RN, you will meticulously review medical ... Bachelor's Degree in Nursing (BSN) or related healthcare field. At least five (5) years of nursing ...

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

As of Sep 14, 2026, the average hourly pay for utilization review behavioral health rn 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 states have the most Utilization Review Behavioral Health Rn jobs?

States with the most job openings for Utilization Review Behavioral Health Rn jobs include:

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For Utilization Review Behavioral Health Rn jobs, the most frequently searched job titles are:

Infographic showing various Utilization Review Behavioral Health Rn job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 15% Part Time, and 6% Contract. Highlights an 92% Physical, 1% Hybrid, and 7% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

RN Case Manager - Behavioral Health Utilization Review

Goddard, KS • On-site

MLee Healthcare Staffing and Recruiting, Inc
Health Care and Social Assistance • 51 - 200 employees
Learn more about MLee Healthcare Staffing and Recruiting, Incexternal

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Posted 2 days ago

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Job description

RN Case Manager - Behavioral Health Utilization Review

Join a dedicated healthcare team in the Midwest region as a Registered Nurse Case Manager specializing in behavioral health utilization review. In this role, you will collaborate closely with healthcare providers and members to evaluate patient needs and benefit requirements, ensuring optimal resource use. You will manage patient cases within the behavioral health unit, reviewing medical necessity for admissions, continued stays, and services.

Essential Responsibilities:

  • Assess patient situations and conduct reviews to ensure compliance with eligibility, benefits, policies, and contracts.
  • Manage appeals and coordinate comprehensive reviews of medical records to verify accurate admission and diagnosis information.
  • Promote improved quality of care and support reduced hospital stays when safe and appropriate.
  • Advise pre-certification staff and maintain records and reports related to non-clinical activities.
  • Coordinate with insurance companies to secure authorizations for behavioral health services, ensuring adherence to payer requirements and facility standards.
  • Maintain thorough documentation of utilization review activities, including clinical justifications and authorization requests.
  • Assist with triage screenings for incoming behavioral health patients to determine immediate care needs and facilitate timely care delivery.
  • Provide psychosocial support to patients and families, addressing emotional, social, and financial barriers.
  • Serve as a liaison between healthcare teams and patients/families to ensure smooth care transitions.
  • Support discharge planning processes when needed, ensuring safe and appropriate discharge plans.
  • Conduct safety assessments and make protective reports for adults and children as indicated.
  • Participate in ongoing professional development and mandatory training, including de-escalation techniques.
  • Adhere to privacy and security regulations regarding Protected Health Information (PHI).
  • Maintain effective communication and professional relationships with patients, team members, physicians, and external agencies.

Education and Experience:

  • Graduate of a nursing or Bachelor of Social Work (BSW) program.
  • Experience in behavioral health settings, particularly crisis management and inpatient care.

Licenses and Certifications:

  • Current licensure as a Registered Nurse (RN) or BSW in the relevant state.
  • Current Basic Life Support (BLS) certification from American Heart Association or American Red Cross within 30 days of hire.
  • De-escalation training required within six months of start date.

Preferred Qualifications:

  • Experience in utilization review, insurance coordination, and interdisciplinary team collaboration.
  • Advanced degrees such as BSN or MSW are a plus.

Skills and Abilities:

  • Strong collaboration skills with interdisciplinary teams to ensure high-quality care.
  • Familiarity with community resources, mental health services, and post-acute care.
  • Basic computer proficiency and experience documenting in electronic health records.
  • Ability to multitask, prioritize, and communicate effectively.

Physical Requirements: Medium work involving occasional exertion up to 50 lbs and frequent standing or walking (26-50% of the day).

This position offers a competitive salary and benefits package, providing a meaningful opportunity to impact behavioral health care in a supportive regional healthcare environment.

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