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Utilization Review Lpc Jobs in California (NOW HIRING)

Acadia Healthcare

Utilization Specialist PRN

Riverside, CA · On-site

$31 - $50/hr

Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides ...

Pacific Grove

Utilization Specialist PRN

Riverside, CA · On-site

$31 - $50/hr

Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides ...

Acadia Healthcare

Utilization Specialist PRN

Riverside, CA · On-site

$31 - $50/hr

Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides ...

Newport Academy

Discharge Planner

Orange, CA · On-site

Maintain consistent contact with the utilization review team to monitor current and anticipated ... State of California License Preferred (LCSW, LPC or LMFT) * Minimum of one (1) experience in a ...

Newport Academy

Discharge Planner

Orange, CA · On-site

Maintain consistent contact with the utilization review team to monitor current and anticipated ... State of California License Preferred (LCSW, LPC or LMFT) * Minimum of one (1) experience in a ...

Integrated Resources INC

Case Manager BH

San Diego, CA · On-site

Authorizes and reviews utilization of mental health and substance abuse services provided in ... LPC, LCSW or RN Education: All licenses require a Masters Degree EXCEPT for the RN. The RN requires ...

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Utilization Review Lpc information

What is the difference between Utilization Review Lpc vs Mental Health Counselor?

AspectUtilization Review LpcMental Health Counselor
CredentialsLicensed Professional Counselor (LPC)Licensed Professional Counselor (LPC) or similar
Work EnvironmentInsurance companies, healthcare organizations, utilization review settingsPrivate practice, clinics, hospitals, community agencies
Primary FocusReviewing medical necessity, authorizing services, ensuring complianceProviding therapy, mental health assessment, treatment planning

The Utilization Review LPC primarily focuses on evaluating healthcare services for insurance approval and compliance, often working within healthcare organizations. In contrast, a Mental Health Counselor provides direct patient care through therapy and assessments. While both roles require LPC licensure, their work environments and responsibilities differ significantly.

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For Utilization Review Lpc jobs in California, the most frequently searched job titles are:

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Utilization Review Lpc jobs near you
Infographic showing various Utilization Review Lpc job openings in California as of August 2026, with employment types broken down into 8% As Needed, and 92% Full Time. Highlights an 92% In-person, and 8% Remote job distribution.

Utilization Specialist - Full Time

San Jose, CA

Acadia Healthcare
Hospitals • 10K+ employees

6.2

Company rating: 6.2 out of 10

Based on 190 frontline employees who took The Breakroom Quiz

697th of 895 rated healthcare providers

People enjoy working here

Recommended by students

Recommended by parents

Learn more about Acadia Healthcareexternal

$60/hr

Full-time

Posted 28 days ago

Job description

Salary Range:LMFT/LPCC/LCSW $33.00 - $50.00 per hour  - Based on Experience

Salary Range: LVN $33.00  - $43.75 per hour - Based on Experience

Salary Range: RN: $60.00 - per hour -  Based on Experience 

Location: ONSITE ONLY

San Jose Behavioral Health is currently seeking a Utilization Review Specialist - Full Time to assist the Utilization Department staff with comprehensive inpatient care and treatment within our 133-bed Acute Psychiatric Hospital. San Jose Behavioral Health is where adults and adolescents can receive comprehensive inpatient treatment for a range of behavioral and mental health disorders. Conveniently located in the heart of San Jose the hospital is easily accessible to residents in Santa Clara County, San Mateo County, and Alameda County. 

PURPOSE STATEMENT: 

The Utilization Review Specialist coordinates and assesses the inpatient census for appropriate alternate health care service needs. Responsibilities include performing on-site and/or telephonic concurrent review of acute and sub-acute services, as well as pre-certification review for all services following the plans authorization guidelines. Also, coordinate with appropriate discharge planning processes, providing feedback on documentation processes; and functions as a resource to the clinical team regarding approved criteria, practice guidelines and alternative treatment options.


ESSENTIAL FUNCTIONS: 

  • Act as liaison between managed care organizations and the facility professional clinical staff. 
  • Conduct reviews, in accordance with certification requirements, of insurance plans or other managed care organizations (MCOs) and coordinate the flow of communication concerning reimbursement requirements. 
  • Monitor patient length of stay and extensions and inform clinical and medical staff on issues that may impact length of stay.  
  • Gather and develop statistical and narrative information to report on utilization, non-certified days (including identified causes and appeal information), discharges and quality of services, as required by the facility leadership or corporate office. 
  • Conduct quality reviews for medical necessity and services provided.   
  • Facilitate peer review calls between facility and external organizations.  
  • Initiate and complete the formal appeal process for denied admissions or continued stay.  
  • Assist the admissions department with pre-certifications of care.  
  • Provide ongoing support and training for staff on documentation or charting requirements, continued stay criteria and medical necessity updates. 

OTHER FUNCTIONS:  

  • Perform other functions and tasks as assigned. 

EDUCATION/EXPERIENCE/SKILL REQUIREMENTS: 

  • Associate Degree in Nursing(LPN/LVN/RN) Required. 
  • Bachelors or Masters degree in Social Work, Behavioral Health Or Mental Health, Nursing or Other related health field preferred.
  • Two or more year's experience with the population of the facility preferred. 
  • Previous experience in utilization management is preferred 

LICENSES/DESIGNATIONS/CERTIFICATIONS:  

  • LMFT, LMSW, LCSW, LPC, LPC-I within the state where the facility provides services; or current clinical professional license or certification, as required, within the state where the facility provides services. 
  • CPR and de-escalation and restraint certification required (training available upon hire and offered by facility.   

 

ADDITIONAL REGULATORY REQUIREMENTS: 

While this job description is intended to be an accurate reflection of the requirements of the job, management reserves the right to add or remove duties from particular jobs when circumstances  
(e.g. emergencies, changes in workload, rush jobs or technological developments) dictate.

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About Acadia Healthcare

Sourced by ZipRecruiter

Acadia Healthcare is a leading provider in the healthcare and hospital industry, based in Franklin, Tennessee, United States. The company is recognised for its commitment to creating a behavioural health network that provides accessible, high-quality treatment options for individuals suffering from mental health issues, addiction, eating disorders, and PTSD. Acadia Healthcare was founded in 2005, with the mission to create a world-class organization that sets the standard of excellence in the treatment of specialty behavioural health and addiction disorders.

Industry

Hospitals

Company size

10,000+ Employees

Headquarters location

Franklin, TN, US

Year founded

2005

Social media

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