Behavioral Health Utilization Reviewer
Louisiana Blue · Latvia
Utilization Review
Remote
Nurse
Demand75
Career growth65
Healthcare fit88
Remote potential65
5-year outlook
Stable payer-side utilization review role with salary growth tied to licensure, managed care experience, and leadership progression. Exact compensation varies by Louisiana market and employer, but demand for behavioral health utilization review remains steady.
Clinical license
Required
Applicant reach
moderate
Seniority
mid
Employment type
full-time
Date found
2026-10-03
Intelligence details
Flexible work details
- Engagement type
- Permanent
- Hours
- Full-time
- Eligible countries
- United States
- License jurisdiction
- US
- Profession fit
- Nurse
- Rate period
- Annual
Listing via Himalayas.
Eligibility, licensing, and location restrictions can change. Always confirm details on the source posting before applying.
Why this is worth applying to
A strong transition for licensed behavioral health clinicians seeking non-clinical payer-side work with predictable hours and no direct patient care. Less suitable for those without a required behavioral health license or those needing immigration sponsorship.
Who should apply
Licensed behavioral health clinicians such as RNs, LPNs, LCSWs, LPCs, LMFTs, and LMSWs with at least 3 years of behavioral health experience, especially those in Louisiana or willing to relocate and interested in managed care or utilization review.
CV angle
Highlight behavioral health clinical assessment, treatment planning, level-of-care decisions, interdisciplinary collaboration, and documentation. Emphasize any managed care, insurance, CPT coding, Medicare/Commercial, appeals, EHR, and case management system experience.
Skills to highlight
- Behavioral health clinical assessment
- Medical necessity criteria (InterQual)
- Utilization review
- Appeals and regulatory timelines
- Managed care
- CPT coding and billing
- EHR and case management systems
- Provider and member communication
Role summary
Reviews behavioral health pre-authorization, concurrent, and retrospective requests against InterQual and medical policy, refers cases not meeting criteria to the Psychiatric Medical Director, supports appeals, documents decisions, and communicates with providers and members.
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