Behavioral Health Utilization Manager

Banner Health

. Review prior authorization requests for outpatient behavioral health services .

Posted 11/6/2026full-timeRemote • Arizona • United StatesMid-LevelSenior💰 $28 - $47 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in behavioral health care management, including prior authorization processes, care planning, and interdisciplinary collaboration. Holds relevant licensure and possesses strong clinical experience in counseling and case management.

Highest-signal resume keywords

Master's Degree In Social WorkLicensure In Social Work, Professional Counseling, Or Marriage And FamilyClinical Experience In Counseling, Care Management, Or Case ManagementPrior Authorization ReviewInterdisciplinary Team Collaboration

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Behavioral Health Services ReviewCare ManagementCase ManagementMedical Necessity EvaluationResource Utilization MonitoringCare Plan DevelopmentTelephonic Document ReviewQuality Of Care MonitoringProcess Improvement ActivitiesDischarge Planning

Soft Skills

Critical ThinkingProblem-SolvingEffective CommunicationTime ManagementIndependent Work

Certifications & Qualifications

LCSWLMSWLPCLACLicensed Psychologist

Industry Keywords

Outpatient Behavioral Health ServicesClinical GuidelinesHealth Plan RequirementsInterdisciplinary TeamsUtilization ReviewArizona ResidencyInpatient CareResidential CareSubstance Abuse ServicesManaged Care Concepts

About the role

Key responsibilities & impact

Review prior authorization requests for outpatient behavioral health services
Ensure medical necessity and alignment with clinical guidelines and health plan requirements
Collaborate with providers and interdisciplinary teams to support timely care decisions
Manage individual members across the health care continuum
Review and authorize behavioral health and substance abuse services in inpatient, residential, and outpatient settings
Monitor care to ensure treatment is appropriate and effective
Assess, develop, implement, monitor, and document member care plans and resource utilization
Facilitate options and services to meet members’ health care needs
Provide telephonic or electronic document review
Engage internal and external resources for appropriate care planning and discharge planning
Monitor for quality-of-care concerns
Staff regularly with medical directors
Provide education and recommend alternative care plans when treatment does not meet medical necessity criteria
Conduct prior authorization, concurrent, retrospective, and appeal reviews
Lead process improvement activities for patient populations
Evaluate medical necessity and appropriateness of care
Establish collaborative relationships with physicians, payers, and interdisciplinary health care teams
Collect and communicate pertinent information for utilization and regulatory requirements
Develop and manage interdisciplinary patient discharge plans
Educate internal health care team members on case management and managed care concepts

Requirements

What you’ll need

Requires master’s degree in social work, counseling or related field or independent or associate licensure
Licensure in at least one of the following categories as required by state law: social work, professional counseling or marriage and family
Appropriate licenses include: LCSW, LMSW, LPC, LAC, or Licensed Psychologist
Three years of clinical experience in counseling, care management, case management, or care coordination in inpatient or outpatient levels of care
Working knowledge of care management, case management, hospital and community resources
Critical thinking, problem-solving, effective communication, and time management skills
Ability to work effectively independently and in an interdisciplinary team format
Arizona residency required for compliance