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Anthem Utilization Review Jobs (NOW HIRING)

ncgCARE

Clinical Supervisor (3375)

Newnan, GA · On-site

$64K - $83K/yr

Monitors utilization of the caseloads of assigned team members * Provides consultation for crisis ... Reviews clinical documentation of assigned team members and makes recommendations and approvals as ...

True Team Medical

Clinical Supervisor

Winchester, VA · On-site

$61K - $83K/yr

Review clinical documentation and approve as needed to ensure quality and compliance. * Conduct ... Consumer-driven health plan coverage provided by Anthem * Wellness: When you enroll in a medical ...

Apply Early

True Team Medical

Clinical Supervisor

Suffolk, VA · Hybrid

$61K - $83K/yr

Review clinical documentation and approve as needed to ensure quality and compliance. * Conduct ... Consumer-driven health plan coverage provided by Anthem * Wellness: When you enroll in a medical ...

Apply Early

Amylyx Pharmaceuticals

Elevance Health - Anthem/CarelonRx * Assigned national and regional payer accounts * Assigned State ... utilization management frameworks, and formulary review processes. * Develop customized, data ...

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$42

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How much do anthem utilization review jobs pay per hour?

As of Jul 2, 2026, the average hourly pay for anthem utilization review 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 is an Anthem Utilization Review job?

An Anthem Utilization Review job involves assessing medical services and treatments to ensure they are necessary, cost-effective, and aligned with insurance policies. Professionals in this role review patient records, apply clinical guidelines, and collaborate with healthcare providers to determine coverage eligibility. They help prevent unnecessary procedures while supporting quality patient care. This position typically requires a healthcare background, such as nursing or case management, along with knowledge of insurance regulations and medical necessity criteria.

What does a typical day look like for someone in an Anthem Utilization Review role?

A typical day in an Anthem Utilization Review position involves evaluating medical records and authorization requests to determine if healthcare services meet established criteria for coverage. You’ll collaborate frequently with healthcare providers, case managers, and internal teams to clarify clinical information and help guide appropriate care pathways. The job is largely desk-based and requires strong organizational skills to manage multiple concurrent cases and meet tight deadlines. Most professionals in this role work within a team structure, sharing best practices and supporting each other in making objective, evidence-based decisions. This dynamic environment offers exposure to a variety of healthcare scenarios and opportunities for ongoing learning in utilization management.

What are the key skills and qualifications needed to thrive in the Anthem Utilization Review position, and why are they important?

To thrive as an Anthem Utilization Review professional, you need a background in nursing or healthcare, strong analytical abilities, and familiarity with medical terminology and insurance guidelines. Experience with clinical documentation systems, review software, and URAC or NCQA certifications are commonly required. Excellent communication, critical thinking, and attention to detail are crucial soft skills in this position. These capabilities ensure accurate review of medical necessity, effective collaboration with providers, and regulatory compliance, which are vital for quality patient outcomes and cost management.

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What cities are hiring for Anthem Utilization Review jobs? Cities with the most Anthem Utilization Review job openings:
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Anthem Utilization Review jobs near you
Infographic showing various Anthem Utilization Review job openings in the United States as of June 2026, with employment types broken down into 100% Full Time. Highlights an 94% In-person, and 6% Hybrid job distribution, with an average salary of $87,946 per year, or $42.3 per hour.
Primary Therapist I- Adult Residential Healthcare

Primary Therapist I- Adult Residential Healthcare

AMFM Healthcare

San Juan Capistrano, CA • On-site

$72K - $96K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 23 days ago

Be an early applicant

Job description

Join Our Team as a Primary Therapist at AMFM Healthcare!

Job Type: Full-time, Salary, Exempt

Work Requirement: In-person, must be willing to work over the weekend if needed.

Are you passionate about transforming lives through compassionate, evidence-based mental health care? AMFM Healthcare, a leading adult residential treatment center around the nation, is seeking a Primary Therapist to join our dedicated team. If you’re looking for a career where you can make a lasting impact, work in a supportive team environment, and grow professionally, we’d love to hear from you!

Why AMFM Healthcare?

At AMFM Healthcare, our mission is to provide personalized, comprehensive care that helps individuals achieve long-term recovery and a better quality of life. We specialize in evidence-based treatment approaches, offering a structured yet nurturing environment where clients can heal and thrive.

Your Role as a Primary Therapist

As a Primary Therapist, you will provide individual and group therapy to adults in our residential treatment program. You will work collaboratively with a multidisciplinary team to develop and implement treatment plans that support clients in their recovery journey. This role is ideal for a compassionate professional who is committed to delivering high-quality mental health care and is experienced in working with diverse populations.

What You’ll Do:

  • Conduct clinical evaluations, biopsychosocial assessments, and diagnostic assessments to develop individualized treatment plans.

  • Provide individual and group therapy sessions using evidence-based approaches such as CBT, DBT, and trauma-informed care.

  • Offer crisis counseling and intervention when needed.

  • Maintain accurate and timely Electronic Health Records (EHR).

  • Assist in insurance pre-certification/authorization and utilization review.

  • Collaborate with a multidisciplinary team to ensure comprehensive client care.

  • Support clients in developing coping skills and strategies for long-term recovery.

  • Participate in staff meetings, training sessions, and case consultations.

  • Provide emergency crisis services during work hours and after-hours as assigned.

  • Uphold ethical, legal, and professional standards at all times.


What We Offer:

  • Comprehensive Benefits Package:

    • Medical, Dental, and Vision plans through Anthem

    • FSA/HSA Accounts

    • 100% employer-paid Life/AD&D Insurance

    • 401(k) plan with employer match

    • PTO and Self-Care Day

    • Educational Assistance Reimbursement Program

    • Employee Assistance Program (EAP)

    • Health & Wellness Membership

What We’re Looking For:

  • Education: Master’s or Doctoral degree in Psychology, Social Work, Counseling, or a related field.

  • Licensure: Must be registered with the California Board of Behavioral Sciences (BBS) as an Associate or Independently licensed MFT, CSW, or PCC.

  • Experience: Working with adults diagnosed with mood disorders, anxiety disorders, personality disorders, and trauma-related conditions.

  • Clinical Skills: Strong assessment, diagnostic, and treatment planning skills.

  • Flexibility: Willingness to work some weekends on call and assist with after-hours crisis calls when needed.

  • Teamwork: Ability to work effectively in a collaborative, team-oriented environment.

  • Commitment to Excellence: Dedication to ethical practice and professional development.

Preferred Qualifications:

  • Experience in residential treatment settings

  • Specialized training or certification in trauma-informed care, substance use disorders, or other relevant areas


Make a Difference at AMFM Healthcare

At AMFM Healthcare, we are more than just a treatment center—we are a community dedicated to healing, hope, and transformation. If you are looking for a rewarding career where you can truly impact lives, we encourage you to apply today.

Join our team and be part of something meaningful!



AMFM Healthcare is committed to providing equal employment opportunities to all employees and applicants without regard to race, ethnicity, religion, color, sex (including childbirth, breast feeding and related medical conditions), gender, gender identity or expression, sexual orientation, national origin, ancestry, citizenship status, uniform service member and veteran status, marital status, pregnancy, age, protected medical condition, genetic information, disability, or any other protected status in accordance with all applicable federal, state and local laws.