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Authorization Utilization Review Jobs in Arizona

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Phoenix, AZ · On-site

$71K/yr

Behavioral Health Prior Authorization Utilization Review Consultant Division of Fee for Service Management (DFSM) Job Location: Address: 150 North 18th Avenue Phoenix, Arizona 85007 This position may ...

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Authorization Utilization Review information

What are the key skills and qualifications needed to thrive as an Authorization Utilization Review Specialist, and why are they important?

To thrive as an Authorization Utilization Review Specialist, you need a solid understanding of medical terminology, healthcare regulations, and insurance policies, often backed by a clinical background or relevant certifications. Familiarity with utilization management software, electronic health records (EHR), and payer portals is typically required. Strong attention to detail, analytical thinking, and effective communication are vital soft skills for coordinating with providers and payers. These skills ensure accurate authorization decisions, regulatory compliance, and efficient patient care coordination.

What are some common challenges faced by professionals in Authorization Utilization Review roles, and how can they be addressed?

Professionals in Authorization Utilization Review often encounter challenges such as managing high caseloads, navigating complex insurance guidelines, and ensuring timely communication with providers and patients. Staying organized and up-to-date with evolving payer requirements is essential to avoid delays or denials. Building strong collaboration with clinical teams and leveraging electronic health record systems can help streamline workflows and improve efficiency in the review process.

What is the difference between Authorization Utilization Review vs Claims Reviewer?

AspectAuthorization Utilization ReviewClaims Reviewer
CredentialsTypically requires healthcare or insurance-related certifications, such as RN, CPC, or licensed healthcare professionalsOften requires similar credentials, focusing on insurance policies and claims processing
Work EnvironmentHospitals, insurance companies, healthcare facilitiesInsurance companies, third-party administrators, healthcare organizations
Industry UsageUsed to assess medical necessity before approving servicesUsed to evaluate claims for payment accuracy and compliance

Authorization Utilization Review and Claims Reviewer roles both involve insurance and healthcare knowledge, but Authorization Utilization Review focuses on pre-authorization of services, while Claims Review centers on post-service claims assessment. Understanding these differences helps clarify career paths and job expectations in healthcare insurance.

What is Authorization Utilization Review?

Authorization Utilization Review is a process used by healthcare organizations and insurance companies to assess the medical necessity and appropriateness of medical services before they are provided. The main goal is to ensure that patients receive care that is effective, efficient, and covered by their health plan. This review typically involves evaluating patient records, treatment plans, and provider requests to decide if the requested services meet established guidelines. By doing so, it helps control healthcare costs and ensures quality care for patients.
What cities in Arizona are hiring for Authorization Utilization Review jobs? Cities in Arizona with the most Authorization Utilization Review job openings:
Infographic showing various Authorization Utilization Review job openings in Arizona as of July 2026, with employment types broken down into 1% As Needed, 88% Full Time, 9% Part Time, and 2% Contract. Highlights an 91% Physical, 4% Hybrid, and 5% Remote job distribution.

Utilization Review Specialist

Lifepoint Health

Tucson, AZ

Part-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 27 days ago


LifePoint Health rating

6.0

Company rating: 6.0 out of 10

Based on 269 frontline employees who took The Breakroom Quiz

748th of 887 rated healthcare providers


Job description

Your experience matters 

El Dorado Springs Behavioral Health is part of Lifepoint Health, a diversified healthcare delivery network with facilities coast to coast. We are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. As a Utilization Review Specialistjoining our team, you're embracing a vital mission dedicated to making communities healthier . Join us on this meaningful journey where your skills, compassion and dedication will make a remarkable difference in the lives of those we serve.

How you'll contribute 

A Utilization Review Specialist who excels in this role:

  • Facilitates clinical reviews for all patient admissions and continued stays.
  • Analyzes patient records to determine the appropriateness of admission, treatment, and length of stay, and interfaces with managed care organizations, external reviewers, and other payers.
  • Advocates on behalf of patients with substance abuse, dual diagnosis, psychiatric, or emotional disorders to managed care providers to ensure access to necessary treatment.
  • Contacts external case managers and managed care organizations to obtain certification of insurance benefits throughout the patient's stay and assists the treatment team in understanding requirements for continued stay and discharge planning.
  • Demonstrates knowledge of clinical criteria and managed care requirements for inpatient and outpatient authorization, and advocates for coverage of necessary services.
  • Completes pre-certifications and re-certifications for inpatient and outpatient services; reports denials and authorization information to the appropriate resource.
  • Actively communicates with the interdisciplinary team to obtain pertinent information and provide updates on authorizations.
  • Participates in treatment team meetings to ensure staff understand coverage and to gather information for communication with external agencies.
  • Collaborates with the Director of Nursing (DON) to ensure documentation requirements are met.
  • Ensures appeals are completed thoroughly and in a timely manner.
  • Interfaces with managed care organizations, external reviewers, and other payers.
  • Communicates with physicians to schedule peer-to-peer reviews.
  • Accurately reports denials.

About our Team

Driven by a mission to help individuals regain stability and wellness, our multidisciplinary team works collaboratively to provide compassionate care while fostering a supportive, safetyfocused workplace culture for our staff and patients alike.

What we're looking for

Applicants must have a Bachelor's degree (required). Master's degree is preferred.  Additional requirements include:

  • Previous utilization review experience in a psychiatric healthcare facility preferred.
  • Current unencumbered clinical license is strongly preferred.
  • CPR certification and Crisis Prevention Training (CPI) preferred. May be required to work flexible hours and overtime

Schedule:  PRN (as needed)

This position does not have a set weekly schedule. You'll be called in to work when extra help is needed-such as covering for someone, handling busy periods, or filling gaps in the schedule. Hours can vary from week to week, and there's no guaranteed hours.
 

Why join us 

We believe that investing in our employees is the first step to providing excellent patient care. In addition to your base compensation, this position also offers: 

  • Comprehensive Benefits: Multiple levels of medical, dental and vision coverage for full-time and part-time employees.
  • Financial Protection & PTO: Life, accident, critical illness, hospital indemnity insurance, short- and long-term disability, paid family leave and paid time off.
  • Financial & Career Growth: Higher education and certification tuition assistance, loan assistance and 401(k) retirement package and company match.
  • Employee Well-being: Mental, physical, and financial wellness programs (free gym memberships, virtual care appointments, mental health services and discount programs).
  • Professional Development: Ongoing learning and career advancement opportunities.

More about El Dorado Springs

El Dorado Springs features a stateoftheart facility with over 100 private and semiprivate rooms, providing a secure and therapeutic setting focused on comfort, dignity, and healing. Patients receive 24/7 medically supervised care, evidencebased therapy, medication management, and comprehensive discharge and aftercare planning.

Accredited by The Joint Commission and certified by CMS, El Dorado Springs Behavioral Health is committed to delivering relationshipcentered, evidencebased care that improves outcomes and supports longterm recovery. 

The hospital offers a full continuum of care, including inpatient psychiatric stabilization, medically assisted detox (MAT), Partial Hospitalization Program (PHP), and Intensive Outpatient Program (IOP). These programs are designed to support individuals experiencing acute mental health symptoms, substance use disorders, or cooccurring conditions in a safe, structured environment.

EEOC Statement

El Dorado Springs Behavioral Health is an Equal Opportunity Employer. El Dorado Springs Behavioral Health is committed to Equal Employment Opportunity for all applicants and employees and complies with all applicable laws prohibiting discrimination and harassment in employment."

Lifepoint Health is a leader in community-based care and driven by a mission of Making Communities Healthier. Our diversified healthcare delivery network spans 29 states and includes 63 community hospital campuses, 32 rehabilitation and behavioral health hospitals, and more than 170 additional sites of care across the healthcare continuum, such as acute rehabilitation units, outpatient centers and post-acute care facilities. We believe that success is achieved through talented people. We want to create places where employees want to work, with opportunities to pursue meaningful and satisfying careers that truly make a difference in communities across the country.We employ and provide care to people from all walks of life. We are committed to promoting healing, providing hope, preserving dignity and producing value with an inclusive workforce in which diversity is leveraged, respected, and reflective of the patients, family members, customers and team members we serve.

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About LifePoint Health

Sourced by ZipRecruiter

Lifepoint Health serves patients, clinicians, communities and partners across the healthcare continuum. Our diversified healthcare delivery network extends from coast to coast, consisting of community hospitals, rehabilitation and behavioral health hospitals, and additional sites of care.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Brentwood, TN, US

Year founded

1999

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