ZipRecruiter

Log In

1

Authorization Utilization Review Jobs in Washington

UHS

Utilization Review Coordinator

Washington, DC · On-site

$33.60 - $50.40/hr

Six months psychiatric utilization review either for hospital or external review organization ... authorization. Please note that we do not use this information to pre-screen job applicants. EEO ...

UHS

Utilization Review Coordinator

Washington, DC

... authorization. Please note that we do not use this information to pre-screen job applicants. EEO ... Six months psychiatric utilization review either for hospital or external review organization ...

UHS

Utilization Review Coordinator

Washington, DC · On-site

... authorization. Please note that we do not use this information to pre-screen job applicants. EEO ... Six months psychiatric utilization review either for hospital or external review organization ...

MedStar Health

RN Team Lead Utilization Review

Clinton, MD · On-site

$89K - $162K/yr

About the Job Candidate must have acute care Utilization Review experience. Candidate must live in ... Identifies insurance information obtains authorization communicates with financial counseling and ...

Luminis Health

Utilization Management Nurse

Annapolis, MD · On-site

$34 - $55/hr

... reviews, care coordinators, and providers; reconciles and records days authorized in EPIC 2. Denial Management : Monitors and identifies patterns or trends in utilization management; monitors ...

Luminis Health

Utilization Management Nurse

Lanham, MD · On-site

$34 - $55/hr

... reviews, care coordinators, and providers; reconciles and records days authorized in EPIC 2. Denial Management : Monitors and identifies patterns or trends in utilization management; monitors ...

next page

Showing results 1-20

All JobsAuthorization Utilization Review JobsAuthorization Utilization Review Jobs in Washington

Authorization Utilization Review information

What are the key skills and qualifications needed to thrive as an authorization utilization review specialist?

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 are popular job titles related to Authorization Utilization Review jobs in Washington? For Authorization Utilization Review jobs in Washington, the most frequently searched job titles are:
What job categories do people searching Authorization Utilization Review jobs in Washington look for? The top searched job categories for Authorization Utilization Review jobs in Washington are:
Authorization Utilization Review jobs near you
Infographic showing various Authorization Utilization Review job openings in Washington as of August 2026, with employment types broken down into 1% As Needed, 83% Full Time, 13% Part Time, and 3% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution.

Utilization Review Coordinator

UHS

Washington, DC • On-site

$33.60 - $50.40/hr

Per diem

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 13 days ago

Universal Health Services rating

6.8

Company rating: 6.8 out of 10

Based on 253 frontline employees who took The Breakroom Quiz

492nd of 887 rated healthcare providers

Job description

Responsibilities
The Psychiatric Institute of Washington is a152-bed facility with inpatient, outpatient and partial hospitalization programs. Excellence in behavioral health programs for children, adolescents and adults has been the mission of The Psychiatric Institute of Washington since it opened nearly 50 years ago. As the first and only free standing psychiatric care facilities in Washington, DC, our team has a reputation for providing innovative treatment and care. We strive for excellence, never losing sight of providing patients with hope - hope that although their stay is relatively brief, they may find their way to a brighter future.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
  • Tracks new admissions or transfers to assigned area and is responsible for knowing and following through with certification requirements from admission through discharge. Serves as liaison to on-site external reviewers.
  • Uses Midas for recording reviews and tracking denials. Adds to Midas databases as needed.
  • Teaches staff to document medical necessity through in-services or individual meetings. Monitors quality of records and notifies staff and program director of problems. Available to program director to develop plan for improvement as needed.
  • Supports and guides treatment planning as needed. Continues to bring to staff awareness the need for documentation to flow from and correlate with treatment plan.
  • Informs department director of changes in managed care companies. Maintains awareness of unique status to propose out of plan benefits or to open the door to increase hospital's opportunity to provide services to a larger group.
  • Works appropriately and professionally with all staff and demonstrates a supportive attitude toward the goals of the hospital. Makes recommendations for the hospital based on identified trends.
  • Arranges schedule in consideration of needs of the department, participates in arranging coverage for planned absences and demonstrates a supportive attitude toward the goals of the department.
  • Performs other job related duties as assigned.
Benefit Highlights:
Our employees are our most valuable asset and we are dedicated to provide a challenging and rewarding work environment to all our employees.
  • Generous Paid Time Off
  • Excellent Medical, Dental, Vision and Prescription Drug Plans
  • 401(K) with company match and discounted stock plan
  • UHS employee discounted stock option plan
  • Tuition Reimbursement and Student Loan Repay Program
  • Employee Assistant Program (EAP)
  • Life Insurance and Disability Insurances
  • Flexible Spending Account
  • Pre-tax Metro SmartTrip Benefits
  • Career development opportunities within UHS and its 300+ Subsidiaries!

Who we are:
One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, annual revenues were $11.6 billion in 2020. In 2021, UHS was again recognized as one of the World's Most Admired Companies by Fortune; in 2020, ranked #281 on the Fortune 500; and listed #330 in Forbes ranking of U.S.' Largest Public Companies. Headquartered in King of Prussia, PA, UHS has 89,000 employees and through its subsidiaries operates 26 acute care hospitals, 334 behavioral health facilities, 39 outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 38 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom.
Qualifications
  • Bachelor's degree in applicable field of study required
  • Six months psychiatric utilization review either for hospital or external review organization preferred.
  • Candidates must meet the company's hiring criteria to include a pre-employment verifications, background investigation and drug test.
COVID Requirements
PIW requires its staff to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, or religious belief that prevents them from being vaccinated.
E-VERIFY Statement
PIW participates in E-Verify. We will provide the Social Security Administration, and if necessary, the Department of Homeland Security, with information from each new employee's Form I-9 to confirm work authorization. Please note that we do not use this information to pre-screen job applicants.
EEO Statement
All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.
We believe that diversity and inclusion among our teammates is critical to our success.
Notice
At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: https://uhs.alertline.com or 1-800-852- 3449.

What Universal Health Services employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Universal Health Services logo

About Universal Health Services

Sourced by ZipRecruiter

Universal Health Services (UHS) is a major player in the healthcare industry, based in King of Prussia, Pennsylvania, U.S. Founded in 1978, UHS offers hospital and healthcare services. Their diverse services range from acute care hospitals, behavioral health facilities and ambulatory centers nationwide. The company's mission of enhancing the health and well-being of their patients is reflected in their commitment to 'Helping Individuals Live Longer, Healthier and Happier Lives'. Universal Health Services' consistent growth and success in their industry have been recognized on numerous occasions, including being ranked amongst the Fortune 500 list of largest companies.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

King of Prussia, PA, US

View All Universal Health Services Jobs

Apply