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Authorization Utilization Review Jobs (NOW HIRING)

Sheppard Pratt

Utilization Review Specialist

Towson, MD · On-site

$26.04/hr

Responsible for supporting the utilization review system including data analysis, report writing ... Also responsible for securing authorizations and tracking entitlements for enrolled clients.

Sheppard Pratt

Utilization Review Specialist

Towson, MD · On-site

$26.04/hr

Responsible for supporting the utilization review system including data analysis, report writing ... Also responsible for securing authorizations and tracking entitlements for enrolled clients.

KPC Health

Utilization Review Tech

Santa Ana, CA

Utilization Review Technician Under direction of the Utilization Review Technician Supervisor, the ... Monitors patient charts and records to provide to responsible parties and request for authorization ...

New

The Meadows

Utilization Review Coordinator

Phoenix, AZ · On-site +1

As the Utilization Review Coordinator, you will develop and implement systems for authorizations ... Monitor each step of the authorization process to proactively identify potential problems and ...

Sheppard Pratt

Utilization Review Specialist

Towson, MD · On-site

$26.04/hr

Responsible for supporting the utilization review system including data analysis, report writing ... Also responsible for securing authorizations and tracking entitlements for enrolled clients.

tmn

Utilization Review Specialist

Akron, OH · On-site

$40.17K/mo

SUMMARY The Utilization Review Specialist is responsible for proactive planning measures, accurate ... Provides professional oversight of service delivery authorizations and assurances, effective ...

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How much do authorization utilization review jobs pay per hour?

As of Jun 1, 2026, the average hourly pay for authorization 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 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 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 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.

More about Authorization Utilization Review jobs
What cities are hiring for Authorization Utilization Review jobs? Cities with the most Authorization Utilization Review job openings:
What states have the most Authorization Utilization Review jobs? States with the most job openings for Authorization Utilization Review jobs include:
What job categories do people searching Authorization Utilization Review jobs look for? The top searched job categories for Authorization Utilization Review jobs are:
Authorization Utilization Review jobs near you
Infographic showing various Authorization Utilization Review job openings in the United States as of May 2026, with employment types broken down into 1% As Needed, 88% Full Time, 9% Part Time, and 2% Contract. Highlights an 80% Physical, 15% Hybrid, and 5% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.
Utilization Review Coordinator

Utilization Review Coordinator

MEADOWS OF WICKENBURG INC

Phoenix, AZ

Full-time

Posted 4 days ago

Job description

This is where you change your story…

At Meadows we understand that new directions to career advancing, and improvement can be scary, but we are excited to offer you a possible new rewarding chapter with us! Come join us in transforming lives!

Who are we?

Meadows Behavioral Healthcare is a leader in the behavioral health industry. Meadows Behavioral Healthcare offer a range of specialized programs including residential, outpatient and virtual treatment. We provide care for drug and alcohol addiction, trauma, sexual addiction, behavioral health conditions, and co-occurring disorders. We offer state-of-the-art care including neurofeedback and other services. Our evidence-based approach is rooted in decades of clinical experience, with more than 45 years in the field. Our approach is different and success stories from our patients are the proof.

Who are you?

Are you compassionate, innovative and have a passion to make an impact?  Are you looking to get your foot in the door with a company that will believe in your abilities and train you to advance? 80% of our current top-level executive staff are organic internal promotions from within.

We might be a perfect fit for you!

Position Summary:

As the Utilization Review Coordinator, you will develop and implement systems for authorizations for Inpatient, RTC, PHP and IOP Services.  You will conduct pre-certs, concurrent and extended reviews.  You will ensure quality documentation of patient care.

Responsibilities:

  • Utilization Review:
    • Provide professional and thorough communication with external representatives to obtain authorization for admission and continued stay.
    • Monitor each step of the authorization process to proactively identify potential problems and optimize outcome.
    • Minimize the number of cases that need to be referred for psychiatric peer/peer review.
    • Interact with patient care staff to assure patient assessment and treatment plan is accurately and consistently reflected in facility documentation.
    • Prioritize multiple and various types of case activity, coordinate with UM team to ensure all deadlines are met with highest possible quality of delivery.
    • Maintain cumulative documentation regarding action taken during the UR process.
    • Conduct reviews to ensure that services and documentation conform to the facility protocols, and the requirements of third-party payer sources.
  • Clinical Team Member
    • Interact with patient care staff as noted above.
    • Attend treatment staffing and other scheduled meetings to obtain and present information on patient status, care and stay.
    • Communicate authorization status, issues or problems to appropriate staff/departments.
  • Payer Management
    • Obtain and maintain authorization for each patient.  Problem-solve issues relating to stay or service.
    • Respond quickly and effectively to requires for information.
    • Nurture positive and professional relationships with external (third-party payers) sources.

Education and Experience:

  • Bachelor's degree required
  • 3-5 years of experience in utilization review in a behavioral health setting
  • Strong communication skills
  • Ability to work in a fast-paced environment

We are a Drug Free Company. All positions are designated as Safety Sensitive positions and in light of our company mission, the Company does not employ medical marijuana cardholders. Following an offer of employment, and prior to reporting to work, all applicants will be required to submit to and pass a substance abuse screen.

Meadows Behavioral Health is an equal opportunity employer committed to diversity and inclusion in the workplace. Qualified candidates will receive consideration without regard to race, color, religion, sex, sexual orientation, age, national origin, disability, protected veteran status or any other factor protected by applicable federal, state or local laws. Meadows Behavioral Health provides reasonable accommodations to individuals with disabilities and if you need reasonable accommodation during any time of the employment process, please reach out.

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