Summary The Utilization Review Specialist supports the organization's utilization management ... and discharge planning processes. * Apply established criteria to routine cases and document ...
Summary The Utilization Review Specialist supports the organization's utilization management ... and discharge planning processes. * Apply established criteria to routine cases and document ...
Utilization Review Nurse | Full Time
Las Vegas, NV · On-site
$41 - $60/hr
- Utilization Review Nurse Position Summary The Utilization Review Nurse is responsible for reviewing ... Minimum 3 years of discharge planning experience in an acute care setting. * Experience in Case ...
Quick apply
Utilization Review Nurse | Full Time
Las Vegas, NV · On-site
$41 - $60/hr
- Utilization Review Nurse Position Summary The Utilization Review Nurse is responsible for reviewing ... Minimum 3 years of discharge planning experience in an acute care setting. * Experience in Case ...
Discharge Planner
$23 - $32.04/hr
Maintains and coordinates Medicaid state submission forms for presentation to on-site reviewer and ... Knowledge of Discharge Planning/ Utilization Management / Case Management terminology and functions ...
Discharge Planner
$23 - $32.04/hr
Maintains and coordinates Medicaid state submission forms for presentation to on-site reviewer and ... Knowledge of Discharge Planning/ Utilization Management / Case Management terminology and functions ...
Knowledge of utilization review, discharge planning, case management, and managed care reimbursement. Strong working knowledge of medical procedures, diagnoses, and procedure codes, including ICD-10, ...
Knowledge of utilization review, discharge planning, case management, and managed care reimbursement. Strong working knowledge of medical procedures, diagnoses, and procedure codes, including ICD-10, ...
This position also assists with discharge planning activities and contributes to quarterly and annual utilization review reporting and performance improvement initiatives. Utilization Review and ...
This position also assists with discharge planning activities and contributes to quarterly and annual utilization review reporting and performance improvement initiatives. Utilization Review and ...
Travel Utilization Review RN
Atlanta, GA · On-site
... Management/Discharge Planning experience Strong interdisciplinary communication and care ... utilization review and discharge planning preferred Shift: Days | 8:30 AM - 5:00 PM | 40 hours/week ...
New
Travel Utilization Review RN
Atlanta, GA · On-site
... Management/Discharge Planning experience Strong interdisciplinary communication and care ... utilization review and discharge planning preferred Shift: Days | 8:30 AM - 5:00 PM | 40 hours/week ...
New
Knowledge of utilization review, discharge planning, case management, and managed care reimbursement. Strong working knowledge of medical procedures, diagnoses, and procedure codes, including ICD-10, ...
Knowledge of utilization review, discharge planning, case management, and managed care reimbursement. Strong working knowledge of medical procedures, diagnoses, and procedure codes, including ICD-10, ...
This position also assists with discharge planning activities and contributes to quarterly and annual utilization review reporting and performance improvement initiatives. Utilization Review and ...
This position also assists with discharge planning activities and contributes to quarterly and annual utilization review reporting and performance improvement initiatives. Utilization Review and ...
Utilization Review Nurse
Miami, FL · On-site
Utilization Review Nurse Job Summary The Utilization Nurse is responsible for conducting ... discharge planning. * Supports appeals and grievances with organized, evidence-based clinical ...
Utilization Review Nurse
Miami, FL · On-site
Utilization Review Nurse Job Summary The Utilization Nurse is responsible for conducting ... discharge planning. * Supports appeals and grievances with organized, evidence-based clinical ...
This position also assists with discharge planning activities and contributes to quarterly and annual utilization review reporting and performance improvement initiatives. Utilization Review and ...
This position also assists with discharge planning activities and contributes to quarterly and annual utilization review reporting and performance improvement initiatives. Utilization Review and ...
Utilization Review Nurse Job Summary The Utilization Nurse is responsible for conducting ... discharge planning. * Supports appeals and grievances with organized, evidence-based clinical ...
Utilization Review Nurse Job Summary The Utilization Nurse is responsible for conducting ... discharge planning. * Supports appeals and grievances with organized, evidence-based clinical ...
Experience with utilization management in behavioral and/or medical healthcare. Experience driving quality and timely discharge planning from residential facilities as deemed appropriate in review of ...
Quick apply
Experience with utilization management in behavioral and/or medical healthcare. Experience driving quality and timely discharge planning from residential facilities as deemed appropriate in review of ...
Experience with utilization management in behavioral and/or medical healthcare. Experience driving quality and timely discharge planning from residential facilities as deemed appropriate in review of ...
Experience with utilization management in behavioral and/or medical healthcare. Experience driving quality and timely discharge planning from residential facilities as deemed appropriate in review of ...
Coordinate clinical reviews, utilization management activities, and application of established care ... discharge planning, and continuity of care. * Monitor utilization data, claims reviews, and ...
Quick apply
Coordinate clinical reviews, utilization management activities, and application of established care ... discharge planning, and continuity of care. * Monitor utilization data, claims reviews, and ...
Utilization Review RN
Brentwood, TN · On-site
Utilization Review RN Are you an experienced Registered Nurse with Utilization Review experience ... Assesses and coordinates simple discharge planning * Identifies quality of care issues ...
Utilization Review RN
Brentwood, TN · On-site
Utilization Review RN Are you an experienced Registered Nurse with Utilization Review experience ... Assesses and coordinates simple discharge planning * Identifies quality of care issues ...
Experience with utilization management in behavioral and/or medical healthcare. Experience driving quality and timely discharge planning from residential facilities as deemed appropriate in review of ...
Experience with utilization management in behavioral and/or medical healthcare. Experience driving quality and timely discharge planning from residential facilities as deemed appropriate in review of ...
Utilization Review Nurse
New Orleans, LA · On-site
The Utilization Review Nurse ensures appropriate utilization of health services by performing ... Understands key aspects of discharge planning, transitional care management and drivers of ...
Utilization Review Nurse
New Orleans, LA · On-site
The Utilization Review Nurse ensures appropriate utilization of health services by performing ... Understands key aspects of discharge planning, transitional care management and drivers of ...
Utilization Review Nurse
Little Rock, AR · On-site
The Utilization Review Nurse plays a crucial role in coordinating patient care and ensuring ... Preferred experience in Psych, discharge planning or utlization management role
Utilization Review Nurse
Little Rock, AR · On-site
The Utilization Review Nurse plays a crucial role in coordinating patient care and ensuring ... Preferred experience in Psych, discharge planning or utlization management role
The Utilization Review Nurse ensures appropriate utilization of health services by performing ... Understands key aspects of discharge planning, transitional care management and drivers of ...
The Utilization Review Nurse ensures appropriate utilization of health services by performing ... Understands key aspects of discharge planning, transitional care management and drivers of ...
Utilization Review Nurse
$33.41 - $44.11/hr
Job Summary and Responsibilities The Utilization Review Nurse plays a crucial role in coordinating ... Preferred experience in Psych, discharge planning or utlization management role Where You'll Work ...
Utilization Review Nurse
$33.41 - $44.11/hr
Job Summary and Responsibilities The Utilization Review Nurse plays a crucial role in coordinating ... Preferred experience in Psych, discharge planning or utlization management role Where You'll Work ...
Discharge Planner Utilization Review information
See salary details
$14.66 - $18.75
7% of jobs
$18.75 - $22.84
17% of jobs
$23.11 is the 25th percentile. Wages below this are outliers.
$22.84 - $26.92
16% of jobs
The median wage is $29.48 / hr.
$26.92 - $31.01
17% of jobs
$31.01 - $35.10
14% of jobs
$37.37 is the 75th percentile. Wages above this are outliers.
$35.10 - $39.18
9% of jobs
$39.18 - $43.27
9% of jobs
$43.27 - $47.36
5% of jobs
$47.36 - $51.44
3% of jobs
$51.44 - $55.53
1% of jobs
$55.53 - $59.62
2% of jobs
$14
$32
$59
How much do discharge planner utilization review jobs pay per hour?
How does a Discharge Planner Utilization Review professional collaborate with interdisciplinary teams to ensure effective patient transitions?
What are the key skills and qualifications needed to thrive as a Discharge Planner Utilization Review, and why are they important?
What are Discharge Planner Utilization Review professionals?
What is the difference between Discharge Planner Utilization Review vs Discharge Planner?
| Aspect | Discharge Planner Utilization Review | Discharge Planner |
|---|---|---|
| Primary Role | Evaluates medical necessity and appropriateness of patient discharges for insurance and healthcare compliance | Coordinates patient discharges, ensures proper placement, and communicates with healthcare teams |
| Credentials | Typically requires a social work, nursing, or healthcare background with certification in utilization review | Usually requires social work or nursing credentials, with focus on discharge planning |
| Work Environment | Hospitals, insurance companies, or healthcare facilities involved in utilization review | Hospitals, rehab centers, or skilled nursing facilities |
While both roles involve discharge processes, Discharge Planner Utilization Review focuses on assessing medical necessity for insurance purposes, whereas Discharge Planner manages patient discharge logistics and coordination. Understanding these differences helps clarify career paths and employer expectations in healthcare settings.
- Utilization Review Manager
- Commission Authorization Utilization Review Bcba
- Psychiatric Utilization Review
- Manager Optum Utilization Review
- Utilization Review Supervisor
- Authorization Utilization Review Bcba
- Milliman
- Utilization Review No Experience
- Temporary Aetna Utilization Review Nurse
- Part Time Utilization Review Manager

Part-time
Medical
Posted 16 days ago
Chesapeake Regional Healthcare rating
6.9
Based on 22 frontline employees who took The Breakroom Quiz
Job description
The Utilization Review Specialist supports the organization's utilization management program by conducting routine admission, concurrent, and retrospective reviews utilizing established screening criteria and organizational guidelines. This position collects, reviews, and documents clinical information to support medical necessity determinations and appropriate resource utilization. Complex, high-risk, or ambiguous cases requiring clinical judgment are referred to a RN Utilization Review for review and determination.
Essential Duties and Responsibilities
These duties and responsibilities described below represent the general tasks performed on a daily basis; other tasks may be assigned.
- Conduct routine utilization reviews using approved screening criteria, established workflows, and departmental guidelines.
- Collect and organize clinical documentation necessary to support utilization review activities.
- Review patient records to identify required information for admission, continued stay, and discharge planning processes.
- Apply established criteria to routine cases and document findings in designated systems.
- Monitor assigned cases for required documentation and timely review completion.
- Communicate with providers, clinical staff, payers, and care team members to obtain necessary information.
- Identify cases that do not clearly meet established criteria and escalate them to an RN Utilization Review.
- Present complex, high-acuity, disputed, or clinically ambiguous cases to an RN Utilization Review Specialist for evaluation and determination.
- Assist with obtaining payer authorizations and tracking authorization status as directed.
- Maintain accurate utilization management records, reports, and audit documentation.
- Support denial prevention efforts through timely documentation and communication.
- Participate in quality improvement initiatives related to utilization management processes.
- Maintain knowledge of applicable payer requirements, regulatory standards, and organizational policies.
- Assist with data collection and reporting related to utilization management metrics.
- Perform other utilization management support duties within the scope of licensure and training.
Supervisory Responsibilities
Reports to: RN Clinical Doc Manager
Supervises: N/A
Responsibilities: N/A
Qualifications
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Education and Experience
Minimum Required Education
Graduate of an approved healthcare program leading to licensure as a healthcare professional i.e. Licensed Practical Nurse (LPN) or other clinically licensed healthcare professionals as approved by the organization.
Experience
Two (2) years of clinical healthcare experience required. Experience in utilization review, utilization management, case management, care coordination, discharge planning, or other related clinical healthcare functions may be considered.
Certificates, Licenses, Registrations
- Current unrestricted license as a Licensed Practical Nurse required at minimum in the Commonwealth of Virginia or compact state. Candidates possessing a higher level of clinical licensure are also eligible for consideration.
- Certification in utilization management or case management preferred.
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights notice from the Department of Labor.
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About CHESAPEAKE REGIONAL HEALTHCARE
Sourced by ZipRecruiter
Industry
Health care and social assistance
Company size
1,001 - 5,000 Employees
Headquarters location
Chesapeake, VA, US
Year founded
1976