Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Provide ongoing support and training for staff on documentation or charting requirements, continued ...
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Provide ongoing support and training for staff on documentation or charting requirements, continued ...
Utilization Review Manager
Chicago, IL · On-site
Provide guidance and training to staff on documentation standards related to utilization review and medical necessity. * Participate in internal audits and assist in developing corrective action ...
Quick apply
Utilization Review Manager
Chicago, IL · On-site
Provide guidance and training to staff on documentation standards related to utilization review and medical necessity. * Participate in internal audits and assist in developing corrective action ...
Utilization Review Manager
Chicago, IL · On-site
Provide guidance and training to staff on documentation standards related to utilization review and medical necessity. * Participate in internal audits and assist in developing corrective action ...
Utilization Review Manager
Chicago, IL · On-site
Provide guidance and training to staff on documentation standards related to utilization review and medical necessity. * Participate in internal audits and assist in developing corrective action ...
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Provide ongoing support and training for staff on documentation or charting requirements, continued ...
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Provide ongoing support and training for staff on documentation or charting requirements, continued ...
Summary The Utilization Review Specialist supports the organization's utilization management ... Perform other utilization management support duties within the scope of licensure and training.
Summary The Utilization Review Specialist supports the organization's utilization management ... Perform other utilization management support duties within the scope of licensure and training.
Mandatory Basic and Advanced Life Support Training per policy Benefits Prairie Lakes Healthcare ... Drug Free Workplace Policy. An accepted offer will require positive reference checks and pre ...
Mandatory Basic and Advanced Life Support Training per policy Benefits Prairie Lakes Healthcare ... Drug Free Workplace Policy. An accepted offer will require positive reference checks and pre ...
Be Seen First
Utilization Review Nurse
Newark, NJ · Remote
$38 - $40/hr
Serves as mentor/trainer to new RN's and other staff as needed, completes audits, reviews and ... Understands fiscal accountability and its impact on the utilization of resources, proceeding to ...
Quick apply
Be Seen First
Utilization Review Nurse
Newark, NJ · Remote
$38 - $40/hr
Serves as mentor/trainer to new RN's and other staff as needed, completes audits, reviews and ... Understands fiscal accountability and its impact on the utilization of resources, proceeding to ...
Utilization Review Manager
Chicago, IL · On-site
Provide guidance and training to staff on documentation standards related to utilization review and medical necessity. * Participate in internal audits and assist in developing corrective action ...
Utilization Review Manager
Chicago, IL · On-site
Provide guidance and training to staff on documentation standards related to utilization review and medical necessity. * Participate in internal audits and assist in developing corrective action ...
Mandatory Basic and Advanced Life Support Training per policy Benefits Prairie Lakes Healthcare ... Drug Free Workplace Policy. An accepted offer will require positive reference checks and pre ...
Mandatory Basic and Advanced Life Support Training per policy Benefits Prairie Lakes Healthcare ... Drug Free Workplace Policy. An accepted offer will require positive reference checks and pre ...
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Provide ongoing support and training for staff on documentation or charting requirements, continued ...
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Provide ongoing support and training for staff on documentation or charting requirements, continued ...
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Provide ongoing support and training for staff on documentation or charting requirements, continued ...
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Provide ongoing support and training for staff on documentation or charting requirements, continued ...
Utilization Review Nurse
Roseburg, OR · Remote
$85K - $105K/yr
UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR ... Provide training and mentorship on UM protocols and workflows * Maintain relationships with ...
Quick apply
Utilization Review Nurse
Roseburg, OR · Remote
$85K - $105K/yr
UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR ... Provide training and mentorship on UM protocols and workflows * Maintain relationships with ...
Utilization Review Registered Nurse
$28.09 - $44.81/hr
Mandatory Basic and Advanced Life Support Training per policy Benefits Prairie Lakes Healthcare ... Drug Free Workplace Policy. An accepted offer will require positive reference checks and pre ...
Utilization Review Registered Nurse
$28.09 - $44.81/hr
Mandatory Basic and Advanced Life Support Training per policy Benefits Prairie Lakes Healthcare ... Drug Free Workplace Policy. An accepted offer will require positive reference checks and pre ...
RN - Utilization Review
Kinston, NC · On-site
$2.3K/wk
Education and Training : * Educate staff and providers on the importance of utilization review processes, medical necessity criteria, and compliance with payer requirements. * Stay current on the ...
RN - Utilization Review
Kinston, NC · On-site
$2.3K/wk
Education and Training : * Educate staff and providers on the importance of utilization review processes, medical necessity criteria, and compliance with payer requirements. * Stay current on the ...
Utilization Review Nurse
New Lenox, IL · On-site
$34.73 - $45.15/hr
... Training : * Nurse, Registered (RN) licensure * BSN preferred. 2-5 years previous Utilization ... Review experience preferred. * Current CPR * Relevant hospital nursing; hospital case management ...
Utilization Review Nurse
New Lenox, IL · On-site
$34.73 - $45.15/hr
... Training : * Nurse, Registered (RN) licensure * BSN preferred. 2-5 years previous Utilization ... Review experience preferred. * Current CPR * Relevant hospital nursing; hospital case management ...
Utilization Review Specialist
Gilbert, AZ · On-site
CPR certification and Crisis Prevention Training (CPI) preferred. May be required to work flexible ... Mental, physical, and financial wellness programs (free gym memberships, virtual care appointments ...
Utilization Review Specialist
Gilbert, AZ · On-site
CPR certification and Crisis Prevention Training (CPI) preferred. May be required to work flexible ... Mental, physical, and financial wellness programs (free gym memberships, virtual care appointments ...
Utilization Review Tech I
Inglewood, CA · On-site
$25.70 - $32.13/hr
The Utilization review tech essentially works to coordinate the utilization review and appeals ... EDUCATION, EXPERIENCE, TRAINING 1. Minimum one year denials management experience in acute care ...
Utilization Review Tech I
Inglewood, CA · On-site
$25.70 - $32.13/hr
The Utilization review tech essentially works to coordinate the utilization review and appeals ... EDUCATION, EXPERIENCE, TRAINING 1. Minimum one year denials management experience in acute care ...
Utilization Review Nurse
New Lenox, IL · On-site
$34.73 - $45.15/hr
... Training : * Nurse, Registered (RN) licensure * BSN preferred. 2-5 years previous Utilization ... Review experience preferred. * Current CPR * Relevant hospital nursing; hospital case management ...
Utilization Review Nurse
New Lenox, IL · On-site
$34.73 - $45.15/hr
... Training : * Nurse, Registered (RN) licensure * BSN preferred. 2-5 years previous Utilization ... Review experience preferred. * Current CPR * Relevant hospital nursing; hospital case management ...
Utilization Review Tech I
Inglewood, CA · On-site
$25.70 - $32.13/hr
Utilization review tech is responsible for coordinating phone calls, data entry and tracking data ... Qualifications EDUCATION, EXPERIENCE, TRAINING 1. Minimum one year denials management experience in ...
Utilization Review Tech I
Inglewood, CA · On-site
$25.70 - $32.13/hr
Utilization review tech is responsible for coordinating phone calls, data entry and tracking data ... Qualifications EDUCATION, EXPERIENCE, TRAINING 1. Minimum one year denials management experience in ...
Job Summary The Utilization Review department carries with it the responsibility of managing those ... Attend staff conferences and in-service training as required or needed Physical Requirements The ...
Quick apply
Job Summary The Utilization Review department carries with it the responsibility of managing those ... Attend staff conferences and in-service training as required or needed Physical Requirements The ...
Free Utilization Review Training information
See salary details
$21.39 - $25.72
2% of jobs
$25.72 - $30.05
9% of jobs
$33.01 is the 25th percentile. Wages below this are outliers.
$30.05 - $34.38
21% of jobs
The median wage is $37.88 / hr.
$34.38 - $38.70
23% of jobs
$38.70 - $43.03
13% of jobs
$46.39 is the 75th percentile. Wages above this are outliers.
$43.03 - $47.36
10% of jobs
$47.36 - $51.68
8% of jobs
$51.68 - $56.01
5% of jobs
$56.01 - $60.34
5% of jobs
$60.34 - $64.66
2% of jobs
$64.66 - $68.99
2% of jobs
$21
$42
$68
How much do free utilization review training jobs pay per hour?
What is free utilization review training?
What is the difference between Free Utilization Review Training vs Utilization Review Nurse?
| Aspect | Free Utilization Review Training | Utilization Review Nurse |
|---|---|---|
| Credentials | Typically no formal credentials required; focus on training programs | Registered Nurse (RN) license required, with possible certifications like CCM or UR-specific credentials |
| Work Environment | Training sessions, online courses, workshops | Hospitals, insurance companies, healthcare facilities |
| Employer & Industry Usage | Used for skill development and certification prep | Performing reviews, making coverage decisions, ensuring appropriate care |
Free Utilization Review Training provides foundational knowledge and skills for those interested in entering or advancing in utilization review roles. In contrast, a Utilization Review Nurse is a licensed healthcare professional actively performing review duties in clinical settings. The training is often a prerequisite or supplement to the nurse's practical work, which requires licensure and clinical experience.
Can you get a job with a free certificate?
How to make an extra $1000 a month as a nurse?
What are the key skills and qualifications needed to thrive as a Utilization Review Nurse, and why are they important?
How do I get into a utilization review?
Is there a utilization review certification?
What are some common challenges faced by professionals during utilization review training, and how can they be overcome?
- Cigna Utilization Review Nurse
- Internship Rn Utilization Review Nurse
- Remote Optum Utilization Review
- Remote Aetna Utilization Review Nurse
- Weekend Utilization Review
- Seasonal Remote Utilization Review
- Volunteer Navihealth Utilization Review
- Contract Utilization Review
- Inpatient Review Nurse
- International Utilization Review Rn

Acadia Healthcare rating
6.2
Based on 189 frontline employees who took The Breakroom Quiz
696th of 884 rated healthcare providers
Job description
PURPOSE STATEMENT: Proactively monitor utilization of services for patients to optimize reimbursement for the facility.
Responsibilities
ESSENTIAL FUNCTIONS:
- Act as liaison between managed care organizations and the facility professional clinical staff.
- Conduct reviews, in accordance with certification requirements, of insurance plans or other managed care organizations (MCOs) and coordinate the flow of communication concerning reimbursement requirements.
- Monitor patient length of stay and extensions and inform clinical and medical staff on issues that may impact length of stay.
- Gather and develop statistical and narrative information to report on utilization, non-certified days (including identified causes and appeal information), discharges and quality of services, as required by the facility leadership or corporate office.
- Conduct quality reviews for medical necessity and services provided.
- Facilitate peer review calls between facility and external organizations.
- Initiate and complete the formal appeal process for denied admissions or continued stay.
- Assist the admissions department with pre-certifications of care.
- Provide ongoing support and training for staff on documentation or charting requirements, continued stay criteria and medical necessity updates.
OTHER FUNCTIONS:
- Perform other functions and tasks as assigned.
Qualifications
EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:
- Required Education: High school diploma or equivalent.
- Preferred Education: Associate's, Bachelor's, or Master's degree in Social Work, Behavioral or Mental Health, Nursing, or a related health field.
- Experience: Clinical experience is required, or two or more years' experience working with the facility's population. Previous experience in utilization management is preferred
LICENSES/DESIGNATIONS/CERTIFICATIONS:
- Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides services; or current clinical professional license or certification, as required, within the state where the facility provides services.
- CPR and de-escalation and restraint certification required (training available upon hire and offered by facility.
- First aid may be required based on state or facility requirements.
ADDITIONAL REGULATORY REQUIREMENTS:
While this job description is intended to be an accurate reflection of the requirements of the job, management reserves the right to add or remove duties from particular jobs when circumstances
(e.g. emergencies, changes in workload, rush jobs or technological developments) dictate.
We are committed to providing equal employment opportunities to all applicants for employment regardless of an individual's characteristics protected by applicable state, federal and local laws.
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About Acadia Healthcare
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Acadia Healthcare is a leading provider in the healthcare and hospital industry, based in Franklin, Tennessee, United States. The company is recognised for its commitment to creating a behavioural health network that provides accessible, high-quality treatment options for individuals suffering from mental health issues, addiction, eating disorders, and PTSD. Acadia Healthcare was founded in 2005, with the mission to create a world-class organization that sets the standard of excellence in the treatment of specialty behavioural health and addiction disorders.
Industry
Hospitals
Company size
10,000+ Employees
Headquarters location
Franklin, TN, US
Year founded
2005