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Full Time Anthem Utilization Review Jobs (NOW HIRING)

Gbmc

Two (2) years of Utilization Review and Case Management experience which includes utilization review processes and discharge planning, and working with Re-Admission Initiatives preferred. Skills:

New

Banyan

Utilization Review Specialist

Pompano Beach, FL · On-site

$50K - $65K/yr

Utilization Review Specialist | Remote | Full-Time $50,000 - $65,000 Annually | Weekdays (Weekend Availability as Needed) Banyan Treatment Centers is seeking an experienced and detail-driven ...

ARcare

Utilization Review Associate

Searcy, AR · On-site

Utilization Review Associate Job Type: Full-time, 40 hours per week required (hourly POSITION SUMMARY Assist with planning and coordinating the duties of Utilization Review. This position is ...

Oscar Health

Utilization Review Nurse

Tempe, AZ · Remote

$35 - $45.94/hr

We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 ...

Oscar Health

Utilization Review Nurse

Dallas, TX · Remote

$35 - $45.94/hr

We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 ...

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Full Time Anthem Utilization Review information

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How much do full time anthem utilization review jobs pay per hour?

As of Aug 16, 2026, the average hourly pay for full time anthem 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 is the difference between Full Time Anthem Utilization Review vs Full Time Medicaid Utilization Review?

AspectFull Time Anthem Utilization ReviewFull Time Medicaid Utilization Review
CertificationsTypically requires certifications like CCM or URAC accreditationOften requires similar certifications, with additional Medicaid-specific knowledge
Work EnvironmentCorporate healthcare setting, insurance company officesGovernment or Medicaid agency offices, healthcare providers
Employer & IndustryInsurance companies, healthcare payersState Medicaid agencies, government healthcare programs
Job FocusReviewing insurance claims for Anthem members, ensuring coverage complianceReviewing Medicaid claims, eligibility, and coverage for state programs

Full Time Anthem Utilization Review primarily involves insurance claim assessments within a corporate setting, focusing on Anthem members. In contrast, Full Time Medicaid Utilization Review centers on government-funded Medicaid programs, requiring knowledge of state-specific policies. Both roles require similar certifications but differ in employer type and scope of coverage.

What cities are hiring for Full Time Anthem Utilization Review jobs?

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States with the most job openings for Full Time Anthem Utilization Review jobs include:

Full Time Anthem Utilization Review jobs near you

Utilization Review Technician

Prime Healthcare

Gadsden, AL

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 5 days ago

Prime Healthcare rating

6.4

Company rating: 6.4 out of 10

Based on 283 frontline employees who took The Breakroom Quiz

641st of 887 rated healthcare providers

Job description

Department: Social Work Services 

Shifts Available: Days  

Employment Type: Full Time 

Hours: 8-hour shift – 7:30am to 3:30pm 

Location: Riverview Regional Medical Center – Gadsden, AL 

We are seeking an Utilization Review Technician II, sometimes referred to as Utilization Management Technician II or Utilization Review Coordinator II. The Utilization Review Technician II supports the utilization review, appeals, and denial management process by coordinating communication and tracking payer-related activity. This role works closely with insurance providers, health plans, Utilization Review teams, the Business Office, and Case Managers to help ensure timely follow-up on authorizations, reviews, appeals, and denials. The position also assists with payer audits, Release of Information, discharge coordination, and other departmental needs. 


  • Coordinate phone calls, data entry, and tracking related to authorizations, expedited reviews, appeals, and denials 
  • Document and track all communication attempts with insurance providers and health plans 
  • Follow up on denials while partnering with Utilization Review, Business Office, and Case Management teams 
  • Maintain accurate tracking of government and payer audits, including RAC, MAC, CERT, ADR, QIO, Medicaid, and pre/post-payment reviews 
  • Provide support with Release of Information, discharge coordination, and other assigned departmental duties 

  • High School Diploma or equivalent
  • Two years of relevant experience
  • Accurate alphabetic, numeric, and/or terminal-digit filing skills
  • Computer data entry with 10-key, with accurate typing speed of 35 wpm
  • Associates Degree or higher, preferred
  • Excel skills. highly preferred
  • Knowledge of terminal digit filing and medical terminology, preferred
  • Knowledge of State and Federal regulatory requirements for medical staff documentation, preferred
  • Completion of a medical terminology course, preferred
  • Background in business and office training, preferred

Here are some of the benefits of working at Prime Healthcare: 

  • Health, dental, and vision insurance options 
  • Paid vacation, sick time and holidays 
  • Bereavement leave, FMLA and other leave options 
  • Employer 401K options 
  • Tuition reimbursement options  
  • Life, disability, and other insurance options 
  • Many other amazing benefits 

Full benefits at Prime Healthcare: https://www.primehealthcare.com/careers/benefits/   

#LI-MP1


Full Time
Days

Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf

 

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