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Full Time Utilization Review Social Worker Jobs (NOW HIRING)

Responsibilities Full-time Utilization Review Coordinator Opening The Pavilion Behavioral Health ... social work) or RN licensure within Illinois required. Previous professional experience in a ...

We are looking to for a Full Time Utilization Review Specialist to join our team. The UR specialist ... This is a Monday-Friday, on-site position working 40 hours per week. PURPOSE STATEMENT: Proactively ...

As a Utilization Review Specialist, you will play a vital role in ensuring that clinical services ... LMSW, LCSW, LMHC, CASAC, CASAC-AC, CASAC-MC, RN, or other qualified health professional recognized ...

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Responsibilities Full-time Utilization Review Coordinator Opening The Pavilion Behavioral Health ... Master's degree in the human services field (counseling, psychology, social work) or RN licensure ...

Website: The Utilization Review Clinician opportunity is a key member of the Lighthouse Case ... LMHC, LMFT, LAPC, LPC, LMSW, LCSW, LPN or RN preferred EEO Statement: All UHS subsidiaries are ...

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Full Time Utilization Review Social Worker information

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

As of Aug 31, 2026, the average hourly pay for full time utilization review social worker 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 does a full time utilization review social worker do?

A Full Time Utilization Review Social Worker evaluates patients’ medical records to ensure that the care provided is necessary and appropriate, based on insurance guidelines and clinical standards. They work with healthcare teams, insurance companies, and patients to coordinate services, advocate for needed care, and help manage healthcare costs. Their role is crucial in ensuring that patients receive the right level of care without unnecessary treatments, while also supporting the hospital or healthcare facility's compliance and reimbursement processes.

How does a full time utilization review social worker typically collaborate with healthcare providers and insurance representatives?

A Full Time Utilization Review Social Worker regularly communicates with physicians, nurses, and insurance representatives to ensure that patients receive appropriate and cost-effective care. They review medical records, participate in interdisciplinary team meetings, and advocate for patients’ needs while adhering to insurance guidelines. This role requires balancing clinical judgment with policy requirements, and effective collaboration is essential to resolving care authorization issues and facilitating smooth discharge planning.

What are the key skills and qualifications needed to thrive as a full time utilization review social worker, and why are they important?

To thrive as a Full Time Utilization Review Social Worker, you need a solid background in social work, case management, and healthcare regulations, typically with a relevant degree and state licensure (e.g., LCSW or LMSW). Familiarity with utilization review software, electronic medical records (EMRs), and knowledge of insurance guidelines such as Medicare/Medicaid are essential. Strong analytical, communication, and advocacy skills help you effectively assess patient needs and interact with healthcare teams and payers. These skills ensure appropriate resource utilization, compliance with policies, and optimal patient care outcomes.

What is the difference between Full Time Utilization Review Social Worker vs Utilization Review Nurse?

AspectFull Time Utilization Review Social WorkerUtilization Review Nurse
CredentialsSocial Work degree, LCSW or equivalent, certification in utilization review often preferredNursing degree, RN license, certification in utilization review (e.g., URAC)
Work EnvironmentHealthcare facilities, insurance companies, government agenciesHospitals, insurance companies, healthcare organizations
Primary ResponsibilitiesAssess patient needs, coordinate care, review medical necessity from a social work perspectiveReview medical records, evaluate treatment plans, ensure appropriate resource utilization

While both roles focus on reviewing healthcare utilization, the Full Time Utilization Review Social Worker emphasizes social work assessments and care coordination, whereas the Utilization Review Nurse concentrates on medical record evaluation and clinical review. Both positions require relevant certifications and work within healthcare or insurance settings, but their core functions differ based on professional background and focus areas.

What cities are hiring for Full Time Utilization Review Social Worker jobs?

Cities with the most Full Time Utilization Review Social Worker job openings:

What are the most commonly searched types of Utilization Review Social Worker jobs?

The most popular types of Utilization Review Social Worker jobs are:

What states have the most Full Time Utilization Review Social Worker jobs?

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

PHP Utilization Review Coordinator

Leesburg, VA • On-site


UHS
Health Care and Social Assistance • 10K+ employees

6.9

Company rating: 6.9 out of 10

Based on 254 frontline employees who took The Breakroom Quiz

459th of 895 rated healthcare providers

People enjoy working here

Recommended by students

Respectful managers


Full-time

Medical, Retirement, PTO

Posted 6 days ago


Job description

Responsibilities

***Join Our Team as a Utilization Review Coordinator!***

North Spring Behavioral Healthcare is looking for a fulltime Utilization Review Coordinator (on-site) to join our compassionate and dynamic team!

What We Offer:

  • Competitive Salary
  • Comprehensive Benefits Package:
    • Health insurance – Available after just 30 days.
    • Paid Time Off – Start earning after 90 days.
    • 401(k) with company match – Eligible after 30 days.

The Utilization Review Coordinator assists admissions in screening patients at the pre-hospital level to ensure that admission criteria are met, and when admitted, follows the chart checking that documentation reflects and meets admission, continued stay, and discharge criteria. Interacts and communicates with clinical staff, Business Office, Admissions, Medical Records, third party reviewers and hospital administration to help receive hospital care they need.

Key Responsibilities: 

  • Performs clinical reviews over the telephone. Reviews that entire chart to evaluate the appropriateness of admission, continued stay, discharge criteria and identifies high-risk cases. 
  • Facilitates discharge planning with treatment team and coordinates continuum of care for the patient with Social Worker. Monitors the effectiveness of patient outcomes. 
  • Attends treatment team meetings and serves as a liaison and patient advocate between insurance companies and the treatment team. 
  • Notifies and alerts Director of Outpatient Services of potential utilization review problems or denials; assists in the preparation and implementation of the appeals process. 
  • Monitors documentation in clinical records and reports problematic areas to appropriate supervisor, Director of Outpatient Services. 
  • Assists admissions with screening patients on the pre-hospitalization level to ensure admission criteria are met. 

North Spring Behavioral Healthcare, a subsidiary of Universal Health Services, Inc. (UHS), is a Department of Behavioral Health and Developmental Services (DBHDS)-licensed, and Joint Commission approved 87-bed Psychiatric Residential Treatment Facility, and a 40-bed Inpatient Acute Psychiatric Hospital. North Spring is situated on 42 acres of scenic greenlands in historic Leesburg, VA, approximately 25 miles northwest of Washington, D.C. We provide therapeutic programs for adolescents in a safe and secure environment that encourages growth and self-responsibility. Universal Health Services, Inc. (UHS) is one of the nation's largest and most respected healthcare management companies, operating through its subsidiaries acute care hospitals, behavioral health facilities and ambulatory centers nationwide. Founded in 1978, UHS subsidiaries now have more than 83,000 employees. The UHS business strategy is to build or purchase healthcare properties in rapidly growing markets and create a strong franchise based on exceptional service and effective cost control. Our success comes from a responsive management style and a service philosophy based on integrity, competence and compassion.

About Universal Health Services 

One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500® corporation, annual revenues  during 2025 were $17.4 billion. In 2026, UHS was again recognized as one of Fortune World’s Most Admired Companies™ and in 2025, was listed in Forbes ranking of America’s Largest Public Companies. Headquartered in King of Prussia, PA, UHS has approximately 101,500 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 40 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom. For additional information visit www.uhs.com. 

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.

Avoid and Report Recruitment Scams

We are aware of a scam whereby imposters are posing as Recruiters from UHS, and our subsidiary hospitals and facilities. Beware of anyone requesting financial or personal information.

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc.

If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.


Qualifications
  • Good verbal and written skills; ability to rotate shifts and programs as necessary; ability to maintain confidentiality of patient information.
  • Must consistently exhibit mental and emotional ability to understand and perform the essential functions of the job.
  • Bachelor's degree in related field required.
  • Master’s Degree in related field preferred.
  • One to three years of related experience required.
  • Prefer experience with children and adolescents in psychiatric facility or rehabilitation program.
  • Physical Requirements: Must be able to lift and carry up to 50 pounds; 80-90% of the time the incumbent is standing, walking, kneeling, reaching while working with residents. Requires full range of body motion including handling and physical restraint of residents.
  • Ability to perform CPR and First Aid.
Qualifications:
  • Good verbal and written skills; ability to rotate shifts and programs as necessary; ability to maintain confidentiality of patient information.
  • Must consistently exhibit mental and emotional ability to understand and perform the essential functions of the job.
  • Bachelor's degree in related field required.
  • Master’s Degree in related field preferred.
  • One to three years of related experience required.
  • Prefer experience with children and adolescents in psychiatric facility or rehabilitation program.
  • Physical Requirements: Must be able to lift and carry up to 50 pounds; 80-90% of the time the incumbent is standing, walking, kneeling, reaching while working with residents. Requires full range of body motion including handling and physical restraint of residents.
  • Ability to perform CPR and First Aid.
Education:UNAVAILABLEEmployment Type: FULL_TIME

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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


What Universal Health Services employees say

Pay

Benefits

Hours and flexibility

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