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Full Time Utilization Review Social Worker Jobs (NOW HIRING)

Utilization Review Specialist | Remote | Full-Time $50,000 - $65,000 Annually | Weekdays (Weekend ... Clinical licensure (LCSW, LMHC, LPC, RN, or equivalent) - valued but not required * Experience ...

... LCSW. Position Details: * Full-time * 8am-430pm * Emergency Department * LCSW Required ... Case Management, Utilization Review, Social Services: Provides admission and continued stay reviews ...

If so, you may enjoy working at The Refuge, a Healing Place, an trauma treatment facility set on 96 ... We are looking to for a Full Time Utilization Review Specialist to join our team. The UR specialist ...

If so, you may enjoy working at The Refuge, a Healing Place, an trauma treatment facility set on 96 ... We are looking to for a Full Time Utilization Review Specialist to join our team. The UR specialist ...

If so, you may enjoy working at The Refuge, a Healing Place, an trauma treatment facility set on 96 ... We are looking to for a Full Time Utilization Review Specialist to join our team. The UR specialist ...

If so, you may enjoy working at The Refuge, a Healing Place, an trauma treatment facility set on 96 ... We are looking to for a Full Time Utilization Review Specialist to join our team. The UR specialist ...

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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 10, 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 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.

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 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.

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:

Utilization Review Specialist

Cutting Edge Staffing LLC

Pompano Beach, FL • Remote

$50K - $65K/yr

Full-time

Posted 13 days ago


Job description

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 Utilization Review Specialist to join our corporate team. In this remote role, you'll manage a caseload of 50–75 patients, conducting admission and continuing-stay reviews, coordinating authorizations, and serving as a key liaison between Banyan's clinical operations and the managed care organizations that fund patient treatment. Your work directly protects patient access to care and keeps the business running.

This is a high-volume, relationship-driven role for someone who thrives on precision, knows how to navigate managed care, and understands the stakes on both sides of the authorization process.

About Banyan Treatment Centers

Banyan Treatment Centers is a leading national provider of intensive treatment for individuals facing substance use and mental health disorders. Backed by TPG, one of the nation’s largest private equity investors, Banyan is rapidly expanding access to high-quality, compassionate care.

Why Join Our Team?

  • Mission-driven work with real business impact — your authorizations directly determine whether patients stay in treatment. Few roles sit closer to the intersection of clinical care and organizational sustainability.
  • Nationally recognized organization — Joint Commission–accredited, with 18 locations and telehealth services nationwide, and the infrastructure to support your work at scale.
  • Remote flexibility — work from anywhere while collaborating with clinical, billing, and operations teams across the country.
  • Collaborative environment — partner closely with clinical, operational, and billing teams to resolve outstanding case issues, support discharge planning, and ensure timely reimbursement.
  • Room to grow — join a rapidly expanding organization where UR professionals have visibility across the enterprise and opportunities to advance.
  • Comprehensive benefits including medical, dental, and vision insurance; whole and term life insurance; short- and long-term disability; 401(k) with employer match; paid time off and holidays; wellness incentives; and employee assistance and referral programs.

Key Responsibilities

  • Manage a caseload of 50–75 patients, authorizing 15–25 cases daily and ensuring timely utilization reviews and appropriate level of care determinations
  • Conduct admission and continuing-stay reviews to assess medical necessity and ensure compliance with treatment standards
  • Verify insurance benefits, coordinate authorizations, and communicate effectively with external case managers and managed care organizations
  • Establish and maintain contracts with managed care companies and request rate increases when appropriate
  • Collaborate with clinical and billing departments to support discharge planning, documentation, and timely reimbursement
  • Identify and address over- and underutilization trends
  • Assist in resolving outstanding case issues with insurers

Qualifications

Required:

  • High school diploma or equivalent
  • Minimum one year of utilization review experience in a psychiatric or chemical dependency setting
  • Strong organizational, documentation, and communication skills
  • Ability to manage high caseloads with accuracy and efficiency
  • Comfortable working independently in a remote environment

Preferred:

  • Graduate degree in a health or behavioral health related field
  • Clinical licensure (LCSW, LMHC, LPC, RN, or equivalent) — valued but not required
  • Experience working with managed care organizations, insurance authorization, and level of care criteria
  • Familiarity with Joint Commission standards and behavioral health regulatory requirements

Apply Now

If you're experienced in utilization review, thrive in a fast-paced and high-volume environment, and want your work to matter beyond the spreadsheet, we'd like to meet you. Apply today to join the Banyan Treatment Centers corporate team.

Banyan Treatment Centers is an equal opportunity employer.