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Full Time Utilization Review Social Worker Jobs (NOW HIRING)

The Utilization Review Coordinator opportunity is a key member of the Lighthouse Case Management ... Must be license-eligible or licensed in Georgia. (LAPC, LPC, LMSW, LCSW, LMFT, LMHC) * Must have 2 ...

Job Type Full-time Description The UR Coordinator's primary responsibility is managing, reviewing ... Psychological and social aspects and characteristics of mental illness and chemical dependency.

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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 Sep 8, 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:

Utilization Review Clinician

UHS

Augusta, GA • On-site

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 16 days ago


Key responsibilities

  • Review clinical content of medical records and participate in treatment team meetings to gather data for insurance authorization.

  • Coordinate with the treatment team to ensure timely input of pre-certifications and continued stay reviews into the system, verify insurance coverage, and follow up on pending authorizations.

  • Communicate clinical criteria and support documentation for pre-certification and continued stay reviews to insurance companies and authorizing entities.


Universal Health Services rating

6.8

Company rating: 6.8 out of 10

Based on 255 frontline employees who took The Breakroom Quiz

495th of 898 rated healthcare providers


Job description

Responsibilities

Lighthouse Care Center of Augusta is seeking a dedicated, compassionate Utilization Review Clinician to add to our growing team.

Lighthouse Care Center of Augusta has been providing psychiatric services to the CSRA for more than 15-years.  Located in Augusta, GA our 84-bed facility provides a therapeutic setting for those seeking treatment for mental illness.  Lighthouse Care Center offers unique and individualized programming for adolescents and adults that sets us apart from many other treatment facilities, and our tenured team includes seasoned medical staff. 

Website: https://www.LighthouseCareCenters.com

The Utilization Review Clinician opportunity is a key member of the Lighthouse Case Management team who will integrate and coordinate clinical content with a keen focus on patient care; ensuring that delivery of high-quality and cost-effective treatment is consistent with the mission, vision, and values of Universal Health Services and in accordance with government regulation, licensing and accreditation requirements. Under the direction of the UR Manager, the Utilization Review Clinician is responsible for conducting clinical review of data to determine eligibility respective to pre-certification and continued stay reviews.

Job Duties/ Responsibilities:

  • Review clinical content of medical records, participate in treatment team meetings, and collaborate with physicians, therapist, nurses and pertinent staff on gathering the necessary data to communicate with insurance companies/authorizing entities to ensure initial precertification and continued authorization is achieved.
  • Ensure input of pre-certifications and continued stay reviews into Midas, follow-up on unfinished pre-certifications from the day before, coordinate with the treatment team on any follow-ups necessary, verify insurance coverage at the first of the month, and post patient payments into MS4. 
  • Trained in all aspects relative to timely gathering of clinical criteria, communication of clinical criteria, and entry of supporting clinical criteria into computer based systems, in addition to other job duties.

Benefit Highlights: 

  • Referral Bonus Program
  • Challenging and rewarding work environment
  • Competitive Compensation & Generous Paid Time Off
  • Excellent Medical, Dental, Vision and Prescription Drug Plans
  • 401(K) with company match and discounted stock plan
  • Career development opportunities within UHS and its 300+ Subsidiaries!
  • More information is available on our Benefits Guest Website: uhsguest.com 

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. 

From Fortune, ©2025, 2026 Fortune Media IP Limited. All rights reserved. Used under license. 


Qualifications

Education and Experience:

  • Masters level education in social science field (social work, counseling, sociology, psychology)
  • Must be license-eligible or licensed in Georgia. (LAPC, LPC, LMSW, LCSW, LMFT, LMHC)
  • Must have 2 years of experience in a psychiatric health care setting, delivery of care to psychiatric and/or chemically dependent patients and utilization review
  • Nurses with a current GA or Multistate license encouraged to apply. (LPN, RN)

Certifications, License, Registration:

LMHC, LMFT, LAPC, LPC, LMSW, LCSW, LPN or RN preferred

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:

Education and Experience:

  • Masters level education in social science field (social work, counseling, sociology, psychology)
  • Must be license-eligible or licensed in Georgia. (LAPC, LPC, LMSW, LCSW, LMFT, LMHC)
  • Must have 2 years of experience in a psychiatric health care setting, delivery of care to psychiatric and/or chemically dependent patients and utilization review
  • Nurses with a current GA or Multistate license encouraged to apply. (LPN, RN)

Certifications, License, Registration:

LMHC, LMFT, LAPC, LPC, LMSW, LCSW, LPN or RN preferred

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. 

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