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Full Time Utilization Review Social Worker Jobs (NOW HIRING)

Collaborates with the physician nurse case manager social worker and other members of the health ... Acts as a resource and mentor to the Utilization Review staff. Primary Duties and Responsibilities

The Director of Utilization Review is a key member of the Lighthouse Case Management Team who will ... LMSW, LCSW, etc) EXPERIENCE: A minimum of five (5) years direct clinical experience in a ...

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Full Time Utilization Review Social Worker information

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$68

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

As of Aug 11, 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:

DIR - UTILIZATION REVIEW / MGMT

UHS

Oakland Park, FL • On-site

Full-time

Medical, Dental, Vision, PTO

Re-posted 15 days ago


Universal Health Services rating

6.8

Company rating: 6.8 out of 10

Based on 253 frontline employees who took The Breakroom Quiz

493rd of 887 rated healthcare providers


Job description

Responsibilities

Fort Lauderdale Behavioral Health Center, is a 182-bed, acute care psychiatric hospital located in the beautiful Oakland Park, neighborhood of Fort Lauderdale, FL.  Fort Lauderdale Behavioral features individual units for children, adolescents, adults, and seniors, and offers inpatient acute care, partial hospitalization, and intensive outpatient programs.  On average, over 10,000 patients receive care from our compassionate health care team each year. FLBHC provides innovative behavioral health treatment and academic services to children, adolescents, and young adults, including:

  • 24/7 Clinical Assessment Center
  • Inpatient Hospitalization
  • Inpatient Program Residential Treatment Facility and Partial Hospitalization Behavioral Health Rehabilitative Services

We are currently looking for a Director Of Utilization Management to support our Fort Lauderdale, FL campus. The Director of Utilization Management is required to meet Foundations standards of customer service and best practices as well as adhere to UHS Code of Conduct. The person must demonstrate excellent interpersonal skills, unquestioned integrity and dedication to their responsibilities and Foundations mission. The Director of Utilization Management is also responsible for ensuring that the utilization review process meets the integrity standards set by FLBHC and UHS. The Director: interfaces with clinical staff as well as managed care organizations, external reviewers and other payers,  ensures that information is communicated in a straightforward, unbiased and timely manner. The Director will ensure that the content is accurate and relevant so that recipients can make informed decisions as well as leads the coordination of appeals including tracking and facilitating of physician reviews.

 

The Director of Utilization Management is responsible for the implementation of systems and standards related to the utilization review function, including the implementation of the Utilization Management Plan and ensuring its adherence to all regulatory standards. The Director coordinates the decimation of information to the CEO, CFO, CMO, medical staff, CNO, Director of Compliance, and Director of Clinical Services in a way that facilitates meaningful decision making. 

The Director of Utilization Management supports the quality of clinical services by identifying issues and trends preventing successful outcomes in treatment through the utilization review process. The Director supervises all Utilization Management activities, including conducting audits to assure medical necessity criteria is met and is clearly documented in the medical record, immediately resolving any issues when medical necessity criteria is not met or not clearly documented. The Director supervises the Utilization Management Coordinators and assures coverage of all UM related activities.


Qualifications

Fort Lauderdale Behavioral Health offers comprehensive benefits for the Director of Utilization Review position, such as:

  • Challenging and rewarding work environment
  • Competitive Compensation
  • Excellent Medical, Dental, Vision, and Prescription Drug Plan
  • Generous Paid Time Off

Requirements:

Masters degree in social work, counseling or related field with respective licensure (LSW, LCSW, LPC) required.

Must have 3-5 years of Utilization Management experience in a behavioral health inpatient and/or residential setting.

Must be familiar with a variety of insurances and funding streams, including commercial insurance, Medicare/Medicaid

Must be familiar with community based resources need to coordinate aftercare, both insurance funded and natural supports

Preferred experience with children and adolescents, and specifically individuals with Autism, intellectual disabilities, or other neurodevelopmental disabilities.

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.

We believe that diversity and inclusion among our teammates is critical to our success.

Notice

At UHS and all subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates with matching skillset and experience with the best possible career at UHS and our subsidiaries.  We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail etc. If you feel suspicious of a job posting or job-related email, let us know by contacting us at: https://uhs.alertline.com or 1-800-852-3449

Qualifications:

Fort Lauderdale Behavioral Health offers comprehensive benefits for the Director of Utilization Review position, such as:

  • Challenging and rewarding work environment
  • Competitive Compensation
  • Excellent Medical, Dental, Vision, and Prescription Drug Plan
  • Generous Paid Time Off

Requirements:

Masters degree in social work, counseling or related field with respective licensure (LSW, LCSW, LPC) required.

Must have 3-5 years of Utilization Management experience in a behavioral health inpatient and/or residential setting.

Must be familiar with a variety of insurances and funding streams, including commercial insurance, Medicare/Medicaid

Must be familiar with community based resources need to coordinate aftercare, both insurance funded and natural supports

Preferred experience with children and adolescents, and specifically individuals with Autism, intellectual disabilities, or other neurodevelopmental disabilities.

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.

We believe that diversity and inclusion among our teammates is critical to our success.

Notice

At UHS and all subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates with matching skillset and experience with the best possible career at UHS and our subsidiaries.  We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail etc. If you feel suspicious of a job posting or job-related email, let us know by contacting us at: https://uhs.alertline.com or 1-800-852-3449

Education:UNAVAILABLEEmployment Type: FULL_TIME

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About Universal Health Services

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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