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Full Time Weekend Utilization Review Jobs in Puerto Rico

OncoHealth

Case Review Specialist - PR

Guaynabo, PR · On-site

Fax intake and labeling on weekends/Holidays as needed About You * Bachelor's Degree or relevant ... Our Current Solutions Through the use of OncoHealth's utilization management system, OneUM , our ...

OncoHealth

Case Review Specialist - PR

Guaynabo, PR · On-site +1

Fax intake and labeling on weekends/Holidays as needed About You * Bachelor's Degree or relevant ... Our Current Solutions Through the use of OncoHealth's utilization management system, OneUM , our ...

ICBD

Board Certified Behavior Analyst / BCBA

San Juan, PR · On-site

$85K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Board Certified Behavior Analyst / BCBA ABA Centers of Puerto Rico San Juan, PR / Full Time ... (QA), Utilization Review (UR), Assessments, Training & Development, and Research. Whether your ...

Jj

Process Engineer

Manati, PR · On-site

Defines, analyzes, reviews and evaluates problems for prompt solutions. * Determines, adapts, and ... weekends per the operational needs. * Some traveling may be required. * Functional knowledge of ...

Telemedik

PR · On-site

  • Retirement

  • PTO

... utilization of employees within an organization. The primary goal of this role is to ensure the ... Occasional availability to work weekends and holidays may be required based on operational needs.

Johnson & Johnson

Process Engineer

Manati, PR · On-site

Defines, analyzes, reviews and evaluates problems for prompt solutions. * Determines, adapts, and ... weekends per the operational needs. * Some traveling may be required. * Functional knowledge of ...

Telemedik

PR · On-site

  • Retirement

  • PTO

... utilization of employees within an organization. The primary goal of this role is to ensure the ... Occasional availability to work weekends and holidays may be required based on operational needs.

Telemedik

PR · On-site

  • Retirement

  • PTO

... utilization of employees within an organization. The primary goal of this role is to ensure the ... Occasional availability to work weekends and holidays may be required based on operational needs.

Telemedik

PR · On-site

  • Retirement

  • PTO

... utilization of employees within an organization. The primary goal of this role is to ensure the ... Occasional availability to work weekends and holidays may be required based on operational needs.

US Department of the Treasury

Program Manager

Caguas, PR · On-site

$125K/yr

LBI - Strategic Programs REVIEW THE ADDITIONAL INFORMATION BELOW FOR FURTHER DETAILS Qualifications ... One year of experience refers to full-time work; part-timework is considered on a prorated basis.

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All JobsUtilization Review JobsFull Time Weekend Utilization Review JobsFull Time Weekend Utilization Review Jobs in Puerto Rico

Full Time Weekend Utilization Review information

What is the difference between Full Time Weekend Utilization Review vs Full Time Weekday Utilization Review?

AspectFull Time Weekend Utilization ReviewFull Time Weekday Utilization Review
Work SchedulePrimarily weekends and possibly some eveningsPrimarily weekdays, Monday to Friday
CertificationsTypically requires medical or insurance-related certificationsSame certifications as weekend roles, often the same qualifications
Work EnvironmentRemote or office-based, with flexible hours on weekendsStandard office hours during weekdays
Employer & IndustryHealthcare insurance companies, utilization review organizationsSame industry, different scheduling focus

Full Time Weekend Utilization Review roles focus on reviewing cases during weekends, offering flexibility for those who prefer weekend work. Full Time Weekday Utilization Review positions operate during standard business hours on weekdays. Both roles require similar certifications and work in the same industry, but differ mainly in scheduling and work hours.

What are popular job titles related to Full Time Weekend Utilization Review jobs in Puerto Rico?

For Full Time Weekend Utilization Review jobs in Puerto Rico, the most frequently searched job titles are:

What job categories do people searching Full Time Weekend Utilization Review jobs in Puerto Rico look for?

The top searched job categories for Full Time Weekend Utilization Review jobs in Puerto Rico are:

What cities in Puerto Rico are hiring for Full Time Weekend Utilization Review jobs?

Cities in Puerto Rico with the most Full Time Weekend Utilization Review job openings:

Full Time Weekend Utilization Review jobs near you
Infographic showing various Full Time Weekend Utilization Review job openings in Puerto Rico as of June 2026, with employment types broken down into 91% Full Time, and 9% Part Time. Highlights an 91% Physical, 2% Hybrid, and 7% Remote job distribution.

Utilization Coordinator

San Juan Capestrano

San Juan, PR

Full-time

Re-posted 2 days ago

Job description

Overview

PURPOSE STATEMENT: 

Proactively monitor utilization of services for patients to optimize reimbursement for the facility.  

Responsibilities

ESSENTIAL FUNCTIONS: 

  • Act as liaison between managed care organizations and the facility professional clinical staff. 
  • Conduct reviews, in accordance with certification requirements, of insurance plans or other managed care organizations (MCOs) and coordinate the flow of communication concerning reimbursement requirements. 
  • Monitor patient length of stay and extensions and inform clinical and medical staff on issues that may impact length of stay.  
  • Gather and develop statistical and narrative information to report on utilization, non-certified days (including identified causes and appeal information), discharges and quality of services, as required by the facility leadership or corporate office. 
  • Conduct quality reviews for medical necessity and services provided.   
  • Facilitate peer review calls between facility and external organizations.  
  • Initiate and complete the formal appeal process for denied admissions or continued stay.  
  • Assist the admissions department with pre-certifications of care.  
  • Provide ongoing support and training for staff on documentation or charting requirements, continued stay criteria and medical necessity updates. 

OTHER FUNCTIONS:  

  • Perform other functions and tasks as assigned. 
Qualifications

EDUCATION/EXPERIENCE/SKILL REQUIREMENTS: 

  • Required Education: High school diploma or equivalent. 
  • Preferred Education: Associate's, Bachelor's, or Master's degree in Social Work, Behavioral or Mental Health, Nursing, or a related health field. 
  • Experience: Clinical experience is required, or two or more years' experience working with the facility's population. Previous experience in utilization management is preferred 

LICENSES/DESIGNATIONS/CERTIFICATIONS:  

  • Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides services; or current clinical professional license or certification, as required, within the state where the facility provides services. 
  • CPR and de-escalation and restraint certification required (training available upon hire and offered by facility.   
  • First aid may be required based on state or facility requirements. 

 

ADDITIONAL REGULATORY REQUIREMENTS: 

While this job description is intended to be an accurate reflection of the requirements of the job, management reserves the right to add or remove duties from particular jobs when circumstances  (e.g. emergencies, changes in workload, rush jobs or technological developments) dictate. 

We are committed to providing equal  employment opportunities to all applicants for employment regardless of an individual's characteristics protected by applicable state, federal and local laws.

Employment Type: FULL_TIME

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