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Hca Utilization Review Jobs (NOW HIRING)

Utilizes knowledge to determine appropriate CPT, HCPC, ICD-10 codes using CMS, NCQA and HCA ... Reviews completed denial letters for accuracy and adherence to compliance deadlines. Edits and ...

... reviews, and field visits that communicate Mindray's clinical, operational, and financial value ... Monitor account performance, pipeline, contract utilization, competitive activity, wins and losses ...

... reviews, and field visits that communicate Mindray's clinical, operational, and financial value ... Monitor account performance, pipeline, contract utilization, competitive activity, wins and losses ...

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Hca Utilization Review information

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How much do hca utilization review jobs pay per hour?

As of Aug 11, 2026, the average hourly pay for hca utilization review 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 is an HCA Utilization Review?

An HCA Utilization Review job involves evaluating medical services to ensure they are necessary, cost-effective, and meet quality standards. Professionals in this role review patient records, coordinate with healthcare providers, and ensure treatments align with insurance guidelines and hospital policies. They play a key role in optimizing resource utilization, preventing unnecessary procedures, and ensuring compliance with regulations. Strong analytical skills and knowledge of medical terminology are essential for success in this position.

What are the key skills and qualifications needed for an HCA Utilization Review?

To thrive as a HCA Utilization Review professional, you need a solid foundation in medical terminology, clinical assessment, and insurance guidelines, often supported by a healthcare-related degree or nursing license. Familiarity with utilization review software, electronic health records (EHR) systems, and certifications like CCM (Certified Case Manager) are highly beneficial. Excellent analytical thinking, attention to detail, and strong communication skills help you effectively evaluate patient records and collaborate with providers. These competencies are key to ensuring appropriate care utilization, supporting cost-effective treatment decisions, and maintaining regulatory compliance.

What does an HCA Utilization Review do?

In HCA Utilization Review, your day usually involves reviewing patient medical records, assessing the necessity and appropriateness of proposed treatments, and communicating decisions to physicians and case managers. You may also participate in interdisciplinary meetings, liaise with insurance providers for authorization, and document your findings in healthcare management systems. The role is collaborative, requiring you to interact with diverse medical and administrative teams to align patient care with policy guidelines. This blend of independent evaluation and team collaboration makes each day varied and impactful for patient outcomes.

More about Hca Utilization Review jobs
What cities are hiring for Hca Utilization Review jobs? Cities with the most Hca Utilization Review job openings:
What are the most commonly searched types of Hca Utilization Review jobs? The most popular types of Hca Utilization Review jobs are:
What states have the most Hca Utilization Review jobs? States with the most job openings for Hca Utilization Review jobs include:
Infographic showing various Hca Utilization Review job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 83% Full Time, 13% Part Time, and 3% Contract. Highlights an 90% Physical, 3% Hybrid, and 7% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

Registered Nurse (RN) - Case Manager, Utilization Review

Perm Staff Jobs

Independence, MO • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 6 days ago


Job description

Perm Staff Jobs is seeking a Registered Nurse (RN) Case Manager, Utilization Review for a nursing job in Independence, Missouri.

Job Description & Requirements
  • Specialty: Utilization Review
  • Discipline: RN
  • Duration: Ongoing
  • Employment Type: Staff
Registered Nurse (RN) - Hiring Now!

As a RN Coord Quality, your voice to influence patient care is valued and empowered at every turn –whether through open, collaborative relationships with your direct manager or more formal opportunities through hospital councils and national nursing initiatives. You'll help shape decisions that elevate both patient outcomes and the future of nursing.

Job Summary and Qualifications This is not a remote position. You would be working in the hospital.

Performs medical record reviews to examine and assess provider documentation and to ensure patient severity of illness and health acuity is accurately reflected. This is accomplished by performing prospective, concurrent and retrospective review of various types of patient medical records from multiple settings. The Clinical Reviewer assessments also provide guidance for ongoing provider coaching, training and facilitation. Adheres to policies, procedures and regulations to ensure compliance and patient safety.  

What qualifications you will need:

    • (RN) Registered Nurse
    • Associate Degree, or Bachelors Degree
     
  • 2 years of quality or performance improvement experience is preferred
Benefits

Centerpoint Medical Center, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

  • Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services
  • Wellbeing support, including free counseling and referral services
  • Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage and leaves of absence
  • Savings and retirement resources, including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support and financial wellbeing counseling
  • Education support through tuition assistance, student loan assistance, certification support, dependent scholarships and a partnership with Galen College of Nursing
  • Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection and consumer discounts

Learn more about Employee Benefits

Note: Eligibility for benefits may vary by location.

"Nurses are essential to the delivery of healthcare and serve as its foundation. At HCA Healthcare, we are committed to equipping nurses with the tools and resources they need to deliver exceptional patient care, championing the profession, and supporting the advancement of nursing’s future."

Erica Rossitto, MBA/HCM, BSN, RN, NEA-BC

Senior Vice President and Chief Nurse Executive

HCA Healthcare

Centerpoint Medical Center is a 285+ bed hospital featuring state-of-the-art equipment and technology. Our hospital offers some of the latest clinical services available to patients. We remain focused on providing compa­ssionate care and top-notch customer service for our patients. We offer many features for visitors, including sleeper chairs in patient rooms, comfortable waiting areas, and wireless internet access. We are a Level II Trauma Center with 24/7 emergency services and an accredited Chest Pain Center. Our Orthopedic Services include Total Joints and Sports Medicine. We are an accredited Cancer Program and Breast Center. We provide Women’s Services, a Level III Neonatal Intensive Care Unit, and a Stroke Center. Our Outpatient Services include a Surgery Center, Advanced Wound Care Center, Pain Center, Sleep Disorder Center, Imaging, and Rehab. We are part of HCA Midwest Health, a network of hospitals in Kansas City and surrounding areas.

HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

If this opportunity is your next step in your career path, we encourage you to apply for our RN Coord Quality opening. We review all applications. Qualified candidates will be contacted by a member of our team. We are interviewing, apply today!

We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.