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Hourly Optum Health Utilization Review Jobs (NOW HIRING)

Utilization Review Nurse

Miami, FL · Remote

$35 - $45.94/hr

We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... We're on a mission to change health care -- an experience made whole by our unique backgrounds and ...

Utilization Review Nurse

Dallas, TX · Remote

$35 - $45.94/hr

We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... We're on a mission to change health care -- an experience made whole by our unique backgrounds and ...

Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care ... Perform concurrent reviews for appropriateness of utilization to optimize clinical and financial ...

Utilization Review Nurse

Atlanta, GA · Remote

$35 - $45.94/hr

We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... We're on a mission to change health care -- an experience made whole by our unique backgrounds and ...

Utilization Review Nurse

Tempe, AZ · Remote

$35 - $45.94/hr

We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... We're on a mission to change health care -- an experience made whole by our unique backgrounds and ...

Utilization Review Associate Job Type: Full-time, 40 hours per week required (hourly POSITION ... Health for All . That mission drives everything we do, from accepting every patient, regardless of ...

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Hourly Optum Health Utilization Review information

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How much do hourly optum health utilization review jobs pay per hour?

As of Aug 8, 2026, the average hourly pay for hourly optum health 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 cities are hiring for Hourly Optum Health Utilization Review jobs? Cities with the most Hourly Optum Health Utilization Review job openings:
What are the most commonly searched types of Optum Health Utilization Review jobs? The most popular types of Optum Health Utilization Review jobs are:
What states have the most Hourly Optum Health Utilization Review jobs? States with the most job openings for Hourly Optum Health Utilization Review jobs include:

Utilization Review Specialist

Diversified Treatment Alternative Centers

Chadds Ford, PA • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 5 days ago


Job description

Utilization Review (UR) Specialist

Location: Chadds Ford, Pennsylvania (Hybrid / Remote Eligible)
Job Type: Full-Time
Schedule: Monday – Friday


Overview

Diversified Treatment Alternative Centers (DTAC) is seeking a detail-oriented and experienced Utilization Review (UR) Specialist to support our behavioral health programs.

This role plays a critical part in ensuring services are medically necessary, appropriately authorized, and compliant with payer, state, and regulatory requirements while supporting timely reimbursement and quality care delivery.


Why Join DTAC

  • Flexible hybrid or remote work options
  • Collaborative, cross-functional team environment
  • Meaningful work supporting behavioral health services
  • Stable organization focused on quality and growth
  • Opportunities for professional development


Position Summary

The Utilization Review Specialist manages the full lifecycle of authorizations and eligibility verification. This role collaborates closely with Clinical, Admissions, and Revenue Cycle teams to ensure compliance, minimize denials, and support accurate billing and reimbursement.


Key Responsibilities

  • Conduct initial, concurrent, and continued stay utilization reviews
  • Submit, track, and manage authorizations and reauthorizations
  • Communicate authorization updates with clinical and admissions teams
  • Maintain accurate documentation in EHR and billing systems
  • Perform ongoing eligibility verification for active clients
  • Identify coverage changes and communicate impacts to appropriate teams
  • Review clinical documentation for medical necessity and compliance
  • Collaborate with clinicians to address documentation gaps
  • Support denial prevention and revenue cycle optimization
  • Assist with appeals and utilization-related inquiries
  • Participate in audits, quality improvement initiatives, and compliance reviews
  • Stay current with payer requirements and regulatory updates


Qualifications

Required:

  • Bachelor’s degree in Healthcare Administration, Nursing, Social Work, Psychology, or related field
  • Minimum of 1–3 years of experience in utilization review, case management, or behavioral health revenue cycle
  • Strong understanding of medical necessity and authorization processes
  • Excellent attention to detail and analytical skills
  • Strong written and verbal communication skills

Preferred:

  • Experience with Pennsylvania and Ohio behavioral health payers
  • Familiarity with EHR systems and billing workflows
  • Experience supporting audits, compliance reviews, or appeals


Requirements

  • Ability to manage multiple priorities and deadlines
  • Strong collaboration across clinical, billing, and administrative teams
  • Commitment to compliance with regulatory and payer requirements
  • Ability to work hybrid or remotely depending on organizational needs


Benefits

  • 401(k)
  • Health, Dental, and Vision Insurance
  • Health Savings Account
  • Paid Time Off
  • Life and Disability Insurance
  • Employee Assistance Program
  • Referral Program


Work Location

This position is based in Chadds Ford, PA (19317) with hybrid or remote work options available based on business needs.


Apply Today

If you are a detail-driven professional with experience in utilization review or behavioral health operations, we encourage you to apply and join DTAC’s team.


Equal Opportunity Employer

Diversified Treatment Alternative Centers is committed to providing equal employment opportunities and maintaining an inclusive workplace in accordance with all applicable laws.