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Hourly Utilization Review Social Worker Jobs (NOW HIRING)

UHS

Utilization Review Clinician

Augusta, GA

Must be license-eligible or licensed in Georgia. (LAPC, LPC, LMSW, LCSW, LMFT, LMHC) Nurses with a ... utilization review. CERTIFICATIONS, LICENSES, REGISTRATION LMHC, LMFT, LAPC, LPC, LMSW, LCSW, LPN ...

UHS

Utilization Review Clinician

Augusta, GA

Must be license-eligible or licensed in Georgia. (LAPC, LPC, LMSW, LCSW, LMFT, LMHC) Nurses with a ... utilization review. CERTIFICATIONS, LICENSES, REGISTRATION LMHC, LMFT, LAPC, LPC, LMSW, LCSW, LPN ...

BJC HealthCare

Clinical Social Worker

Alton, IL · On-site

$63K - $102K/yr

Case Management, Utilization Review, Social Services: Provides admission and continued stay reviews ... Lic Clinical Social Worker Preferred Requirements Experience * 2-5 years Benefits and Legal ...

GRO Community

Utilization Review Manager

Chicago, IL · On-site

Utilization Review Manager Location: Chicago Job Type: Full-Time Reports to: Director of Revenue ... Active LCSW or LCPC clinical licensure highly preferred. Skills: * Strong knowledge of insurance ...

GRO Community

Utilization Review Manager

Chicago, IL · On-site

Utilization Review Manager Location: Chicago Job Type: Full-Time Reports to: Director of Revenue ... Active LCSW or LCPC clinical licensure highly preferred. Skills: * Strong knowledge of insurance ...

UHS

DIR - UTILIZATION REVIEW / MGMT

Augusta, GA

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 ...

GRO Community

Utilization Review Manager

Chicago, IL

Utilization Review Manager Location: Chicago Job Type: Full-Time Reports to: Director of Revenue ... Active LCSW or LCPC clinical licensure highly preferred. Skills: * Strong knowledge of insurance ...

UHS

DIR - UTILIZATION REVIEW / MGMT

Augusta, GA

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 ...

UHS

DIR - UTILIZATION REVIEW / MGMT

Augusta, GA

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

As of Jul 26, 2026, the average hourly pay for hourly 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 is an Hourly Utilization Review Social Worker?

An Hourly Utilization Review Social Worker is a licensed social work professional who evaluates patient care records and clinical information to ensure that healthcare services provided are necessary, appropriate, and efficient. They typically work on an hourly basis, often as consultants or part-time employees, and focus on reviewing cases for compliance with insurance and regulatory guidelines. Their assessments help determine the level of care required and facilitate communication between healthcare providers, patients, and payers. This role is essential in controlling healthcare costs, improving patient outcomes, and ensuring that resources are used responsibly.

What are the key skills and qualifications needed to thrive as an Hourly Utilization Review Social Worker, and why are they important?

To excel as an Hourly Utilization Review Social Worker, you need a background in social work (often requiring an MSW and state licensure), strong knowledge of clinical assessment, and experience with healthcare regulations. Familiarity with utilization review software, electronic health records (EHRs), and insurance authorization systems is crucial. Outstanding communication, critical thinking, and organizational skills help you advocate effectively for patients and collaborate with healthcare teams. These skills are vital to ensure patients receive appropriate care, maximize resource use, and maintain compliance with healthcare policies.

How does an Hourly Utilization Review Social Worker typically collaborate with healthcare providers to ensure appropriate patient care?

As an Hourly Utilization Review Social Worker, you will regularly communicate with physicians, nurses, and case managers to assess patient needs and verify that treatment plans align with payer guidelines. This often involves participating in interdisciplinary team meetings, reviewing patient records, and providing recommendations for care transitions or discharge planning. Effective collaboration is essential to advocate for patients while ensuring compliance with insurance requirements and hospital policies. Strong communication and negotiation skills are key to navigating these interactions and supporting optimal outcomes.
What cities are hiring for Hourly Utilization Review Social Worker jobs? Cities with the most Hourly 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 Hourly Utilization Review Social Worker jobs? States with the most job openings for Hourly Utilization Review Social Worker jobs include:
Hourly Utilization Review Social Worker jobs near you
Behavioral Health Social Worker, Utilization Review, Days

Behavioral Health Social Worker, Utilization Review, Days

ScionHealth

Palestine, TX • On-site

Full-time

Posted 14 days ago

ScionHealth rating

5.6

Company rating: 5.6 out of 10

Based on 49 frontline employees who took The Breakroom Quiz

801st of 890 rated healthcare providers

Job description

Join Palestine Regional Medical Center in Palestine, TX, a 150-bed hospital that has recently earned the prestigious Leapfrog "A" Safety Grade, the Platinum Award for quality from parent-company ScionHealth, and certification as a Chest Pain Center and Level IV Trauma facility. Palestine Regional provides a range of comprehensive care, including the latest in diagnostic, therapeutic, and rehabilitative services, both on an inpatient and outpatient basis. Palestine Regional is an integral part of the local community, giving you the chance to grow your career while making a real impact close to home.
Job Summary
The Social Worker-Utilization Review monitors adherence to the hospital's utilization review plan to ensure appropriate use of hospital services, admissions, and extended stays. The Social Worker-Utilization Review performs pre-certification, concurrent review, and discharge planning in accordance with applicable guidelines and acts as a liaison to support safe, timely, and medically necessary care.
Essential Functions
  • Ensures the medical necessity and appropriateness of all hospital admissions per established criteria
  • Performs concurrent medical record reviews to justify continued stay and documents appropriately
  • Coordinates with care team to facilitate timely and effective discharge planning
  • Communicates with third-party payers and managed care entities to provide required documentation
  • Collaborates with social services and case management to streamline patient transitions and reduce readmissions
  • Reviews and monitors patient charts in alignment with medical staff performance improvement metrics
  • Contributes to organizational quality goals and achieves performance targets in a timely manner

Knowledge/Skills/Abilities/Expectations
  • Strong clinical assessment and critical thinking skills
  • Ability to interpret medical records, criteria, and regulations
  • Knowledge of utilization review processes, discharge planning, and payer requirements
  • Proficient in communication and coordination with interdisciplinary teams
  • Skilled in documentation, confidentiality practices, and health information systems
  • Demonstrates resilience, adaptability, and the ability to manage stress effectively
  • Frequent use of computers and telephone
  • Must be able to sit or stand for prolonged periods
  • Occasional lifting of up to 25 pounds
  • Frequent walking and light movement required during audits or rounding
  • Hospital setting with exposure to general healthcare conditions
  • May involve contact with patients, families, and medical records
  • Potential exposure to communicable diseases, bloodborne pathogens, and chemicals
  • Fast-paced environment requires focus, accuracy, and confidentiality

Qualifications
Education
  • Bachelor of Social Work degree from an accredited school of social work (Required) and
  • Master of Social Work degree from an accredited school of social work (Preferred)

Licenses/Certifications
  • Licensed in the state of practice as LBSW, LMSW, or LCSW.
  • License must be current and without restrictions.

Experience
  • Two (2) years of progressive clinical experience preferred; psychiatric healthcare experience desirable

What ScionHealth employees say

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