Responsibilities DIRECTOR, UTILIZATION REVIEW (UR) Join us in helping others rediscover their "hope ... Excellent and affordable benefits package with 20+ benefit offerings (including pet insurance ...
Responsibilities DIRECTOR, UTILIZATION REVIEW (UR) Join us in helping others rediscover their "hope ... Excellent and affordable benefits package with 20+ benefit offerings (including pet insurance ...
Responsibilities DIRECTOR, UTILIZATION REVIEW (UR) Join us in helping others rediscover their "hope ... Excellent and affordable benefits package with 20+ benefit offerings (including pet insurance ...
Responsibilities DIRECTOR, UTILIZATION REVIEW (UR) Join us in helping others rediscover their "hope ... Excellent and affordable benefits package with 20+ benefit offerings (including pet insurance ...
Responsibilities DIRECTOR, UTILIZATION REVIEW (UR) Join us in helping others rediscover their "hope ... Excellent and affordable benefits package with 20+ benefit offerings (including pet insurance ...
Responsibilities DIRECTOR, UTILIZATION REVIEW (UR) Join us in helping others rediscover their "hope ... Excellent and affordable benefits package with 20+ benefit offerings (including pet insurance ...
... insurance payers. This position is responsible for reviewing behavioral health clinical ... Experience in Utilization Review Not Required While prior utilization review experience is always ...
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... insurance payers. This position is responsible for reviewing behavioral health clinical ... Experience in Utilization Review Not Required While prior utilization review experience is always ...
Refers cases requiring clinical review to a Nurse reviewer. * Responsible for the identification ... Medical terminology training and experience in medical or insurance field preferred. * For URAC ...
Refers cases requiring clinical review to a Nurse reviewer. * Responsible for the identification ... Medical terminology training and experience in medical or insurance field preferred. * For URAC ...
... review, and regulatory compliance. May also be responsible for ensuring that medical payments are ... Familiarity with health insurance industry trends and technology. * Demonstrated competency related ...
... review, and regulatory compliance. May also be responsible for ensuring that medical payments are ... Familiarity with health insurance industry trends and technology. * Demonstrated competency related ...
Crisis/Intake Counselor
Millcreek, UT · On-site
$36K - $41K/yr
Processes and supports insurance Verification of Benefits (VOBs) in collaboration with the UR/Admissions team. * Collaborates with Utilization Review staff to support authorization, clinical ...
Crisis/Intake Counselor
Millcreek, UT · On-site
$36K - $41K/yr
Processes and supports insurance Verification of Benefits (VOBs) in collaboration with the UR/Admissions team. * Collaborates with Utilization Review staff to support authorization, clinical ...
Crisis/Intake Counselor
Salt Lake City, UT · On-site
$36K - $41K/yr
Processes and supports insurance Verification of Benefits (VOBs) in collaboration with the UR/Admissions team. * Collaborates with Utilization Review staff to support authorization, clinical ...
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Crisis/Intake Counselor
Salt Lake City, UT · On-site
$36K - $41K/yr
Processes and supports insurance Verification of Benefits (VOBs) in collaboration with the UR/Admissions team. * Collaborates with Utilization Review staff to support authorization, clinical ...
Crisis/Intake Counselor
$35K - $40K/yr
Processes and supports insurance Verification of Benefits (VOBs) in collaboration with the UR/Admissions team. * Collaborates with Utilization Review staff to support authorization, clinical ...
Crisis/Intake Counselor
$35K - $40K/yr
Processes and supports insurance Verification of Benefits (VOBs) in collaboration with the UR/Admissions team. * Collaborates with Utilization Review staff to support authorization, clinical ...
Full-Time Billing and Accounts Receivable Specialist
Saint George, UT · On-site
$49K - $56K/yr
Knowledge of behavioral health inpatient billing, insurance requirements, and payer processes strongly preferred. * Willingness to learn authorization and utilization review processes and support ...
Full-Time Billing and Accounts Receivable Specialist
Saint George, UT · On-site
$49K - $56K/yr
Knowledge of behavioral health inpatient billing, insurance requirements, and payer processes strongly preferred. * Willingness to learn authorization and utilization review processes and support ...
Intake Specialist
Millcreek, UT · On-site
$16.75 - $22.25/hr
The Receptionist / Intake Specialist works closely with the Utilization Review and Admissions team to collect intake information, verify insurance benefits, and ensure accurate documentation to ...
Intake Specialist
Millcreek, UT · On-site
$16.75 - $22.25/hr
The Receptionist / Intake Specialist works closely with the Utilization Review and Admissions team to collect intake information, verify insurance benefits, and ensure accurate documentation to ...
Medical Director - Utilization Management (Remote)
Salt Lake City, UT · On-site +1
$240K/yr
Perform utilization management case reviews. * Maintain productivity score per company standard ... Malpractice insurance is not required, as physicians do not provide direct patient care. Reviewers ...
Medical Director - Utilization Management (Remote)
Salt Lake City, UT · On-site +1
$240K/yr
Perform utilization management case reviews. * Maintain productivity score per company standard ... Malpractice insurance is not required, as physicians do not provide direct patient care. Reviewers ...
Dental Director, Health Plan - REMOTE
Provo, UT · Remote
$129K - $215K/yr
Essential Job Duties Oversees all aspects of utilization review and quality management activities ... care, insurance, or benefits administration setting, or equivalent combination of relevant ...
Dental Director, Health Plan - REMOTE
Provo, UT · Remote
$129K - $215K/yr
Essential Job Duties Oversees all aspects of utilization review and quality management activities ... care, insurance, or benefits administration setting, or equivalent combination of relevant ...
Dental Director, Health Plan - REMOTE
Salt Lake City, UT · Remote
$129K - $215K/yr
Essential Job Duties • Oversees all aspects of utilization review and quality management ... care, insurance, or benefits administration setting, or equivalent combination of relevant ...
Dental Director, Health Plan - REMOTE
Salt Lake City, UT · Remote
$129K - $215K/yr
Essential Job Duties • Oversees all aspects of utilization review and quality management ... care, insurance, or benefits administration setting, or equivalent combination of relevant ...
Dental Director, Health Plan - REMOTE
Lehi, UT · Remote
$129K - $215K/yr
Essential Job Duties • Oversees all aspects of utilization review and quality management ... care, insurance, or benefits administration setting, or equivalent combination of relevant ...
Dental Director, Health Plan - REMOTE
Lehi, UT · Remote
$129K - $215K/yr
Essential Job Duties • Oversees all aspects of utilization review and quality management ... care, insurance, or benefits administration setting, or equivalent combination of relevant ...
Dental Director, Health Plan - REMOTE
Ogden, UT · Remote
$129K - $215K/yr
Essential Job Duties • Oversees all aspects of utilization review and quality management ... care, insurance, or benefits administration setting, or equivalent combination of relevant ...
Dental Director, Health Plan - REMOTE
Ogden, UT · Remote
$129K - $215K/yr
Essential Job Duties • Oversees all aspects of utilization review and quality management ... care, insurance, or benefits administration setting, or equivalent combination of relevant ...
Dental Director, Health Plan - REMOTE
Saint George, UT · Remote
$129K - $215K/yr
Essential Job Duties • Oversees all aspects of utilization review and quality management ... care, insurance, or benefits administration setting, or equivalent combination of relevant ...
Dental Director, Health Plan - REMOTE
Saint George, UT · Remote
$129K - $215K/yr
Essential Job Duties • Oversees all aspects of utilization review and quality management ... care, insurance, or benefits administration setting, or equivalent combination of relevant ...
Dental Director, Health Plan - REMOTE
Provo, UT · Remote
$129K - $215K/yr
Essential Job Duties • Oversees all aspects of utilization review and quality management ... care, insurance, or benefits administration setting, or equivalent combination of relevant ...
Dental Director, Health Plan - REMOTE
Provo, UT · Remote
$129K - $215K/yr
Essential Job Duties • Oversees all aspects of utilization review and quality management ... care, insurance, or benefits administration setting, or equivalent combination of relevant ...
Clinical Manager Home Health
Ogden, UT · On-site
Work with Utilization Review staff relative to data tracking for performance review and outcomes of ... Valid driver's license, auto insurance and reliable transportation. * Two years as a Registered ...
Clinical Manager Home Health
Ogden, UT · On-site
Work with Utilization Review staff relative to data tracking for performance review and outcomes of ... Valid driver's license, auto insurance and reliable transportation. * Two years as a Registered ...
Dental Director, Health Plan - REMOTE
Clearfield, UT · Remote
$129K - $215K/yr
Essential Job Duties • Oversees all aspects of utilization review and quality management ... care, insurance, or benefits administration setting, or equivalent combination of relevant ...
Dental Director, Health Plan - REMOTE
Clearfield, UT · Remote
$129K - $215K/yr
Essential Job Duties • Oversees all aspects of utilization review and quality management ... care, insurance, or benefits administration setting, or equivalent combination of relevant ...
Insurance Utilization Review information
See Utah salary details
$19.48 - $23.42
2% of jobs
$23.42 - $27.36
9% of jobs
$30.05 is the 25th percentile. Wages below this are outliers.
$27.36 - $31.29
21% of jobs
The median wage is $34.48 / hr.
$31.29 - $35.23
23% of jobs
$35.23 - $39.17
13% of jobs
$42.24 is the 75th percentile. Wages above this are outliers.
$39.17 - $43.11
10% of jobs
$43.11 - $47.05
8% of jobs
$47.05 - $50.99
5% of jobs
$50.99 - $54.93
5% of jobs
$54.93 - $58.87
2% of jobs
$58.87 - $62.81
2% of jobs
$19
$38
$62
How much do insurance utilization review jobs pay per hour?
What are the most common challenges faced by Insurance Utilization Review professionals?
One common challenge in Insurance Utilization Review is balancing the need for cost-effective care with the clinical needs of patients, which often requires careful analysis and decision-making. Professionals in this role frequently navigate complex medical records, strict policy guidelines, and collaborate with healthcare providers who may advocate strongly for particular treatments. Managing challenging conversations while maintaining professionalism and ensuring timely determinations are also a regular part of the role. Developing expertise in these areas can make the job both demanding and rewarding, while building a strong foundation for career growth within healthcare administration.
What are the key skills and qualifications needed to thrive in the Insurance Utilization Review position, and why are they important?
To thrive in Insurance Utilization Review, you generally need a strong background in healthcare or nursing, an understanding of medical terminology, and analytical thinking skills, often supported by an RN license or relevant clinical experience. Familiarity with utilization management software, coding systems like ICD-10, and knowledge of regulatory requirements (such as Medicare or Medicaid) are important. Strong communication, attention to detail, and problem-solving abilities help professionals excel when interacting with providers and insurers. These skills are essential to ensure appropriate care is authorized while maintaining regulatory compliance and cost-effectiveness.
What is an Insurance Utilization Review job?
An Insurance Utilization Review job involves evaluating medical treatments and services to determine if they are necessary, appropriate, and covered by a patient's insurance plan. Professionals in this role review medical records, treatment plans, and insurance policies to ensure compliance with guidelines and cost-effectiveness. They work closely with healthcare providers, insurance companies, and patients to facilitate approvals or appeals. The goal is to balance quality patient care with cost containment in the healthcare system.
- Medical Review Nurse
- Remote Utilization Management Pharmacist
- Part Time Utilization Review Nurse
- No Experience Utilization Review Nurse
- Behavioral Health Utilization Review
- Per Diem Utilization Review Nurse
- Utilization Review Physician
- Remote Utilization Review Physical Therapist
- Flex Schedule Remote Utilization Review Nurse
- Remote Prior Authorization Nurse
- Remote Physical Therapy Utilization Review
- Contract Utilization Review
- Remote Utilization Review
- Cigna Utilization Review Remote
- Utilization Care Manager
- Full Time Navihealth Utilization Review
- Remote Optum Utilization Review
- Authorization Utilization Review
- Manager Aetna Utilization Review
- Commission Authorization Utilization Review Bcba
Universal Health Services rating
6.8
Based on 250 frontline employees who took The Breakroom Quiz
483rd of 877 rated healthcare providers
Job description
DIRECTOR, UTILIZATION REVIEW (UR)
Join us in helping others rediscover their “hope.” Since our establishment in 2011, we have been dedicated to providing exceptional and specialized mental health and addiction treatment in a nurturing and supportive environment. Together, we will work toward a future where mental health is prioritized, stigma is diminished and individuals can live their lives to the fullest potential. If you’re looking for an opportunity to build the career of your dreams and join a team of professionals passionate about helping others, Aspen Grove Behavioral Hospital may be the place for you! Please visit www.aspengrovehospital.com
Position Details & Benefits:
- Full-Time, Salaried Exempt Mon - Fri 9am - 5pm
- Paid Time Off (PTO) & Extended Leave (ELB) - earn time off from your first day
- Excellent and affordable benefits package with 20+ benefit offerings (including pet insurance)
- 401(k) company matched retirement plan + discounted stock purchase plan
- FREE meals and FREE parking
- Career development opportunities across UHS and its 300+ locations!
Your position objectives include:
- Responsible for directing and overseeing the Utilization Review Program for in-patient and outpatient services.
- Implementation of case management scenarios, consulting with all services to ensure the provision of an effective treatment plan for all patients
- Oversees the response to requests for services and interfaces with managed care organizations, external reviewers, and other payors.
- Provides direct supervision to assigned employees; including hiring, training, performance improvement and separations
Qualifications
Your Skills & Qualifications will include:
- License: Valid Utah RN license or license authorized to practice in Utah OR Valid Utah LMSW/LCSW license
- Experience: Requires (3-5) years of experience working in utilization review preferrably in a psych inpatient setting
- Education: ASN or BSN or a MSW degree REQUIRED
- Other: Must be at least 21 years of age or older and able to pass a pre-employment background check & drug screen
EEO Statement - We believe that diversity and inclusion among our teammates is critical to our success. 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.
Avoid and Report Recruitment Scams - At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.
Qualifications:Your Skills & Qualifications will include:
- License: Valid Utah RN license or license authorized to practice in Utah OR Valid Utah LMSW/LCSW license
- Experience: Requires (3-5) years of experience working in utilization review preferrably in a psych inpatient setting
- Education: ASN or BSN or a MSW degree REQUIRED
- Other: Must be at least 21 years of age or older and able to pass a pre-employment background check & drug screen
EEO Statement - We believe that diversity and inclusion among our teammates is critical to our success. 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.
Avoid and Report Recruitment Scams - At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.
Education:UNAVAILABLEEmployment Type: FULL_TIMEWhat Universal Health Services employees say
Pay
Benefits
Hours and flexibility
Workplace
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About Universal Health Services
Sourced by ZipRecruiter
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