Life Insurance and Disability Insurances * Flexible Spending Account * Pre-tax Metro SmartTrip ... Six months psychiatric utilization review either for hospital or external review organization ...
Life Insurance and Disability Insurances * Flexible Spending Account * Pre-tax Metro SmartTrip ... Six months psychiatric utilization review either for hospital or external review organization ...
Utilization Review Coordinator
Washington, DC · On-site
$33.60 - $50.40/hr
Life Insurance and Disability Insurances * Flexible Spending Account * Pre-tax Metro SmartTrip ... Six months psychiatric utilization review either for hospital or external review organization ...
Utilization Review Coordinator
Washington, DC · On-site
$33.60 - $50.40/hr
Life Insurance and Disability Insurances * Flexible Spending Account * Pre-tax Metro SmartTrip ... Six months psychiatric utilization review either for hospital or external review organization ...
Life Insurance and Disability Insurances * Flexible Spending Account * Pre-tax Metro SmartTrip ... Six months psychiatric utilization review either for hospital or external review organization ...
Life Insurance and Disability Insurances * Flexible Spending Account * Pre-tax Metro SmartTrip ... Six months psychiatric utilization review either for hospital or external review organization ...
RN Team Lead Utilization Review
Clinton, MD · On-site
$89K - $162K/yr
About the Job Candidate must have acute care Utilization Review experience. Candidate must live in ... Identifies insurance information obtains authorization communicates with financial counseling and ...
RN Team Lead Utilization Review
Clinton, MD · On-site
$89K - $162K/yr
About the Job Candidate must have acute care Utilization Review experience. Candidate must live in ... Identifies insurance information obtains authorization communicates with financial counseling and ...
When necessary, cases are escalated to the Medical Director for further review. The reviewer ... events, health insurance coverage for you and your dependents on Day 1, 401(k), tuition ...
When necessary, cases are escalated to the Medical Director for further review. The reviewer ... events, health insurance coverage for you and your dependents on Day 1, 401(k), tuition ...
When necessary, cases are escalated to the Medical Director for further review. The reviewer ... insurance, 401(k), paid time off and more. The targeted hiring range for this role is expected to ...
When necessary, cases are escalated to the Medical Director for further review. The reviewer ... insurance, 401(k), paid time off and more. The targeted hiring range for this role is expected to ...
When necessary, cases are escalated to the Medical Director for further review. The reviewer ... insurance, 401(k), paid time off and more. The targeted hiring range for this role is expected to ...
When necessary, cases are escalated to the Medical Director for further review. The reviewer ... insurance, 401(k), paid time off and more. The targeted hiring range for this role is expected to ...
Reviews the medical record by applying utilization review criteria, to assess clinical, financial ... Pay Range $34--$55 USD Luminis Health Benefits Overview: • Medical, Dental, and Vision Insurance ...
Reviews the medical record by applying utilization review criteria, to assess clinical, financial ... Pay Range $34--$55 USD Luminis Health Benefits Overview: • Medical, Dental, and Vision Insurance ...
Utilization Management Nurse - Emergency Department
Annapolis, MD · On-site
$34 - $55/hr
Reviews the medical record by applying utilization review criteria, to assess clinical, financial ... Pay Range $34-$55 USD Luminis Health Benefits Overview: • Medical, Dental, and Vision Insurance ...
Utilization Management Nurse - Emergency Department
Annapolis, MD · On-site
$34 - $55/hr
Reviews the medical record by applying utilization review criteria, to assess clinical, financial ... Pay Range $34-$55 USD Luminis Health Benefits Overview: • Medical, Dental, and Vision Insurance ...
Utilization Management Nurse
$34 - $55/hr
Reviews the medical record by applying utilization review criteria, to assess clinical, financial ... Pay Range $34--$55 USD Luminis Health Benefits Overview: • Medical, Dental, and Vision Insurance ...
Utilization Management Nurse
$34 - $55/hr
Reviews the medical record by applying utilization review criteria, to assess clinical, financial ... Pay Range $34--$55 USD Luminis Health Benefits Overview: • Medical, Dental, and Vision Insurance ...
Utilization Management Nurse
Annapolis, MD · On-site
$34 - $55/hr
Reviews the medical record by applying utilization review criteria, to assess clinical, financial ... Pay Range $34-$55 USD Luminis Health Benefits Overview: • Medical, Dental, and Vision Insurance ...
Utilization Management Nurse
Annapolis, MD · On-site
$34 - $55/hr
Reviews the medical record by applying utilization review criteria, to assess clinical, financial ... Pay Range $34-$55 USD Luminis Health Benefits Overview: • Medical, Dental, and Vision Insurance ...
Utilization Management Nurse
$34 - $55/hr
Reviews the medical record by applying utilization review criteria, to assess clinical, financial ... Pay Range $34--$55 USD Luminis Health Benefits Overview: • Medical, Dental, and Vision Insurance ...
Utilization Management Nurse
$34 - $55/hr
Reviews the medical record by applying utilization review criteria, to assess clinical, financial ... Pay Range $34--$55 USD Luminis Health Benefits Overview: • Medical, Dental, and Vision Insurance ...
Utilization Management CoordinatorNE
Glen Burnie, MD · On-site
$40.61 - $60.96/hr
General Summary Using the established guidelines for Utilization Review, the Utilization Management Coordinator collaborates with members of the hospital team, the insurance provider, and regulatory ...
Utilization Management CoordinatorNE
Glen Burnie, MD · On-site
$40.61 - $60.96/hr
General Summary Using the established guidelines for Utilization Review, the Utilization Management Coordinator collaborates with members of the hospital team, the insurance provider, and regulatory ...
Utilization Management CoordinatorNE
Glen Burnie, MD · On-site
$406K/yr
General Summary Using the established guidelines for Utilization Review, the Utilization Management Coordinator collaborates with members of the hospital team, the insurance provider, and regulatory ...
Utilization Management CoordinatorNE
Glen Burnie, MD · On-site
$406K/yr
General Summary Using the established guidelines for Utilization Review, the Utilization Management Coordinator collaborates with members of the hospital team, the insurance provider, and regulatory ...
Utilization Partner - Washington, DC
Bowie, MD · On-site
$54K - $58K/yr
We offer a comprehensive benefits package including: - Medical, dental, vision, life insurance, and a health savings account - 401(k) with up to 6% matching - Company car for business and personal ...
Utilization Partner - Washington, DC
Bowie, MD · On-site
$54K - $58K/yr
We offer a comprehensive benefits package including: - Medical, dental, vision, life insurance, and a health savings account - 401(k) with up to 6% matching - Company car for business and personal ...
Clinical Reviewer DC
Washington, DC · On-site
Medical, dental and vision insurance * Paid time off for vacation, illness and volunteering ... Document utilization review decision in the appropriate database. * Act as a resource for peers and ...
Clinical Reviewer DC
Washington, DC · On-site
Medical, dental and vision insurance * Paid time off for vacation, illness and volunteering ... Document utilization review decision in the appropriate database. * Act as a resource for peers and ...
Clinical Reviewer DC
Washington, DC · On-site
Medical, dental and vision insurance * Paid time off for vacation, illness and volunteering ... Document utilization review decision in the appropriate database. * Act as a resource for peers and ...
Clinical Reviewer DC
Washington, DC · On-site
Medical, dental and vision insurance * Paid time off for vacation, illness and volunteering ... Document utilization review decision in the appropriate database. * Act as a resource for peers and ...
Travel Position Overview This is a 54-day remote assignment for an experienced Utilization Review ... insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life ...
Travel Position Overview This is a 54-day remote assignment for an experienced Utilization Review ... insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life ...
Clinical Medical Director
Annapolis Junction, MD · On-site
$275K - $375K/yr
Background in health insurance, utilization review, or healthcare claims processing, including familiarity with medical necessity criteria and coverage determination standards. * Demonstrated ...
Clinical Medical Director
Annapolis Junction, MD · On-site
$275K - $375K/yr
Background in health insurance, utilization review, or healthcare claims processing, including familiarity with medical necessity criteria and coverage determination standards. * Demonstrated ...
Pharmacy Benefit Coordinator
$67K - $72K/yr
... utilization review, quality improvement, provider relations, and population health initiatives ... Experience working in a managed care, insurance, PBM, or equivalent environment is strongly ...
Pharmacy Benefit Coordinator
$67K - $72K/yr
... utilization review, quality improvement, provider relations, and population health initiatives ... Experience working in a managed care, insurance, PBM, or equivalent environment is strongly ...
Insurance Utilization Review information
See Washington salary details
$24.23 - $29.13
2% of jobs
$29.13 - $34.03
9% of jobs
$37.39 is the 25th percentile. Wages below this are outliers.
$34.03 - $38.93
21% of jobs
The median wage is $42.90 / hr.
$38.93 - $43.83
23% of jobs
$43.83 - $48.73
13% of jobs
$52.55 is the 75th percentile. Wages above this are outliers.
$48.73 - $53.63
10% of jobs
$53.63 - $58.54
8% of jobs
$58.54 - $63.44
5% of jobs
$63.44 - $68.34
5% of jobs
$68.34 - $73.24
2% of jobs
$73.24 - $78.14
2% of jobs
$24
$47
$78
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.
- Evening Optum Health Utilization Review
- Remote Chart Review Nurse
- Utilization Review Physician
- Night Shift Remote Utilization Review Nurse
- Utilization Review Nurse
- Remote Cvs Utilization Management Nurse
- Full Time Remote Behavioral Health Utilization Review
- Part Time Utilization Review Nurse
- Freelance Utilization Review Nurse
- Flex Schedule Remote Utilization Review Nurse
- Work From Home Utilization Review
- Utilization Review 1099
- Utilization Care Manager
- Per Diem Remote Occupational Therapy Utilization Review
- Dental Utilization Review
- Utilization Review Salary
- Weekend Utilization Review
- Remote Hca Utilization Review
- Utilization Review Nurse Compact License
- Cigna Utilization Review Remote

Other
Medical, Dental, Vision, Life, Retirement, PTO
Posted 2 days ago
Universal Health Services rating
6.8
Based on 253 frontline employees who took The Breakroom Quiz
493rd of 890 rated healthcare providers
Job description
The Psychiatric Institute of Washington is a152-bed facility with inpatient, outpatient and partial hospitalization programs. Excellence in behavioral health programs for children, adolescents and adults has been the mission of The Psychiatric Institute of Washington since it opened nearly 50 years ago. As the first and only free standing psychiatric care facilities in Washington, DC, our team has a reputation for providing innovative treatment and care. We strive for excellence, never losing sight of providing patients with hope – hope that although their stay is relatively brief, they may find their way to a brighter future.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
- Tracks new admissions or transfers to assigned area and is responsible for knowing and following through with certification requirements from admission through discharge. Serves as liaison to on-site external reviewers.
- Uses Midas for recording reviews and tracking denials. Adds to Midas databases as needed.
- Teaches staff to document medical necessity through in-services or individual meetings. Monitors quality of records and notifies staff and program director of problems. Available to program director to develop plan for improvement as needed.
- Supports and guides treatment planning as needed. Continues to bring to staff awareness the need for documentation to flow from and correlate with treatment plan.
- Informs department director of changes in managed care companies. Maintains awareness of unique status to propose out of plan benefits or to open the door to increase hospital’s opportunity to provide services to a larger group.
- Works appropriately and professionally with all staff and demonstrates a supportive attitude toward the goals of the hospital. Makes recommendations for the hospital based on identified trends.
- Arranges schedule in consideration of needs of the department, participates in arranging coverage for planned absences and demonstrates a supportive attitude toward the goals of the department.
- Performs other job related duties as assigned.
Benefit Highlights:
Our employees are our most valuable asset and we are dedicated to provide a challenging and rewarding work environment to all our employees.
- Generous Paid Time Off
- Excellent Medical, Dental, Vision and Prescription Drug Plans
- 401(K) with company match and discounted stock plan
- UHS employee discounted stock option plan
- Tuition Reimbursement and Student Loan Repay Program
- Employee Assistant Program (EAP)
- Life Insurance and Disability Insurances
- Flexible Spending Account
- Pre-tax Metro SmartTrip Benefits
- Career development opportunities within UHS and its 300+ Subsidiaries!
Who we are:
One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, annual revenues were $11.6 billion in 2020. In 2021, UHS was again recognized as one of the World’s Most Admired Companies by Fortune; in 2020, ranked #281 on the Fortune 500; and listed #330 in Forbes ranking of U.S.’ Largest Public Companies. Headquartered in King of Prussia, PA, UHS has 89,000 employees and through its subsidiaries operates 26 acute care hospitals, 334 behavioral health facilities, 39 outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 38 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom.
Qualifications
- Bachelor’s degree in applicable field of study required
- Six months psychiatric utilization review either for hospital or external review organization preferred.
- Candidates must meet the company’s hiring criteria to include a pre-employment verifications, background investigation and drug test.
COVID Requirements
PIW requires its staff to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, or religious belief that prevents them from being vaccinated.
E-VERIFY Statement
PIW participates in E-Verify. We will provide the Social Security Administration, and if necessary, the Department of Homeland Security, with information from each new employee’s Form I-9 to confirm work authorization. Please note that we do not use this information to pre-screen job applicants.
EEO Statement
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.
We believe that diversity and inclusion among our teammates is critical to our success.
Notice
At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: https://uhs.alertline.com or 1-800-852- 3449.
Qualifications:- Bachelor’s degree in applicable field of study required
- Six months psychiatric utilization review either for hospital or external review organization preferred.
- Candidates must meet the company’s hiring criteria to include a pre-employment verifications, background investigation and drug test.
COVID Requirements
PIW requires its staff to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, or religious belief that prevents them from being vaccinated.
E-VERIFY Statement
PIW participates in E-Verify. We will provide the Social Security Administration, and if necessary, the Department of Homeland Security, with information from each new employee’s Form I-9 to confirm work authorization. Please note that we do not use this information to pre-screen job applicants.
EEO Statement
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.
We believe that diversity and inclusion among our teammates is critical to our success.
Notice
At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: https://uhs.alertline.com or 1-800-852- 3449.
Education:UNAVAILABLEEmployment Type: PER_DIEMWhat Universal Health Services employees say
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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