This position is responsible for working with insurance companies and managed care systems for the ... Previous experience in utilization review or case management desirable. This position will obtain ...
Quick apply
This position is responsible for working with insurance companies and managed care systems for the ... Previous experience in utilization review or case management desirable. This position will obtain ...
Quick apply
This position is responsible for working with insurance companies and managed care systems for the ... Previous experience in utilization review or case management desirable. This position will obtain ...
Austin, TX · Remote
$84K - $118K/yr
Managed admissions, case management, discharge planning, and utilization review to support quality ... Benefits Paid time off (PTO)Various health insurance options & wellness plansRetirement benefits ...
Austin, TX · Remote
$84K - $118K/yr
Managed admissions, case management, discharge planning, and utilization review to support quality ... Benefits Paid time off (PTO)Various health insurance options & wellness plansRetirement benefits ...
This position is responsible for working with insurance companies and managed care systems for the ... Previous experience in utilization review or case management desirable. This position will obtain ...
This position is responsible for working with insurance companies and managed care systems for the ... Previous experience in utilization review or case management desirable. This position will obtain ...
This position is responsible for working with insurance companies and managed care systems for the ... Previous experience in utilization review or case management desirable. This position will obtain ...
This position is responsible for working with insurance companies and managed care systems for the ... Previous experience in utilization review or case management desirable. This position will obtain ...
Austin, TX · On-site +1
$260K - $280K/yr
About Curative Curative is building the future of health insurance with a first-of-its-kind ... This pivotal role will be responsible for overseeing and performing utilization reviews, prior ...
Austin, TX · On-site +1
$260K - $280K/yr
About Curative Curative is building the future of health insurance with a first-of-its-kind ... This pivotal role will be responsible for overseeing and performing utilization reviews, prior ...
About Curative Curative is building the future of health insurance with a first-of-its-kind ... This pivotal role will be responsible for overseeing and performing utilization reviews, prior ...
About Curative Curative is building the future of health insurance with a first-of-its-kind ... This pivotal role will be responsible for overseeing and performing utilization reviews, prior ...
About Curative Curative is building the future of health insurance with a first-of-its-kind ... This pivotal role will be responsible for overseeing and performing utilization reviews, prior ...
About Curative Curative is building the future of health insurance with a first-of-its-kind ... This pivotal role will be responsible for overseeing and performing utilization reviews, prior ...
Austin, TX · On-site
$180 - $250/hr
Curative is building the future of health insurance with a first-of-its-kind employer-based plan ... This pivotal role will be responsible for overseeing and performing utilization reviews, prior ...
Austin, TX · On-site
$180 - $250/hr
Curative is building the future of health insurance with a first-of-its-kind employer-based plan ... This pivotal role will be responsible for overseeing and performing utilization reviews, prior ...
The Utilization Review Coordinator is responsible for bridging communications between the hospital treatment team and insurance company/referral agencies. Will analyze clinical documentation to ...
The Utilization Review Coordinator is responsible for bridging communications between the hospital treatment team and insurance company/referral agencies. Will analyze clinical documentation to ...
The Utilization Review Coordinator is responsible for bridging communications between the hospital treatment team and insurance company/referral agencies. Will analyze clinical documentation to ...
The Utilization Review Coordinator is responsible for bridging communications between the hospital treatment team and insurance company/referral agencies. Will analyze clinical documentation to ...
The Utilization Review Coordinator is responsible for bridging communications between the hospital treatment team and insurance company/referral agencies. Will analyze clinical documentation to ...
The Utilization Review Coordinator is responsible for bridging communications between the hospital treatment team and insurance company/referral agencies. Will analyze clinical documentation to ...
Liberty Hill, TX · On-site
The Utilization Review Coordinator is responsible for bridging communications between the hospital treatment team and insurance company/referral agencies. Will analyze clinical documentation to ...
Liberty Hill, TX · On-site
The Utilization Review Coordinator is responsible for bridging communications between the hospital treatment team and insurance company/referral agencies. Will analyze clinical documentation to ...
Liberty Hill, TX · On-site
The Utilization Review Coordinator is responsible for bridging communications between the hospital treatment team and insurance company/referral agencies. Will analyze clinical documentation to ...
Liberty Hill, TX · On-site
The Utilization Review Coordinator is responsible for bridging communications between the hospital treatment team and insurance company/referral agencies. Will analyze clinical documentation to ...
Austin, TX · On-site
$4.8K - $7.7K/wk
Our comprehensive benefits package includes 100% paid employee health insurance for full-time ... Under the direct supervision of the Utilization Review Nurse Manager, the utilization review (UR ...
Austin, TX · On-site
$4.8K - $7.7K/wk
Our comprehensive benefits package includes 100% paid employee health insurance for full-time ... Under the direct supervision of the Utilization Review Nurse Manager, the utilization review (UR ...
Essential Functions • Perform concurrent, retroactive and pre-service authorization reviews for ... Experience Requirements * 2+ years Utilization management experience with a health insurance ...
Essential Functions • Perform concurrent, retroactive and pre-service authorization reviews for ... Experience Requirements * 2+ years Utilization management experience with a health insurance ...
Essential Functions Perform concurrent, retroactive and pre-service authorization reviews for ... Experience Requirements * 2+ years Utilization management experience with a health insurance ...
Essential Functions Perform concurrent, retroactive and pre-service authorization reviews for ... Experience Requirements * 2+ years Utilization management experience with a health insurance ...
Round Rock, TX · On-site
$20.25 - $26.50/hr
Knowledge of Medicare benefits and insurance processes and contracts. * Knowledge of accreditation ... Experience in case management, utilization review, or discharge planning a plus.
Round Rock, TX · On-site
$20.25 - $26.50/hr
Knowledge of Medicare benefits and insurance processes and contracts. * Knowledge of accreditation ... Experience in case management, utilization review, or discharge planning a plus.
... home insurance, identity theft protection, legal counseling, long-term care coverage, moving ... utilization review, resource management, discharge planning, and care coordination. * You will ...
... home insurance, identity theft protection, legal counseling, long-term care coverage, moving ... utilization review, resource management, discharge planning, and care coordination. * You will ...
Social Worker - Utilization Management Team COMPANY OVERVIEW At Harbor Health, we're transforming ... Insurance Company) members identified through UM reviews who may have behavioral health, mental ...
Social Worker - Utilization Management Team COMPANY OVERVIEW At Harbor Health, we're transforming ... Insurance Company) members identified through UM reviews who may have behavioral health, mental ...
Social Worker - Utilization Management Team COMPANY OVERVIEW At Harbor Health, we're transforming ... Insurance Company) members identified through UM reviews who may have behavioral health, mental ...
Quick apply
Social Worker - Utilization Management Team COMPANY OVERVIEW At Harbor Health, we're transforming ... Insurance Company) members identified through UM reviews who may have behavioral health, mental ...
$21.20 - $25.49
2% of jobs
$25.49 - $29.78
9% of jobs
$32.71 is the 25th percentile. Wages below this are outliers.
$29.78 - $34.06
21% of jobs
The median wage is $37.54 / hr.
$34.06 - $38.35
23% of jobs
$38.35 - $42.64
13% of jobs
$45.98 is the 75th percentile. Wages above this are outliers.
$42.64 - $46.93
10% of jobs
$46.93 - $51.22
8% of jobs
$51.22 - $55.50
5% of jobs
$55.50 - $59.79
5% of jobs
$59.79 - $64.08
2% of jobs
$64.08 - $68.37
2% of jobs
$21
$41
$68
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.
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.
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.

Georgetown, TX • On-site
Full-time, Per diem
Medical, Dental, Vision, Retirement, PTO
Re-posted 10 days ago
Our inpatient behavioral health hospital is seeking a PRN Utilization Review Coordinator.
This position is responsible for working with insurance companies and managed care systems for the initial authorization, concurrent and retrospective review of inpatient, partial, and intensive outpatient admissions and services. Previous experience in utilization review or case management desirable.
This position will obtain authorization for each admitted patient. Review and monitor each step of the authorization process to proactively identify potential problems to help patients access the full range of their benefits through the utilization review process.
Requirements
Education and/or Licensure – Bachelor’s degree or equivalent in nursing preferred.
Experience – 3-5 years Admitting or Financial Counseling preferred. Prefer two years clinical experience in a facility with medical terminology and in criteria for acute psychiatric inpatient care. Knowledgeable of insurance coverage and billing practices preferred. Previous experience in utilization review or case management desirable.
Additional Requirements – Must possess or obtain a valid CPR certification and certified in facility approved verbal de-escalation and physical crisis management techniques within 30 days of hire and prior to completion of orientation required.
Benefits
Full-time employees are eligible for medical, dental, vision, company paid disability, 401(k) and a generous amount of paid time off.
Sourced by ZipRecruiter
Health care and social assistance
51 - 200 Employees
Georgetown, TX, US
2014