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Insurance Utilization Review Jobs in Columbia, SC

Trident Pain Center

Physician Assistant

West Columbia, SC · On-site

$90K - $140K/yr

Participates in quality improvement and utilization review activities. * Participates in continuing ... Health Insurance * Dental * Vision * Group and Voluntary Life * Disability Insurance * PTO ...

Trident Pain Center

Physician Assistant

West Columbia, SC · On-site

$92K - $125K/yr

Participates in quality improvement and utilization review activities. * Participates in continuing ... Health Insurance * Dental * Vision * Group and Voluntary Life * Disability Insurance * PTO ...

Lexington Medical Center

CDI Specialist RN

West Columbia, SC · On-site

$32.25 - $43.25/hr

Collaborates with physician, physician extender, nurse, case manager/utilization reviewer and ... Day ONE medical, dental and life insurance benefits * Health care and dependent care flexible ...

Lexington Medical Center

CDI Specialist RN

West Columbia, SC · On-site

$32.25 - $43.25/hr

Collaborates with physician, physician extender, nurse, case manager/utilization reviewer and ... Day ONE medical, dental and life insurance benefits * Health care and dependent care flexible ...

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All JobsInsurance Utilization Review JobsInsurance Utilization Review Jobs in Columbia, SC

Insurance Utilization Review information

See Columbia, SC salary details

$18

$36

$59

How much do insurance utilization review jobs pay per hour?

As of Aug 8, 2026, the average hourly pay for insurance utilization review in Columbia, SC is $36.56, according to ZipRecruiter salary data. Most workers in this role earn between $28.89 and $41.97 per hour, depending on experience, location, and employer.

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 insurance utilization review?

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?

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.

What are the most commonly searched types of Insurance Utilization Review jobs in Columbia, SC? The most popular types of Insurance Utilization Review jobs in Columbia, SC are:
What are popular job titles related to Insurance Utilization Review jobs in Columbia, SC? For Insurance Utilization Review jobs in Columbia, SC, the most frequently searched job titles are:
What job categories do people searching Insurance Utilization Review jobs in Columbia, SC look for? The top searched job categories for Insurance Utilization Review jobs in Columbia, SC are:
Insurance Utilization Review jobs near you
Infographic showing various Insurance Utilization Review job openings in Columbia, SC as of August 2026, with employment types broken down into 1% As Needed, 73% Full Time, 21% Part Time, and 5% Contract. Highlights an 92% Physical, 1% Hybrid, and 7% Remote job distribution, with an average salary of $76,037 per year, or $36.6 per hour.

Home Health Registered Nurse-Pelion, SC

The JAG Group

Pelion, SC

Full-time

Re-posted 19 days ago

Job description

OurHome Health Nurses, RN'shave been called to care when they're needed most. As a member of our home health team, you'll support a full range of patient services to bring comfort and dignity to our clients.
What you'll do:
  • Provide in-home direct patient care according to the provider's prescribed plan of care (and nursing scope of practice) while closely monitoring progress/recovery.
  • Assess and document patient conditions and report changes as needed (vitals, blood/stool/urine, glucose, etc.)
  • Administer medication, insulin, and IV/fluids; documenting thoroughly.
  • Inspect and care for wounds, changing dressings and assisting with personal hygiene.
  • Assess patient for further injuries, infections, bedsores, etc. and deliver appropriate treatments.
  • Collaborate with providers, aides, and allied health professionals to ensure exceptional patient outcomes.

What we're looking for:
  • Education: Associate's Degree in Nursing (ADN) or Associate of Applied Science in Nursing (AAS) required;
  • Licensure: Current unrestricted license to practice as a Registered Nurse (RN) in the state associated with this position.
  • Current CPR/AED/BLS/First Aid certification.
  • Valid state-issued driver's license, automobile insurance, and reliable transportation; willingness to travel.
  • One (1) year of professional experience practicing as a Registered Nurse (RN) in a home health or similar setting; previous case management/utilization review experience preferred.

What we offer:
  • Competitive compensation, benefits, and incentives.
  • Truly flexible scheduling - a dedication to work/life balance.
  • A team environment with a focus on community service.

Call to apply today!!
Derrick Green
The JAG Group
www.thejaggroup.com
dgreen@thejaggroup.com
404-405-6465 Cell
678-884-5696 Direct

Apply