ZipRecruiter

Log In

1

Intern Optum Health Utilization Review Jobs (NOW HIRING)

Prime Time Healthcare

Utilization Review

Washington, DC · On-site

Now Hiring: RN Utilization Review - Washington, DC Are you a passionate RN professional looking for ... Prime Time Healthcare is seeking dynamic individuals like you to join our team in Washington, DC ...

Prime Time Healthcare

Utilization Review

Baltimore, MD · On-site

Now Hiring: RN Utilization Review - Baltimore, MD Are you a passionate RN professional looking for ... Prime Time Healthcare is seeking dynamic individuals like you to join our team in Baltimore, MD and ...

Merrimack Health

Utilization Review Nurse

Lawrence, MA · On-site

Utilization Review Nurse Responsible for determining the appropriateness of hospital admission, utilization of resources and medical necessity for continued stay. Responsible for working with the ...

previous pagenext page

Showing results 21-40

All JobsHealthcare JobsNursing JobsNurse Case Manager JobsIntern Optum Health Utilization Review Jobs

Intern Optum Health Utilization Review information

See salary details

$9

$16

$22

How much do intern optum health utilization review jobs pay per hour?

As of Sep 14, 2026, the average hourly pay for intern optum health utilization review in the United States is $16.77, according to ZipRecruiter salary data. Most workers in this role earn between $14.42 and $18.75 per hour, depending on experience, location, and employer.

What is the difference between Intern Optum Health Utilization Review vs Intern UnitedHealth Group Case Management?

AspectIntern Optum Health Utilization ReviewIntern UnitedHealth Group Case Management
CertificationsNone required, healthcare-related knowledge preferredNone required, healthcare knowledge beneficial
Work EnvironmentHealthcare settings, insurance review teamsHealthcare settings, patient coordination teams
Employer & IndustryOptum Health, healthcare and insurance industryUnitedHealth Group, healthcare and insurance industry

Both roles are healthcare internships within the insurance industry, focusing on different aspects. The Utilization Review intern primarily assesses insurance claims and medical necessity, while the Case Management intern coordinates patient care. They share similar environments and may require healthcare knowledge, but their core responsibilities differ, making each role unique within the healthcare insurance sector.

What cities are hiring for Intern Optum Health Utilization Review jobs?

Cities with the most Intern Optum Health Utilization Review job openings:

What are the most commonly searched types of Optum Health Utilization Review jobs?

The most popular types of Optum Health Utilization Review jobs are:

What states have the most Intern Optum Health Utilization Review jobs?

States with the most job openings for Intern Optum Health Utilization Review jobs include:

What are popular job titles related to Intern Optum Health Utilization Review jobs?

For Intern Optum Health Utilization Review jobs, the most frequently searched job titles are:

Intern Optum Health Utilization Review jobs near you

Utilization Review

Marlboro, NJ • On-site

Discovery Institute
See more jobs at Discovery Instituteexternal

Other

Re-posted 12 days ago

Job description

Position Summary

The Utilization Review (UR) Specialist is responsible for obtaining and maintaining insurance authorizations for clients receiving substance use disorder treatment services. This position works closely with clinical staff, admissions, and insurance companies to ensure medical necessity documentation is accurate, authorizations are obtained timely, and reimbursement is maximized while maintaining compliance with payer requirements, Medicaid regulations, and accreditation standards.

Essential Duties and Responsibilities
  • Obtain initial and concurrent insurance authorizations for all levels of care.
  • Review clinical documentation to ensure it supports medical necessity.
  • Submit clinical information to insurance companies within required timeframes.
  • Monitor authorization expiration dates and request extensions before expiration.
  • Communicate authorization decisions and payer requirements to clinical staff.
  • Track approved days and notify leadership of denials or reductions in care.
  • Prepare and submit appeals for denied services when appropriate.
  • Maintain accurate authorization records in the electronic health record (EHR).
  • Work collaboratively with Admissions, Clinical, Nursing, and Billing departments.
  • Verify insurance benefits and coverage when necessary.
  • Monitor payer portals for authorization updates.
  • Assist with Medicaid and managed care authorization processes.
  • Participate in utilization review meetings and case conferences.
  • Generate reports on authorization status, denials, appeals, and payer trends.
  • Ensure compliance with Joint Commission, state, federal, and payer regulations.
  • Maintain confidentiality in accordance with HIPAA regulations.
  • Perform other duties as assigned.
Qualifications
  • High school diploma required; Associate's or Bachelor's degree preferred.
  • Minimum of two years of utilization review, case management, medical billing, or behavioral healthcare experience preferred.
  • Experience in substance use disorder or behavioral health treatment strongly preferred.
  • Knowledge of ASAM Criteria preferred.
  • Familiarity with Medicaid, commercial insurance, and managed care plans.
  • Strong organizational and time management skills.
  • Excellent verbal and written communication skills.
  • Ability to prioritize multiple cases in a fast-paced environment.
  • Proficient in Microsoft Office and electronic health record systems.
Knowledge, Skills, and Abilities
  • Understanding of insurance authorization processes.
  • Knowledge of medical necessity criteria and documentation standards.
  • Strong analytical and critical thinking skills.
  • Excellent customer service and professional communication.
  • Ability to work independently while collaborating with interdisciplinary teams.
  • Attention to detail and accuracy.
  • Ability to maintain confidentiality.
Performance Expectations
  • Maintain timely insurance authorizations with minimal lapses.
  • Reduce avoidable authorization denials.
  • Ensure documentation meets payer standards.
  • Maintain accurate records and reporting.
  • Demonstrate professionalism, teamwork, and excellent customer service.
  • Comply with all organizational policies, HIPAA, Joint Commission standards, and applicable federal and New Jersey regulations.

Apply