Responsibilities Utilization Review (UR) / Utilization Management (UM) Coordinator (Licensed Therapist or RN) The Utilization Review / Utilization Management Coordinator works closely with the other ...
Responsibilities Utilization Review (UR) / Utilization Management (UM) Coordinator (Licensed Therapist or RN) The Utilization Review / Utilization Management Coordinator works closely with the other ...
UR RN Will complete Utilization review and case management and discharge planning will Need experience in MCG EPIC Experience Medlivo Job ID #KAISJP00253804. Pay package is based on 8 hour shifts and ...
New
UR RN Will complete Utilization review and case management and discharge planning will Need experience in MCG EPIC Experience Medlivo Job ID #KAISJP00253804. Pay package is based on 8 hour shifts and ...
New
Active RN license (State License required) BLS Certification Recent Acute Care Case Management ... utilization review and discharge planning preferred Shift: Days | 8:30 AM - 5:00 PM | 40 hours/week ...
Active RN license (State License required) BLS Certification Recent Acute Care Case Management ... utilization review and discharge planning preferred Shift: Days | 8:30 AM - 5:00 PM | 40 hours/week ...
The UR RN Preceptor must be an expert in the utilization review functions and able to cover any role at any given time as well as manage an active UR assignment/caseload. The UR RN Preceptor will be ...
The UR RN Preceptor must be an expert in the utilization review functions and able to cover any role at any given time as well as manage an active UR assignment/caseload. The UR RN Preceptor will be ...
Ensures completion of appropriate clinical review of all applicable patients as stated in system utilization management plan. Oversees Clinical Review Specialist as indicated. Maintains necessary ...
Ensures completion of appropriate clinical review of all applicable patients as stated in system utilization management plan. Oversees Clinical Review Specialist as indicated. Maintains necessary ...
Ensures completion of appropriate clinical review of all applicable patients as stated in system utilization management plan. Oversees Clinical Review Specialist as indicated. Maintains necessary ...
Ensures completion of appropriate clinical review of all applicable patients as stated in system utilization management plan. Oversees Clinical Review Specialist as indicated. Maintains necessary ...
The UR RN Preceptor must be an expert in the utilization review functions and able to cover any role at any given time as well as manage an active UR assignment/caseload. The UR RN Preceptor will be ...
The UR RN Preceptor must be an expert in the utilization review functions and able to cover any role at any given time as well as manage an active UR assignment/caseload. The UR RN Preceptor will be ...
The UR RN Preceptor must be an expert in the utilization review functions and able to cover any role at any given time as well as manage an active UR assignment/caseload. The UR RN Preceptor will be ...
The UR RN Preceptor must be an expert in the utilization review functions and able to cover any role at any given time as well as manage an active UR assignment/caseload. The UR RN Preceptor will be ...
The UR RN Preceptor must be an expert in the utilization review functions and able to cover any role at any given time as well as manage an active UR assignment/caseload. The UR RN Preceptor will be ...
The UR RN Preceptor must be an expert in the utilization review functions and able to cover any role at any given time as well as manage an active UR assignment/caseload. The UR RN Preceptor will be ...
The UR RN Preceptor must be an expert in the utilization review functions and able to cover any role at any given time as well as manage an active UR assignment/caseload. The UR RN Preceptor will be ...
The UR RN Preceptor must be an expert in the utilization review functions and able to cover any role at any given time as well as manage an active UR assignment/caseload. The UR RN Preceptor will be ...
Clinical Utilization Review Nurse Preceptor / RN
$49.77 - $57.70/hr
The UR RN Preceptor must be an expert in the utilization review functions and able to cover any role at any given time as well as manage an active UR assignment/caseload. The UR RN Preceptor will be ...
Clinical Utilization Review Nurse Preceptor / RN
$49.77 - $57.70/hr
The UR RN Preceptor must be an expert in the utilization review functions and able to cover any role at any given time as well as manage an active UR assignment/caseload. The UR RN Preceptor will be ...
Perform the utilization and review process, for continued stay, in an appropriate and timely manner ... One to Two years related experience and/or training preferred Must have some management experience ...
Perform the utilization and review process, for continued stay, in an appropriate and timely manner ... One to Two years related experience and/or training preferred Must have some management experience ...
Responsibilities Coastal Harbor Health is currently seeking a Utilization Review Coordinator Per ... One to Two years related experience and/or training preferred Must have some management experience ...
Responsibilities Coastal Harbor Health is currently seeking a Utilization Review Coordinator Per ... One to Two years related experience and/or training preferred Must have some management experience ...
ResponsibilitiesProvide system-level leadership and operational oversight of the Behavioral Health Utilization Review (UR) and Utilization Management (UM) processes across two hospital campuses and ...
ResponsibilitiesProvide system-level leadership and operational oversight of the Behavioral Health Utilization Review (UR) and Utilization Management (UM) processes across two hospital campuses and ...
Provide system-level leadership and operational oversight of the Behavioral Health Utilization Review (UR) and Utilization Management (UM) processes across two hospital campuses and multiple ...
Provide system-level leadership and operational oversight of the Behavioral Health Utilization Review (UR) and Utilization Management (UM) processes across two hospital campuses and multiple ...
Responsibilities Provide system-level leadership and operational oversight of the Behavioral Health Utilization Review (UR) and Utilization Management (UM) processes across two hospital campuses and ...
Responsibilities Provide system-level leadership and operational oversight of the Behavioral Health Utilization Review (UR) and Utilization Management (UM) processes across two hospital campuses and ...
Formulary Strategy & Utilization Review Pharmacist
Atlanta, GA · On-site
$56 - $67.25/hr
Formulary Strategy & Utilization Review Pharmacist Shape the drug benefit landscape-analyze and ... PharmD with managed care, DUR, or pharmacy benefit experience. * Strong Excel/data analytics ...
Formulary Strategy & Utilization Review Pharmacist
Atlanta, GA · On-site
$56 - $67.25/hr
Formulary Strategy & Utilization Review Pharmacist Shape the drug benefit landscape-analyze and ... PharmD with managed care, DUR, or pharmacy benefit experience. * Strong Excel/data analytics ...
The position combines utilization review, care coordination, insurance authorization management, and administrative oversight within behavioral health services. Location/Schedule: 3575 Fulton Mill ...
The position combines utilization review, care coordination, insurance authorization management, and administrative oversight within behavioral health services. Location/Schedule: 3575 Fulton Mill ...
The position combines utilization review, care coordination, insurance authorization management, and administrative oversight within behavioral health services. Location/Schedule: 3575 Fulton Mill ...
The position combines utilization review, care coordination, insurance authorization management, and administrative oversight within behavioral health services. Location/Schedule: 3575 Fulton Mill ...
PURPOSE STATEMENT: Proactively monitor utilization of services for patients to optimize ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...
PURPOSE STATEMENT: Proactively monitor utilization of services for patients to optimize ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...
Manager Optum Utilization Review information
What does a manager Optum Utilization Review do?
What are the key skills and qualifications needed to thrive as a manager Optum Utilization Review, and why are they important?
How does a manager Optum Utilization Review typically collaborate with clinical and non-clinical teams to ensure effective case management?
What is the difference between Manager Optum Utilization Review vs Utilization Review Nurse?
| Aspect | Manager Optum Utilization Review | Utilization Review Nurse |
|---|---|---|
| Credentials | Typically requires a nursing license, certifications in case management or utilization review | Registered Nurse (RN) license, certifications in case management or utilization review |
| Work Environment | Supervises teams, manages review processes, collaborates with healthcare providers | Conducts patient reviews, assesses medical necessity, documents findings |
| Employer & Industry Usage | Common in health insurance companies, managed care organizations, healthcare providers | Primarily in hospitals, insurance companies, healthcare organizations |
The main difference is that the Manager Optum Utilization Review oversees the review process and team management, while the Utilization Review Nurse focuses on conducting individual patient assessments and reviews. Both roles require nursing credentials and knowledge of healthcare policies, but the manager has additional responsibilities in leadership and process oversight.
- Behavioral Health Utilization Review Nurse
- Full Time Optum Health Utilization Review
- Weekend Physician Advisor Utilization Review
- Full Time Remote Behavioral Health Utilization Review
- Utilization Management Nurse
- Manager Utilization Management
- Remote Medical Record Review Nurse
- Optum Clinical Claim Review Nurse
- Utilization Review Physician
- Cvs Health Utilization Management

Full-time
Medical, Dental, Vision, Life, Retirement
Posted 25 days ago
Universal Health Services rating
6.8
Based on 253 frontline employees who took The Breakroom Quiz
491st of 887 rated healthcare providers
Job description
Utilization Review (UR) / Utilization Management (UM) Coordinator (Licensed Therapist or RN)
The Utilization Review / Utilization Management Coordinator works closely with the other staff of Utilization Review/Management, Intake, Business Office, Medical Records, Clinical Staff, Nursing, and providers to coordinate and communicate patient information to insurance companies for the assignment of benefits.
- Performs clinical reviews over the telephone and electronically.
- Utilizes ASAM criteria (DSM-V) to determine appropriateness of admission, continued stay, discharge criteria and identifies high-risk cases.
- Adheres to accrediting and regulatory agency requirements in maintaining records to ensure compliance.
Apply online at https://jobs.uhsinc.com/turning-point-care-center
Interested in relocating to our community? Learn more about the city of Moultrie and Colquitt County here:
https://moultriechamber.com;
https://colquittcountyga.gov;
https://moultriega.com.
Centrally located in South Georgia, our facility is 30 minutes from I-75, 1.5 hours north of Tallahassee, FL, 3 hours south of Atlanta, GA, and 2.5 hours west of Jacksonville, FL. Our employees reside in Moultrie or surrounding communities including Albany, Tifton, Thomasville, and Valdosta, GA.
Join our team and discover a rewarding, fulfilling career.
Turning Point Care Center, LLC
For more than 40 years, Turning Point Care Center has provided a place of healing and hope to adults who suffer from behavioral health disorders and/or substance abuse. We are committed to providing quality behavioral health care through our inpatient and outpatient gender specific programs in Moultrie, GA. Our serene, rural setting gives patients a secure environment where they can build their foundation for lifelong recovery. We believe in creating healthy communities, which start with healthy individuals, linked through sound relationships to their families, friends, neighbors and peers.
Quality Healthcare is our passion, improving lives is our reward. We are working to change lives and transform the delivery of healthcare. Visit our website at https://turningpointcare.com to learn more.
We offer a competitive and comprehensive benefits program including:
- Medical
- Dental
- Vision
- Life Insurance
- Flexible Spending Accounts
- Health Savings Accounts
- Short and Long Term Disability
- 401K with match
- Employee Stock Purchase Plan
- and additional voluntary benefits and discounts. (Even Pet Insurance!!)
Additional benefit details provided at https://benefits.uhsguest.com . Choose “I am a Guest” to view options designed to enhance and promote our employees’ health and wellbeing.
Qualifications
- Licensure through state composite board for nursing or counseling/therapy:
- Minimum RN, LMSW, LAPC, LAMFT
- Preferred BSN, MSN, LCSW, LPC, LMFT
- Three (3) years of experience in chart analysis, utilization review, medical/clinical terminology, and acuity of illness
- Knowledge and understanding of a variety of insurances including: Traditional Medicare, Medicare Advantage Plans, and Commercial Plans
- Knowledge and experience with chemical dependency programs, mental health programs, situational evaluations, and crisis intervention, preferred.
This opportunity offers the following:
- CEUs required for biannual licensure for Therapists (provided for free without having to use leave to attend)
- Rewarding work environment
- Growth and Development Opportunities within UHS and its 300+ Subsidiaries
- Excellent Medical, Dental, Vision and Prescription Drug Plan
- 401k plan with company match and discounted stock plan
- SoFi Student Loan Refinancing Program
Apply online at https://jobs.uhsinc.com/turning-point-care-center
About Universal Health Services
One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500® corporation, annual revenues during 2025 were $17.4 billion. In 2026, UHS was again recognized as one of Fortune World’s Most Admired Companies™ and in 2025, was listed in Forbes ranking of America’s Largest Public Companies.
Headquartered in King of Prussia, PA, UHS has approximately 101,500 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 40 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom. For additional information visit www.uhs.com.
From Fortune, ©2025, 2026 Fortune Media IP Limited. All rights reserved. Used under license.
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.
Avoid and Report Recruitment Scams
We are aware of a scam whereby imposters are posing as Recruiters from UHS, and our subsidiary hospitals and facilities. Beware of anyone requesting financial or personal information.
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.
Utilization Review, UR, Utilization Management, UM
Qualifications:- Licensure through state composite board for nursing or counseling/therapy:
- Minimum RN, LMSW, LAPC, LAMFT
- Preferred BSN, MSN, LCSW, LPC, LMFT
- Three (3) years of experience in chart analysis, utilization review, medical/clinical terminology, and acuity of illness
- Knowledge and understanding of a variety of insurances including: Traditional Medicare, Medicare Advantage Plans, and Commercial Plans
- Knowledge and experience with chemical dependency programs, mental health programs, situational evaluations, and crisis intervention, preferred.
This opportunity offers the following:
- CEUs required for biannual licensure for Therapists (provided for free without having to use leave to attend)
- Rewarding work environment
- Growth and Development Opportunities within UHS and its 300+ Subsidiaries
- Excellent Medical, Dental, Vision and Prescription Drug Plan
- 401k plan with company match and discounted stock plan
- SoFi Student Loan Refinancing Program
Apply online at https://jobs.uhsinc.com/turning-point-care-center
About Universal Health Services
One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500® corporation, annual revenues during 2025 were $17.4 billion. In 2026, UHS was again recognized as one of Fortune World’s Most Admired Companies™ and in 2025, was listed in Forbes ranking of America’s Largest Public Companies.
Headquartered in King of Prussia, PA, UHS has approximately 101,500 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 40 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom. For additional information visit www.uhs.com.
From Fortune, ©2025, 2026 Fortune Media IP Limited. All rights reserved. Used under license.
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.
Avoid and Report Recruitment Scams
We are aware of a scam whereby imposters are posing as Recruiters from UHS, and our subsidiary hospitals and facilities. Beware of anyone requesting financial or personal information.
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.
Utilization Review, UR, Utilization Management, UM
Education:UNAVAILABLEEmployment Type: FULL_TIMEWhat Universal Health Services employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom
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