ZipRecruiter

Log In

2

Pt Ot Utilization Review Jobs (NOW HIRING)

Providence Service

Utilization Review RN

Portland, OR · On-site

... part time and full-time opportunities for day shift. The RN Coordinator-Utilization Review supports ... overtime, premiums, extra shift incentives, or bonus opportunities. Providence offers a ...

Providence Service

Utilization Review RN

Portland, OR · On-site

... part time and full-time opportunities for day shift. The RN Coordinator-Utilization Review supports ... overtime, premiums, extra shift incentives, or bonus opportunities. Providence offers a ...

next page

Showing results 1-20

All JobsHealthcare JobsNursing JobsNurse Case Manager JobsPt Ot Utilization Review Jobs

PT OT Utilization Review information

See salary details

$15

$31

$53

How much do pt ot utilization review jobs pay per hour?

As of Sep 4, 2026, the average hourly pay for pt ot utilization review in the United States is $31.94, according to ZipRecruiter salary data. Most workers in this role earn between $22.36 and $40.62 per hour, depending on experience, location, and employer.

What is a PT OT utilization review?

A PT OT Utilization Review is a process where physical therapy (PT) and occupational therapy (OT) services are evaluated to ensure that they are medically necessary, appropriate, and efficient. Utilization review professionals review patient records, treatment plans, and clinical documentation to determine if the care provided meets established guidelines and standards. This role is often performed by licensed PTs or OTs working for insurance companies, healthcare providers, or third-party administrators. The main goal is to promote high-quality care while preventing unnecessary or excessive therapy services.

What are jobs in PT OT utilization review?

PT/OT utilization review jobs involve nurses and clinical reviewers who review an occupational or physical therapy patient case documentation to determine if the services the patient received meet the qualifications for their insurance coverage. Your responsibilities as a PT/OT utilization review worker are to write letters to an insurance company about the services a physical or occupational therapist provided, review a patient’s medical records, monitor a patient’s progress with therapy, and continue contact with a patient’s insurance company, the patient, and the patient’s medical team to ensure proper coverage of services. These jobs can be both part-time and full-time.

What are the key skills and qualifications needed to thrive as a PT OT utilization review specialist, and why are they important?

To thrive as a PT/OT Utilization Review Specialist, you generally need a valid physical or occupational therapy license, strong clinical knowledge, and experience in rehabilitation settings. Familiarity with utilization review software, electronic health records (EHRs), and knowledge of insurance guidelines and medical necessity criteria are important technical qualifications. Excellent communication, critical thinking, and attention to detail are essential soft skills for collaborating with providers and payers. These competencies ensure accurate evaluations, compliance with regulations, and optimal patient outcomes while managing healthcare costs.

What are some common challenges faced by PT OT utilization review professionals, and how can they be managed?

PT/OT Utilization Review professionals often encounter challenges such as balancing clinical judgment with payer guidelines, managing a high volume of case reviews, and navigating communication between providers and insurance companies. Staying current with evolving policies and maintaining strong documentation are key to overcoming these obstacles. Effective time management and proactive collaboration with both clinical teams and payers can help ensure timely and accurate reviews while supporting patient care decisions.

What is the difference between Pt Ot Utilization Review vs Pt Ot Case Management?

AspectPt Ot Utilization ReviewPt Ot Case Management
CredentialsLicensed Occupational Therapist (OT)Licensed Occupational Therapist (OT) with case management training
Work EnvironmentInsurance companies, healthcare facilities, or third-party review organizationsHospitals, clinics, insurance companies, or outpatient settings
Primary FocusAssessing medical necessity and approving treatment plansCoordinating patient care, advocating for patients, and managing treatment progress

While both roles involve occupational therapy expertise, Pt Ot Utilization Review primarily focuses on evaluating the necessity of services, whereas Pt Ot Case Management emphasizes coordinating ongoing patient care and support. Understanding these differences helps clarify career paths and job expectations in the occupational therapy field.

More about PT OT Utilization Review jobs

What cities are hiring for Pt Ot Utilization Review jobs?

Cities with the most Pt Ot Utilization Review job openings:

What are the most commonly searched types of Pt Ot Utilization Review jobs?

The most popular types of Pt Ot Utilization Review jobs are:

What states have the most Pt Ot Utilization Review jobs?

States with the most job openings for Pt Ot Utilization Review jobs include:

What job categories do people searching Pt Ot Utilization Review jobs look for?

The top searched job categories for Pt Ot Utilization Review jobs are:

PT OT Utilization Review jobs near you
Infographic showing various Pt Ot Utilization Review job openings in the United States as of August 2026, with employment types broken down into 100% Part Time. Highlights an 75% In-person, 17% Hybrid, and 8% Remote job distribution, with an average salary of $66,436 per year, or $31.9 per hour.

Utilization Review Specialist

Lifepoint Health

Tucson, AZ • On-site

Part-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 23 hours ago

Key responsibilities

  • Facilitates clinical reviews for all patient admissions and continued stays.

  • Analyzes patient records to determine the appropriateness of admission, treatment, and length of stay, and interfaces with managed care organizations, external reviewers, and other payers.

  • Completes pre-certifications and re-certifications for inpatient and outpatient services; reports denials and authorization information to the appropriate resource.

LifePoint Health rating

5.9

Company rating: 5.9 out of 10

Based on 272 frontline employees who took The Breakroom Quiz

766th of 898 rated healthcare providers

Job description


Your experience matters
El Dorado Springs Behavioral Health is part of Lifepoint Health, a diversified healthcare delivery network with facilities coast to coast. We are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. As a Utilization Review Specialistjoining our team, you're embracing a vital mission dedicated to making communities healthier ®. Join us on this meaningful journey where your skills, compassion and dedication will make a remarkable difference in the lives of those we serve.
How you'll contribute
A Utilization Review Specialist who excels in this role:
  • Facilitates clinical reviews for all patient admissions and continued stays.
  • Analyzes patient records to determine the appropriateness of admission, treatment, and length of stay, and interfaces with managed care organizations, external reviewers, and other payers.
  • Advocates on behalf of patients with substance abuse, dual diagnosis, psychiatric, or emotional disorders to managed care providers to ensure access to necessary treatment.
  • Contacts external case managers and managed care organizations to obtain certification of insurance benefits throughout the patient's stay and assists the treatment team in understanding requirements for continued stay and discharge planning.
  • Demonstrates knowledge of clinical criteria and managed care requirements for inpatient and outpatient authorization, and advocates for coverage of necessary services.
  • Completes pre-certifications and re-certifications for inpatient and outpatient services; reports denials and authorization information to the appropriate resource.
  • Actively communicates with the interdisciplinary team to obtain pertinent information and provide updates on authorizations.
  • Participates in treatment team meetings to ensure staff understand coverage and to gather information for communication with external agencies.
  • Collaborates with the Director of Nursing (DON) to ensure documentation requirements are met.
  • Ensures appeals are completed thoroughly and in a timely manner.
  • Interfaces with managed care organizations, external reviewers, and other payers.
  • Communicates with physicians to schedule peer-to-peer reviews.
  • Accurately reports denials.

About our Team
Driven by a mission to help individuals regain stability and wellness, our multidisciplinary team works collaboratively to provide compassionate care while fostering a supportive, safety-focused workplace culture for our staff and patients alike.
What we're looking for
Applicants must have a Bachelor's degree (required). Master's degree is preferred. Additional requirements include:
  • Previous utilization review experience in a psychiatric healthcare facility preferred.
  • Current unencumbered clinical license is strongly preferred.
  • CPR certification and Crisis Prevention Training (CPI) preferred. May be required to work flexible hours and overtime

Schedule: PRN (as needed)
This position does not have a set weekly schedule. You'll be called in to work when extra help is needed-such as covering for someone, handling busy periods, or filling gaps in the schedule. Hours can vary from week to week, and there's no guaranteed hours.
Why join us
We believe that investing in our employees is the first step to providing excellent patient care. In addition to your base compensation, this position also offers:
  • Comprehensive Benefits: Multiple levels of medical, dental and vision coverage for full-time and part-time employees.
  • Financial Protection & PTO: Life, accident, critical illness, hospital indemnity insurance, short- and long-term disability, paid family leave and paid time off.
  • Financial & Career Growth: Higher education and certification tuition assistance, loan assistance and 401(k) retirement package and company match.
  • Employee Well-being: Mental, physical, and financial wellness programs (free gym memberships, virtual care appointments, mental health services and discount programs).
  • Professional Development: Ongoing learning and career advancement opportunities.

More about El Dorado Springs
El Dorado Springs features a state-of-the-art facility with over 100 private and semi-private rooms, providing a secure and therapeutic setting focused on comfort, dignity, and healing. Patients receive 24/7 medically supervised care, evidence-based therapy, medication management, and comprehensive discharge and aftercare planning.
Accredited by The Joint Commission and certified by CMS, El Dorado Springs Behavioral Health is committed to delivering relationship-centered, evidence-based care that improves outcomes and supports long-term recovery.
The hospital offers a full continuum of care, including inpatient psychiatric stabilization, medically assisted detox (MAT), Partial Hospitalization Program (PHP), and Intensive Outpatient Program (IOP). These programs are designed to support individuals experiencing acute mental health symptoms, substance use disorders, or co-occurring conditions in a safe, structured environment.
EEOC Statement
El Dorado Springs Behavioral Health is an Equal Opportunity Employer. El Dorado Springs Behavioral Health is committed to Equal Employment Opportunity for all applicants and employees and complies with all applicable laws prohibiting discrimination and harassment in employment."
About Us
Lifepoint Health is a leader in community-based care and driven by a mission of Making Communities Healthier. Our diversified healthcare delivery network spans 29 states and includes 63 community hospital campuses, 32 rehabilitation and behavioral health hospitals, and more than 170 additional sites of care across the healthcare continuum, such as acute rehabilitation units, outpatient centers and post-acute care facilities. We believe that success is achieved through talented people. We want to create places where employees want to work, with opportunities to pursue meaningful and satisfying careers that truly make a difference in communities across the country.
About the Team
We employ and provide care to people from all walks of life. We are committed to promoting healing, providing hope, preserving dignity and producing value with an inclusive workforce in which diversity is leveraged, respected, and reflective of the patients, family members, customers and team members we serve.

What LifePoint Health employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

LifePoint Health logo

About LifePoint Health

Sourced by ZipRecruiter

Lifepoint Health serves patients, clinicians, communities and partners across the healthcare continuum. Our diversified healthcare delivery network extends from coast to coast, consisting of community hospitals, rehabilitation and behavioral health hospitals, and additional sites of care.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Brentwood, TN, US

Year founded

1999

Social media

FacebookTwitter

View All LifePoint Health Jobs

Apply