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Pt Utilization Review Jobs (NOW HIRING)

PACS

Physical Therapist (PT) - PRN

Concord, CA · On-site

$64 - $65/hr

Physical Therapist (PT) - PRN Make a Meaningful Clinical Impact at Concord Post Acute Concord Post ... Participate in interdisciplinary care planning, patient conferences, and utilization review ...

Pacs

Physical Therapist (PT) - PRN

Concord, NH

$64 - $65/hr

Physical Therapist (PT) - PRN Make a Meaningful Clinical Impact at Concord Post Acute Concord Post ... Participate in interdisciplinary care planning, patient conferences, and utilization review ...

PACS

Physical Therapist (PT)

Anderson, SC · On-site

$40 - $50/hr

Physical Therapist (PT) - Full-Time $40-$50/hour Anderson, SC About Us Linley Park Post Acute is a ... Participate in care conferences, utilization review, and rehab meetings * Educate residents ...

Pacs

Physical Therapist (PT) - PRN

Concord, NH · On-site

$64 - $65/hr

Physical Therapist (PT) - PRN Make a Meaningful Clinical Impact at Concord Post Acute Concord Post ... Participate in interdisciplinary care planning, patient conferences, and utilization review ...

Harmony Park at Wilson

Physical Therapist

Wilson, NC · On-site

$1.4K - $1.8K/wk

... and utilization review meetings • Educate residents, families, and staff on therapy goals and ... PT) • Current state licensure in PT • Long-term care experience preferred • Strong ...

Harmony Park at Wilson

Physical Therapist

Wilson, NC · On-site

$1.4K - $1.8K/wk

... and utilization review meetings • Educate residents, families, and staff on therapy goals and ... PT) • Current state licensure in PT • Long-term care experience preferred • Strong ...

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Pt Utilization Review information

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$21

$42

$68

How much do pt utilization review jobs pay per hour?

As of Jul 16, 2026, the average hourly pay for pt utilization review in the United States is $42.28, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 per hour, depending on experience, location, and employer.

What are the typical challenges faced by Physical Therapy Utilization Review professionals, and how can they be managed?

Physical Therapy Utilization Review professionals often encounter challenges such as balancing clinical judgment with payer guidelines, managing high caseloads, and communicating effectively with both therapists and insurance representatives. Navigating differing opinions about medical necessity and ensuring timely reviews are also common hurdles. Building strong organizational skills, staying updated on insurance policies, and fostering collaborative relationships with clinical teams can help manage these challenges and ensure optimal patient care.

What are Pt Utilization Review jobs?

Pt Utilization Review jobs involve reviewing patient medical records and treatment plans to ensure that the care provided is medically necessary, appropriate, and in line with insurance policies or regulatory guidelines. Professionals in these roles, often physical therapists or nurses, assess whether ongoing physical therapy services are justified and help facilitate communication between healthcare providers and insurance companies. Their goal is to promote quality patient care while managing healthcare costs and ensuring compliance with regulations.

What is the difference between Pt Utilization Review vs Physical Therapist?

AspectPt Utilization ReviewPhysical Therapist
CredentialsTypically requires licensure, certification in utilization review or case managementRequires a Doctor of Physical Therapy (DPT) degree and state licensure
Work EnvironmentHealthcare facilities, insurance companies, case management settingsHospitals, outpatient clinics, rehab centers
Job FocusReviewing medical necessity, approving or denying treatments, ensuring complianceAssessing and treating patients' physical conditions, developing rehab plans

While both roles operate within healthcare, Pt Utilization Review focuses on evaluating treatment necessity and insurance compliance, whereas Physical Therapists provide direct patient care and rehabilitation services.

What are the key skills and qualifications needed to thrive as a Physical Therapy Utilization Review (PT Utilization Review) Specialist, and why are they important?

To thrive as a PT Utilization Review Specialist, you need a background in physical therapy (often requiring a DPT degree and state licensure) and strong analytical skills to assess medical necessity and treatment appropriateness. Familiarity with electronic medical records (EMRs), utilization management software, and knowledge of insurance guidelines are typically required. Exceptional communication, critical thinking, and attention to detail help facilitate collaboration with providers and ensure accurate case reviews. These skills are crucial for ensuring patients receive appropriate, evidence-based care while maintaining compliance with regulatory and payer requirements.
More about Pt Utilization Review jobs
What cities are hiring for Pt Utilization Review jobs? Cities with the most Pt Utilization Review job openings:
What states have the most Pt Utilization Review jobs? States with the most job openings for Pt Utilization Review jobs include:
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Pt Utilization Review jobs near you
Infographic showing various Pt Utilization Review job openings in the United States as of July 2026, with employment types broken down into 50% Full Time, and 50% Part Time. Highlights an 33% In-person, and 67% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.
RN - Utilization Review - PT

RN - Utilization Review - PT

University of Mississippi Medical Center

Jackson, MS • On-site

Part-time

Posted 7 days ago

University Of Mississippi Medical Center rating

7.2

Company rating: 7.2 out of 10

Based on 46 frontline employees who took The Breakroom Quiz

398th of 1,020 rated hospitals

Job description

Hello,
Thank you for your interest in career opportunities with the University of Mississippi Medical Center. Please review the following instructions prior to submitting your job application:
  • Provide all of your employment history, education, and licenses/certifications/registrations. You will be unable to modify your application after you have submitted it.
  • You must meet all of the job requirements at the time of submitting the application.
  • You can only apply one time to a job requisition.
  • Once you start the application process you cannot save your work. Please ensure you have all required attachment(s) available to complete your application before you begin the process.
  • Applications must be submitted prior to the close of the recruitment. Once recruitment has closed, applications will no longer be accepted.

After you apply, we will review your qualifications and contact you if your application is among the most highly qualified. Due to the large volume of applications, we are unable to individually respond to all applicants. You may check the status of your application via your Candidate Profile.
Thank you,
Human Resources
Important Applications Instructions:
Please complete this application in entirety by providing all of your work experience, education and certifications/
license. You will be unable to edit/add/change your application once it is submitted.
Job Requisition ID:
R00052155
Job Category:
Nursing
Organization:
Utilization Review
Location/s:
Main Campus Jackson
Job Title:
RN - Utilization Review - PT
Job Summary:
RN-Utilization Review is accountable to perform utilization management services for designated patient case load, including prospective, concurrent, retrospective, and denial management reviews by applying clinical protocols and review medical necessity criteria. Reports quality of care issues identified during the utilization management process to the appropriate manager.
Education & Experience
Education and Experience Required:
One (1) year of nursing experience in an inpatient setting.
Certifications, Licenses, or Registration required:
Valid RN license.
Knowledge, Skills & Abilities
Knowledge, Skills, and Abilities:
Knowledge of utilization review, discharge planning, case management, and managed care reimbursement. Strong working knowledge of medical procedures, diagnoses, and procedure codes, including ICD-10, CPT, and DSM-IV. Excellent interpersonal, verbal, written communication, and negotiation skills. Ability to gather data, prepare reports, and identify process improvements. Able to work independently, exercise sound judgment, and apply medical necessity guidelines with minimal supervision. Committed to quality patient care, customer service, safety, cost efficiency, and continuous quality improvement (CQI). Proficient in the use of computers and related software applications.
Responsibilities:
  • Performs prospective, concurrent, retrospective, and denials review for individual cases, including benefit coverage, medical necessity, appropriate level of care, and mandated services.
  • Assists in collecting and reporting financial and performance indicators, including case mix, length of stay, cost per case, resource utilization, readmission rates, denials, and appeals.
  • Uses data to drive decisions and implement performance improvement strategies related to case management, including fiscal, clinical, and patient satisfaction outcomes.
  • Collects and analyzes variances from the plan of care and collaborates with physicians and the healthcare team to address issues and improve outcomes.
  • Applies clinical appropriateness criteria to monitor admissions and continued stays, identifies at-risk populations, and refers cases to the care management physician advisor as needed.
  • Communicates with third-party payers to facilitate reimbursement certification, resolves payor issues, and completes utilization management and quality screening for assigned patients.
  • Works collaboratively with the interdisciplinary care team to ensure timely, appropriate patient management, remove barriers to care, and proactively address delays or discharge obstacles.
  • Ensures safe, high-quality care in compliance with policies, procedures, and standards, while managing time, supplies, productivity, and accuracy within budgetary guidelines.
  • The duties listed are general in nature and are examples of the duties and responsibilities performed and are not meant to be construed as exclusive or all-inclusive. Management retains the right to add or change duties at any time.

Physical and Environmental Demands:
Requires occasional exposure to unpleasant or disagreeable physical environment such as high noise level and exposure to heat and cold, no handling or working with potentially dangerous equipment, occasional working hours beyond regularly scheduled hours, occasional travelling to offsite locations, occasional activities subject to significant volume changes of a seasonal/clinical nature, occasional work produced is subject to precise measures of quantity and quality, occasional bending, occasional lifting/carrying up to 10 pounds, occasional lifting/carrying up to 25 pounds, no lifting/carrying up to 50 pounds, no lifting/carrying up to 75 pounds, no lifting/carrying up to100 pounds, no lifting/carrying 100 pounds or more, no climbing, no crawling, occasional crouching/stooping, no driving, occasional kneeling, occasional pushing/pulling, occasional reaching, frequent sitting, occasional standing ,occasional twisting, and frequent walking. (Occasional-up to 20%, frequent-from 21% to 50%, constant-51% or more)
Time Type:
Part time
FLSA Designation/Job Exempt:
Yes
Pay Class:
Salary
FTE %:
100
Work Shift:
Benefits Eligibility:
Grant Funded:
Job Posting Date:
07/10/2026
Job Closing Date (open until filled if no date specified):

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About University of Mississippi Medical Center

Sourced by ZipRecruiter

The University of Mississippi Medical Center (UMMC) is the state's sole academic medical center, focused on enhancing the lives of Mississippi residents through education, research, and healthcare. UMMC houses seven health science schools with over 3,000 enrolled students, and its researchers are renowned for their contributions to areas like heart disease, diabetes, hypertension, and cancer treatment. Their efforts not only improve health outcomes but also drive economic growth and job opportunities in the state.

Industry

Health care and social assistance

Company size

5,001 - 10,000 Employees

Headquarters location

Jackson, MS, US

Year founded

1955

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