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Pt Utilization Review Jobs (NOW HIRING)

Harmony Park at Wilson

Physical Therapist

Wilson, NC · On-site

$50 - $65/hr

... 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 ...

Ballard Nursing Center

Therapy - PT

Ada, OK · On-site

$1.3K - $1.7K/wk

Participates in required meetings, including but not limited to patient care conferences, utilization review meetings, and rehabilitation meetings. Participates in facility and company-required ...

August Iliff

Physical Therapist

Dunn Loring, VA · On-site

$45 - $58/hr

... 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 ...

Gates Health and Rehab

Physical Therapist

Gatesville, NC · On-site

$1.5K - $1.9K/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 ...

Gates Health and Rehab

Physical Therapist

Gatesville, NC · On-site

$45 - $58/hr

... 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 ...

PACS

Physical Therapist PT-Full-Time

Modesto, CA · On-site

$55 - $60/hr

Physical Therapist (PT) - Full-Time Garden City Health Care Center Location: Modesto, CA Pay Range ... Participate in patient care conferences, utilization review, and rehab meetings as needed

August Iliff

Physical Therapist

Dunn Loring, VA · On-site

$1.6K - $2.1K/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 ...

Raisso

PT - Rehab (Days) Hondo

Hondo, TX · On-site

$1.4K - $1.8K/wk

... utilization review meetings, rehabilitation meetings, etc. Participate in facility and company ... SUBMISSION REQUIREMENTS 1 year of PT experience - Required LTC or Rehab experience - Required TX ...

Pacs

Physical Therapist PT-Full-Time

Garden City, KS · On-site

$55 - $60/hr

Physical Therapist (PT) - Full-Time Garden City Health Care Center Location: Modesto, CA Pay Range ... Participate in patient care conferences, utilization review, and rehab meetings as needed

PACS Inc

Physical Therapist PT-Full-Time

Modesto, CA · On-site

$55 - $60/hr

Physical Therapist (PT) - Full-Time Garden City Health Care Center Location: Modesto, CA Pay Range ... Participate in patient care conferences, utilization review, and rehab meetings as needed

Pacs

Physical Therapist (PT), PRN

River Falls, WI · On-site

$1.6K - $2.1K/wk

Participate in Patient Care Conferences, Utilization Review meetings and Rehabilitation Conferences ... Supervisory Requirements Supervises PT assistants, aides and students. Qualification Education and ...

Thunder Care and Rehab

Therapy - PT

Oklahoma City, OK · On-site

$1.5K - $2.0K/wk

Participates in required meetings, including patient care conferences, utilization review meetings, and rehabilitation meetings. Participates in facility and company-required trainings, in-services ...

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Showing results 41-60

All JobsPt Utilization Review Jobs

Pt Utilization Review information

See salary details

$21

$42

$68

How much do pt utilization review jobs pay per hour?

As of Aug 7, 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 PT 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 is a PT Utilization Review?

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 PT Utilization Review specialist?

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 August 2026, with employment types broken down into 1% As Needed, 83% Full Time, 13% Part Time, and 3% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

Nurse Reviewer - Sarasota, FL

Healthcare Quality Strategies, Inc.

Sarasota, FL • Remote

$40/hr

Part-time

Medical, Dental, Vision, Life, Retirement

Re-posted 3 days ago

Job description

Nurse Reviewer
PT (20-30 hours week) – Remote Work Environment
Non-Exempt: $40.00 hour
Supports Medical Review Services. The Nurse Reviewer plays a critical role in supporting the Medical Review Services department by performing comprehensive medical necessity reviews and policy reviews for Medicaid claims. This involves meticulous examination of claims and medical records to ensure compliance with established guidelines and regulations. The RN will work closely with the Team Lead, Physician Peer Reviewer and contract team. Reviews must be completed timely.
Essential Duties and Responsibilities:
  • Conduct comprehensive medical record reviews to assess medical necessity and compliance with established standards of care and applicable policies
  • Manage end-to-end case screening processes, ensuring all activities are completed within established deadlines
  • Document evidence-based criteria applicable to specific contract requirements
  • Record and report screening results, including relevant referral questions, into a centralized database
  • Evaluate medical claims against industry standards, utilizing research of relevant ICD-10, CPT, and HCPCS codes to determine medical necessity
  • Maintain expert knowledge of evolving multi-state Medicaid policies and vendor expectations
  • Participate in ongoing training and consistently meet or exceed productivity and quality assurance standards
Knowledge, Experience, Skills and Education:
  • Medical terminology, ICD-10, CPT and HCPCS
  • Clinical criteria (InterQual and MCG)
  • Utilization/Medical record review and chart abstraction
  • Current standards of medical practice
  • Comply with HIPAA/HITECH laws and regulations
Experience in:
  • At least three- five years performing medical record review and/or abstraction (Utilization Review experience preferred)
  • Experience performing medical record review, audit for federal or state contracts
  • Knowledge and experience of Medicare and Medicaid policy
  • Proficiency with Microsoft Office (Word, Excel, and Outlook)
  • Proficiency with Adobe PDF files and features
  • Generating accurate, timely, and understandable correspondence
  • Current experience (within the last 3 years) in the application of clinical screening criteria (InterQual and MCG)
Skills Requirements include:
  • Professional interpersonal skills; ability to interact with providers, physicians and peers
  • Solid analytical, assessment and documentation skills
  • Effective written and verbal communication, both internally and externally
  • Strong attention to detail
  • Strong attention to deadlines
  • Organizational skills including effective time management, priority setting and process improvement
  • Ability to work independently and as a member of a team
  • Adapt to changing work situations and readily adjusts schedules, tasks and priorities when necessary to meet business fluctuations
Educational Background:
  • BSN with active RN licensure in good standing
Physical Demands:
Remote Work, Prolonged Sitting, Screen Exposure
This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee. Duties, responsibilities and activities may change or new ones may be assigned at any time with or without notice.
Healthcare Quality Strategies, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
This position qualifies for the following Company benefits: Medical/Dental/Vision, FSA and HSA, group life/AD amp;D, voluntary life/AD amp;D, 401k
For immediate consideration, please apply via the HQSI Careers Page at: www.hqsi.org gt; Careers gt; Current Employment Opportunities
EOE: Minorities/Females/Disabled/Veterans
Healthcare Quality Strategies, Inc. is Equal Opportunity, Affirmative Action Employer and an Alcohol/Drug Free Workplace
Healthcare Quality Strategies, Inc. is an E-Verify Employer

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