1

Urgently Hiring Insurance Utilization Review Jobs

Job Summary and Responsibilities As our Utilization Review Nurse, you will ensure the medical ... Knowledge of core insurance coverage guidelines and financial principles. * Acute care nursing ...

Verify insurance benefits, coordinate authorizations, and communicate effectively with external case managers and managed care organizations * Establish and maintain contracts with managed care ...

Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care ... Perform concurrent reviews for appropriateness of utilization to optimize clinical and financial ...

Utilization Review Associate Job Type: Full-time, 40 hours per week required (hourly POSITION ... That mission drives everything we do, from accepting every patient, regardless of insurance status ...

Utilization Review Technician Under direction of the Utilization Review Technician Supervisor, the ... Reviews treatment plans and status of approvals from insurers. Collects and compiles data as ...

... insurance companies/authorizing entities to ensure initial precertification and continued ... utilization review. CERTIFICATIONS, LICENSES, REGISTRATION LMHC, LMFT, LAPC, LPC, LMSW, LCSW, LPN ...

Showing results 41-60

Urgently Hiring Insurance Utilization Review information

See salary details

$21

$42

$68

How much do urgently hiring insurance utilization review jobs pay per hour?

As of Aug 8, 2026, the average hourly pay for urgently hiring insurance 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 is the difference between Urgently Hiring Insurance Utilization Review vs Insurance Claims Processor?

AspectUrgently Hiring Insurance Utilization ReviewInsurance Claims Processor
Primary RoleAssess medical necessity and appropriateness of services for insurance coverageReview and process insurance claims for payment and reimbursement
Required CredentialsLicenses or certifications in health insurance or medical review, often with healthcare backgroundKnowledge of insurance policies, claims processing systems, and basic healthcare understanding
Work EnvironmentHealthcare or insurance companies, often in office or remote settingsInsurance companies, healthcare providers, or third-party claims processing centers
Common Search/ComparisonUrgently Hiring Insurance Utilization Review vs Insurance Claims Processor

While both roles involve insurance and healthcare, Insurance Utilization Review focuses on evaluating the necessity of medical services, whereas Insurance Claims Processors handle the processing and payment of claims. Understanding these differences helps job seekers find the right position aligned with their skills and credentials.

What is an insurance utilization review?

An Insurance Utilization Review is a process used by insurance companies and healthcare organizations to evaluate the medical necessity, appropriateness, and efficiency of healthcare services, procedures, and facilities. Professionals in this role review patient records, treatment plans, and coverage policies to determine if the requested healthcare services meet established criteria for payment and care. Their work helps control healthcare costs, ensures quality care, and supports compliance with regulations. They often collaborate with physicians, nurses, and insurance providers to make informed decisions. Typically, strong analytical, communication, and clinical knowledge are required for this job.

What are the main challenges faced by professionals in insurance utilization review, and how can they be addressed?

One of the main challenges in Insurance Utilization Review is balancing the need to ensure appropriate patient care with the necessity of complying with insurance coverage criteria. This often involves interpreting complex medical records and guidelines under tight deadlines, while communicating effectively with healthcare providers and payers. Building strong organizational and communication skills, and staying updated on changing insurance policies and regulations, can help professionals navigate these challenges successfully. Collaboration with clinical teams and ongoing professional development are also key to thriving in this fast-paced environment.

What are the key skills and qualifications needed to thrive as an insurance utilization review specialist?

To excel as an Insurance Utilization Review Specialist, you generally need a healthcare background (often as an RN, LPN, or similar credential), strong analytical skills, and in-depth knowledge of medical terminology and insurance guidelines. Familiarity with utilization management software, electronic medical records (EMR), and certifications such as Certified Professional in Utilization Review (CPUR) are typically required. Exceptional attention to detail, critical thinking, and effective communication with both healthcare providers and insurers set top performers apart. These skills ensure accurate coverage determinations, compliance with regulations, and cost-effective patient care management.
What cities are hiring for Urgently Hiring Insurance Utilization Review jobs? Cities with the most Urgently Hiring Insurance Utilization Review job openings:
What are the most commonly searched types of Insurance Utilization Review jobs? The most popular types of Insurance Utilization Review jobs are:
What states have the most Urgently Hiring Insurance Utilization Review jobs? States with the most job openings for Urgently Hiring Insurance Utilization Review jobs include:

Utilization Review Director

Freedom Behavioral Hospital of Lake Charles, LLC

Lake Charles, LA โ€ข On-site

Other

Medical, Dental, Vision, Retirement, PTO

Re-posted 27 days ago


Job description

Salary: $24.00 OR DOE

NOTE: this position is currently filled. However, it is the policy of Freedom Behavioral to continue to
take applications so that we can ensure there is no disruption in patient care if a vacancy occurs.


Freedom Behavioral Lake Charles is a rapidly expanding psychiatric hospital committed to providing compassionate, high-quality care to both adult and geriatric patients. We are proud to foster a positive, team-oriented environment where exceptional patient care and strong employee support remain at the center of everything we do. Since opening our first facility in Magnolia, Mississippi in 2015, Freedom Behavioral has continued to grow and now operates 12 facilities across Louisiana, Texas, and Mississippi.


As we continue to grow, we are excited to expand our Lake Charles team in preparation for increasing our capacity to 46 beds, allowing us to provide care and support to even more individuals within our community.


At Freedom Behavioral Lake Charles, our employees are the foundation of our success. Their dedication, compassion, and commitment make a meaningful impact every day, and we are devoted to creating a workplace where team members feel appreciated, respected, and empowered to succeed. We proudly offer competitive compensation, opportunities for career advancement, ongoing education and training, and a strong commitment to promoting a healthy work-life balance.


If you are searching for more than just a careerif you are looking for purpose, professional growth, a supportive team environment, and the opportunity to truly make a difference in the lives of othersFreedom Behavioral Lake Charles is the place for you.


POSITION SUMMARY:

A Utilization Review (UR) Director at Freedom Behavioral Hospital is responsible for overseeing utilization review and discharge planning processes in compliance with CMS, federal, and state regulations, as well as the organizations mission, policies, procedures, and performance improvement standards.


In this role, the UR Director works closely with admissions, medical providers, and clinical staff to ensure patients receive appropriate, medically necessary care throughout their stay. They review patient records to evaluate the medical necessity of admissions, treatment plans, and length of stay while ensuring compliance with insurance and government reimbursement requirements.


The UR Director manages utilization review activities, including precertification and continued stay authorizations, and serves as the primary point of contact for payor sources. They communicate admission and continued stay criteria with referral sources, families, insurance representatives, and the interdisciplinary treatment team to maintain effective coordination of care. Cases requiring additional clinical expertise are referred to the Medical Director for further review.


As a key member of the multidisciplinary team, the UR Director helps facilitate treatment team processes, supports discharge planning efforts, and promotes effective communication among departments. They also maintain performance improvement initiatives within the department and participate in quality management activities to support regulatory compliance and patient care excellence.


This position requires strong analytical, organizational, and communication skills, along with a commitment to maintaining the highest ethical standards regarding patient care, confidentiality, and patient rights.


PREFERRED KNOWLEDGE, SKILLS AND/OR EXPIERENCE:

Education: A degree in a social science is preferred or nursing education
License:
Experience: 1+ years coordinating utilization review and discharge planning activities


BENEFITS:

Challenging and rewarding work environment

Excellent staff to patient ratio
Competitive Compensation
Medical, Dental, Vision, and Prescription Drug Plan
Generous Paid Time Off
401(K) with company match


Freedom 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 any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.

****All applicants selected for employment will be required to undergo a post-offer drug test and federal background investigation. ****