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Utilization Review Lcsw Jobs (NOW HIRING)

UHS

Utilization Review Coordinator

Augusta, GA

CERTIFICATIONS, LICENSES, REGISTRATION LMHC, LAPC, LPC, LMSW, LCSW, LPN or RN preferred ... utilization review. CERTIFICATIONS, LICENSES, REGISTRATION LMHC, LAPC, LPC, LMSW, LCSW, LPN or RN ...

Imh

Utilization Management Behavioral Health

Murray, UT · Hybrid

$38.77 - $59.82/hr

REQUIRED LCSW LICENSURE Essential Functions * Utilization Review and Care Management of members with specific treatment plans, conditions, or diagnosis including medical and behavioral health ...

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How much do utilization review lcsw jobs pay per hour?

As of Jun 14, 2026, the average hourly pay for utilization review lcsw 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 the difference between Utilization Review Lcsw vs Medical Social Worker?

AspectUtilization Review LcswMedical Social Worker
CredentialsLicensed Clinical Social Worker (LCSW), certification in utilization review often preferredLicensed Clinical Social Worker (LCSW), with clinical social work experience in healthcare
Work EnvironmentInsurance companies, healthcare organizations, utilization review departmentsHospitals, clinics, patient homes, healthcare settings
Primary FocusReviewing medical necessity, insurance approvals, and utilization managementProviding psychosocial support, discharge planning, and patient advocacy

The Utilization Review Lcsw primarily focuses on insurance review and utilization management within healthcare settings, requiring knowledge of medical necessity criteria. In contrast, Medical Social Workers provide direct patient support, counseling, and discharge planning. While both roles require an LCSW license, their daily responsibilities and work environments differ significantly.

What are the key skills and qualifications needed to thrive as a Utilization Review LCSW, and why are they important?

To thrive as a Utilization Review LCSW, you need a master's degree in social work (MSW), LCSW licensure, and a strong understanding of clinical assessment and care coordination. Familiarity with medical necessity criteria, insurance guidelines, and electronic health record (EHR) systems is essential, and certification in case management or utilization review is often preferred. Exceptional analytical skills, attention to detail, and clear communication help you advocate effectively for patients and collaborate with healthcare teams. These competencies ensure appropriate care, cost-effectiveness, and compliance with regulatory standards in healthcare delivery.

What are the main challenges Utilization Review LCSWs face when balancing clinical judgment and insurance guidelines?

Utilization Review LCSWs often encounter the challenge of aligning their clinical assessments with insurance coverage criteria, which can sometimes restrict recommended care options. Navigating these situations requires strong communication skills to advocate for appropriate patient care while adhering to payer policies. Frequent collaboration with healthcare providers and insurance representatives is essential to ensure patients receive necessary services without unnecessary delays. This balancing act can be demanding but is also highly rewarding for those who value systemic impact and patient advocacy.

What is a Utilization Review LCSW?

A Utilization Review LCSW (Licensed Clinical Social Worker) is a mental health professional who evaluates the medical necessity, appropriateness, and efficiency of mental health services for patients. They review clinical documentation to ensure that treatments meet insurance and regulatory guidelines, often acting as a liaison between healthcare providers and payers. Their goal is to ensure patients receive necessary care while also reducing unnecessary costs and maintaining compliance with healthcare policies.
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Utilization Review Lcsw jobs near you

SOCIAL WORKER LCSW

PACIFICA OF THE HOSPITAL OF THE VALLEY

Sun Valley, CA • On-site

$40 - $48/hr

Full-time

Posted 15 days ago

Job description

The LICENSED SOCIAL WORKER (LCSW) is an integral member of the patient care team providing patients and family members with education and advice emotional support, crisis intervention and counseling to cope with a multiplicity of social and emotional issues that arise as a result of a hospital stay. The LICENSED CLINICAL SOCIAL WORKER (LCSW) coordinates a variety of services including crisis intervention, bereavement, patient advocacy, referrals, prevention, education, discharge planning and implementation, and psychosocial assessments.

RESPONSIBILITIES:

  • Collaborates with the healthcare team and involves patient and/or family in the development and implementation of plan of care
  • Identify patient’s specific needs, coordinating linkage with community agencies, in-home services, and institutional short-term and long-term placement for continuing care
  • Assist patient and/or family and all members of the healthcare team in the discharge planning process
  • Contributes to the monitoring of the quality and appropriateness of patient care delivered
  • Participates in the reporting and analysis of patient satisfaction survey data
  • Promotes and provides for optimum patient outcomes through the use of Socials Services scope of practice and scope of service
  • Complete necessary documentation and maintain clinical record for each client during the patient’s length of stay

EDUCATION/TRAINING/EXPERIENCE:

  • CA Licensed Clinical Social Worker
  • One (1) year experience as LCSW in an acute care environment
  • Experience in Behavioral Health Unit preferred
  • Understands the relationship of hospital utilization review, care coordination, patient access, discharge planning, and acute care and community-based social services
  • Excellent listening and interpersonal skills
  • Above average verbal and written communication skills
  • Ability to handle grief
  • Strong problem-solving skills
  • Ability to exercise professional judgment in performing day-to-day activities, ensuring adherence to hospital policies and procedures