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Utilization Review Lcsw Jobs (NOW HIRING)

NHC HomeCare

Masters Social Worker

Antioch, TN · On-site

Current license as Licensed Clinical Social Worker (LCSW) SOUTH CAROLINA * Current state licensure ... Serves as Utilization Review and/or Advisory Board Member as requested by Administrator/Director of ...

UHS

DIR - UTILIZATION REVIEW / MGMT

Augusta, GA

The Director of Utilization Review is a key member of the Lighthouse Case Management Team who will ... Required with licensure, APRN, LPC, LMSW, LCSW, RN preferred EEO Statement: All UHS subsidiaries ...

UHS

DIR - UTILIZATION REVIEW / MGMT

Augusta, GA · On-site

The Director of Utilization Review is a key member of the Lighthouse Case Management Team who will ... Required with licensure, APRN, LPC, LMSW, LCSW, RN preferred EEO Statement: All UHS subsidiaries ...

UHS

DIR - UTILIZATION REVIEW / MGMT

Augusta, GA · On-site

The Director of Utilization Review is a key member of the Lighthouse Case Management Team who will ... Required with licensure, APRN, LPC, LMSW, LCSW, RN preferred EEO Statement: All UHS subsidiaries ...

NHC HomeCare - Laurens

Masters Social Worker

Clinton, SC · On-site

Current license as Licensed Clinical Social Worker (LCSW) SOUTH CAROLINA * Current state licensure ... Serves as Utilization Review and/or Advisory Board Member as requested by Administrator/Director of ...

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Utilization Review Lcsw information

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How much do utilization review lcsw jobs pay per hour?

As of Sep 5, 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 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.

What are the key skills and qualifications needed to thrive as a utilization review LCSW?

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 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.

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Utilization Review Lcsw jobs near you
Infographic showing various Utilization Review Lcsw job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 13% Part Time, 3% Contract, and 1% Nights. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $66,436 per year, or $31.9 per hour.

Masters Social Worker

NHC HomeCare

Antioch, TN • On-site

Full-time

Re-posted 15 days ago

National HealthCare Corporation rating

5.6

Company rating: 5.6 out of 10

Based on 152 frontline employees who took The Breakroom Quiz

807th of 898 rated healthcare providers

Job description

Definition:
The Masters Social Worker supervises and provides for the evaluation of the social and emotional needs of the patient related to their medical condition, and provides counseling, etc. based on this evaluation.
Line of Authority:
Administrator/Director of Services
Qualifications:
  1. Master's Degree from a school of social work accredited by the Council on Social Work Education
  2. One year social work experience in a health care setting is required

State-specific requirements:
TENNESSEE
  • Current state certification as a certified master social worker (CMSW as provided in T.C.A. §63-23-102.), OR
  • Current license as Licensed Clinical Social Worker (LCSW)

SOUTH CAROLINA
  • Current state licensure at the Master (LMSW) or Independent (LISW) level

FLORIDA
  • To provide clinical counseling to patients or caregivers, the social worker must have a current state license as a Licensed Clinical Social Worker (LCSW), pursuant to Chapter 491, F.S

MISSOURI
  • Current state licensure as a Licensed Master Social Worker (LMSW), Licensed Advanced Macro Social Worker (LAMSW), or Licensed Clinical Social Worker (LCSW)

Performance Requirements:
  1. Able to speak, read, write and follow written orders
  2. Able to see and hear adequately in order to respond to auditory and visual requests
  3. Able to carry out fine motor skills with manual dexterity
  4. Able to speak in a clear, concise voice in order to communicate adequately
  5. Able to handle emotionally stressful situations on a regular basis, including but not limited to death and dying
  6. Able to organize work procedures, assume responsibility and tactfully supervise others
  7. Able to learn, absorb and apply professional training
  8. Must have reliable personal transportation

Specific Responsibilities:
  1. Provides and accurately documents direct social services to patients planned to restore the patient to optimum social and health adjustment; including:
  • Assesses social and emotional factors, to estimate impact on the patient's capacity and potential to cope with problems of daily living
  • Helps the patients and caregivers to understand, accept, and follow medical recommendations
  • Assists patients and caregivers with personal and environmental difficulties which predispose toward illness or interfere with obtaining maximum benefits from medical care; and
  • Identifies resources, such as caregivers and community agencies, to assist the patient to resume life in the community, including discharge planning
  1. Provides these services according to physician order and in accordance with home care policies and procedures
  2. Educates and supervises designated social work assistants in the implementation of the social service program
  3. Provides inservice training to other home care team members, focusing on psychosocial needs of patients, families and staff, as requested
  4. Contributes to applicable QI activities as requested
  5. Serves as Utilization Review and/or Advisory Board Member as requested by Administrator/Director of Services
  6. Maintains knowledge base of home care social services procedures and regulations as well as professional standards through attendance at workshops and inservice and individual research and reading

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