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Utilization Review Physician Assistant Jobs in Decatur, AL

MainStreet Family Urgent Care

Physician Assistant

Arab, AL · On-site

$90K - $122K/yr

Review of x-rays (to be over-read by Radiologist, too) * General Dermatology * General eye problems ... Physician Assistant Board Certification required * MSN, or higher education required (New graduate ...

MainStreet Family Urgent Care

Physician Assistant

Arab, AL · On-site

$90K - $122K/yr

Review of x-rays (to be over-read by Radiologist, too) * General Dermatology * General eye problems ... Physician Assistant Board Certification required * MSN, or higher education required (New graduate ...

MainStreet Family Urgent Care

Physician Assistant

Arab, AL · On-site

$90K - $122K/yr

Review of x-rays (to be over-read by Radiologist, too) * General Dermatology * General eye problems ... Physician Assistant Board Certification required * MSN, or higher education required (New graduate ...

MainStreet Family Care

Physician Assistant

Arab, AL · On-site

$90K - $122K/yr

Review of x-rays (to be over-read by Radiologist, too) * General Dermatology * General eye problems ... Physician Assistant Board Certification required * MSN, or higher education required (New graduate ...

MainStreet Family Care

Physician Assistant

Arab, AL · On-site

$90K - $122K/yr

Review of x-rays (to be over-read by Radiologist, too) * General Dermatology * General eye problems ... Physician Assistant Board Certification required * MSN, or higher education required (New graduate ...

Loyal Source

Examiner Physician Assistant

Huntsville, AL · On-site

$136K - $166K/yr

The role involves reviewing the claim, performing focused assessments of claimed injuries ... Graduated from an accredited Physician Assistant program. A valid and unrestricted Physician ...

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Utilization Review Physician Assistant information

See Decatur, AL salary details

$39.4K

$131.1K

$175.8K

How much do utilization review physician assistant jobs pay per year?

As of Sep 12, 2026, the average yearly pay for utilization review physician assistant in Decatur, AL is $131,137.00, according to ZipRecruiter salary data. Most workers in this role earn between $113,900.00 and $147,200.00 per year, depending on experience, location, and employer.

What is a utilization review physician assistant?

A Utilization Review Physician Assistant (PA) is a healthcare professional who evaluates medical records and treatment plans to ensure that patient care is medically necessary, appropriate, and cost-effective. They review cases to determine if the care provided meets established guidelines and insurance requirements. Utilization Review PAs collaborate with physicians, nurses, insurance companies, and other healthcare providers to promote quality care while managing healthcare resources efficiently. Their work typically involves less direct patient care and more administrative responsibilities compared to traditional clinical PA roles.

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

To thrive as a Utilization Review Physician Assistant, you need a strong clinical background, current PA licensure, and in-depth knowledge of medical guidelines and insurance protocols. Familiarity with electronic medical records (EMRs), utilization management software, and relevant certification such as the Certified Professional in Utilization Review (CPUR) is often beneficial. Strong analytical thinking, attention to detail, and effective communication are crucial soft skills for evaluating cases and interacting with healthcare providers and payers. These competencies are essential to ensure appropriate care delivery, compliance with regulations, and cost-effective use of medical resources.

What are some of the main challenges utilization review physician assistants face when transitioning from direct patient care to a review-focused role?

One of the main challenges Utilization Review Physician Assistants encounter is adapting to a predominantly administrative and analytical environment, as opposed to the hands-on patient care they may be accustomed to. The role requires interpreting clinical documentation, applying payer criteria, and making objective determinations about medical necessity, often with limited patient interaction. Additionally, there can be pressure to meet productivity targets and deadlines while maintaining accuracy and fairness in reviews. Collaboration with physicians, case managers, and insurance representatives is frequent, requiring strong communication and negotiation skills.

What is the difference between Utilization Review Physician Assistant vs Utilization Review Nurse Practitioner?

AspectUtilization Review Physician AssistantUtilization Review Nurse Practitioner
CredentialsMaster's degree, Physician Assistant (PA) license, certification (e.g., NCCPA)Master's or higher degree, Nurse Practitioner (NP) license, certification (e.g., ANCC, AANP)
Work EnvironmentHospitals, insurance companies, healthcare facilitiesHospitals, clinics, insurance companies
Employer & Industry UsageCommonly employed in healthcare and insurance sectors for review rolesSimilar usage, often in outpatient and insurance settings

Both roles involve reviewing medical necessity and appropriateness of care, but the Physician Assistant typically has a medical model training background, while the Nurse Practitioner has a nursing model. Both are vital in utilization review, with overlapping responsibilities and work environments.

Can physician assistants do utilization review?

Yes, physician assistants can perform utilization review tasks, which involve evaluating the necessity, appropriateness, and efficiency of healthcare services. They often work in collaboration with physicians and may require certification or training in utilization review processes, depending on the healthcare setting and state regulations.

What are popular job titles related to Utilization Review Physician Assistant jobs in Decatur, AL?

For Utilization Review Physician Assistant jobs in Decatur, AL, the most frequently searched job titles are:

What job categories do people searching Utilization Review Physician Assistant jobs in Decatur, AL look for?

The top searched job categories for Utilization Review Physician Assistant jobs in Decatur, AL are:

What cities near Decatur, AL are hiring for Utilization Review Physician Assistant jobs?

Cities near Decatur, AL with the most Utilization Review Physician Assistant job openings:

Utilization Review Physician Assistant jobs near you

Travel RN - Case Management/Utilization Review - Case Management

Madison, AL • On-site

American Traveler
Recruiting and Staffing Services • 501 - 1,000 employees
Learn more about American Travelerexternal

Other

Re-posted 14 days ago

Job description

American Traveler is hiring an experienced RN Case Manager with 5+ years of RN case management experience and inpatient acute case management background for an acute care hospital setting.
Job Details
• Acute care hospital setting within the Case Management department,
• Day shift schedule, 5x8-hour shifts from 8:00 AM to 4:30 PM,
• Required to work every other weekend,
• Patient ratio of 1:10,
• May be assigned to the Emergency Department to address complex clinical and social situations and avoid unnecessary admissions,
Job Requirements
• Active CA RN license required,
• Current BLS certification required,
• Minimum 5 years of RN Case Management experience required,
• Inpatient Acute Case Management hospital experience required,
• Discharge planning experience required with specific experience details to be provided,
• Care coordination and utilization review experience required,
Additional Information
• Responsible for care coordination and care transitions planning throughout the acute care patient experience,
• Collaborates with physicians, utilization managers, medical social workers, and bedside RNs to ensure timely progression and transition of patients to appropriate levels of care,
• Conducts patient assessments to determine readmission risk and screens for ancillary supportive services including palliative care needs,
• Reviews medical records to ensure patients meet level of care requirements and documentation supports LOC determination,
• Monitors length of stay and collaborates with financial counselors regarding inpatient stay denials and insurance status,
• Screens 30-day readmissions and creates effective transition plans in collaboration with interdisciplinary team,
• Identifies ED high utilizers and makes appropriate care plans and community resource referrals,
• Directs and oversees Case Management Assistants for post-acute care service preferences,
• Maintains current knowledge of CMS, Joint Commission, and other regulatory requirements for care transitions,
• Must reside within a 50-mile radius for local candidate rate eligibility,
• Local candidates are accepted at the local rate,
• Returning employees must have a separation period of at least 1 year to be eligible to return as a traveler,
• Maximum RTO of 7 days per contract with only 1 holiday allowed to be requested per contract,
• Holiday coverage required for New Year's Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, and Christmas Day,
• Prior charge experience is preferred but not required

American Traveler logo

About American Traveler

Sourced by ZipRecruiter

With over 20 years of success in healthcare staffing, American Traveler has established a reputation for outstanding customer service. Our full-service agency has earned top ratings from healthcare professionals in every specialty and setting. We offer travel assignments in the most sought-after locations and facilities in the country. We staff major medical centers, prestigious university teaching facilities, Magnet facilities, regional community hospitals, outpatient centers, rehab centers, skilled nursing facilities and more. With our expert team behind you every step of the way, you can enjoy a rewarding travel career that exceeds your expectations. With over 20 years of experience, American Traveler has established a reputation for outstanding customer service. With our team behind you, you can relax and enjoy a rewarding travel career.

Industry

Recruiting and staffing services

Company size

501 - 1,000 Employees

Headquarters location

Boca Raton, FL, US

Year founded

1999

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