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Utilization Review Physician Assistant Jobs in Decatur, AL

SportsMed

PHYSICIAN EXTENDER

Huntsville, AL · On-site

Physician Assistant CRNPs w surgical experience also encouraged to apply We're a high-growth ... Serve as first-assist for spine surgeries with frequent hands-on involvement * Review imaging ...

NHS Management, LLC

Unit Manager RN (7a-3p)

Madison, AL · On-site

$37.50 - $49.50/hr

... utilization review activities. * Receives physicians' instructions regarding resident care and ensures that orders are transmitted to other units as needed. * Oversees delegation of nursing and other ...

NHS Management Services

Unit Manager RN (7a-3p)

Madison, AL · On-site

$34 - $45/hr

... utilization review activities. * Receives physicians' instructions regarding resident care and ensures that orders are transmitted to other units as needed. * Oversees delegation of nursing and other ...

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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

RN Case Mgr-Crestwood Medical Center-Case Management-PRN-1st shift

Huntsville, AL

Huntsville Hospital Health System
Hospitals
Learn more about Huntsville Hospital Health Systemexternal

Per diem

Posted 23 days ago

Huntsville Hospital Health System rating

6.2

Company rating: 6.2 out of 10

Based on 209 frontline employees who took The Breakroom Quiz

Job description

Reporting to the Director of Case Management, the Case Manager is responsible to assist in the development, planning, coordination and administration of the activities of utilization review and/or discharge planning. Including, but not limited to daily review of medical records to determine appropriateness and establishing medical necessity for admission, continued hospital stay, use of ancillary services, and initiating and facilitating discharge planning.  The Case Manager must be able to work independently, be open to covering different assignments, manage time appropriately, communicate effectively, and work under stressful situations


Resposibilities include condcting concurrent case managment and discharge planning activities; identifying and addressing barriers to discharge; coordinating with patients, families, physicians, and community resources; facilitating referrals to post-acute providers; participating in interdisciplinary rounds; supporting patient progression, regulatory compliance,and lenght-of-stay intitiatives; documenting case management interventions; and collaboratng with the interdisciplinary team to ensure safe, efficient transition of care. PRN staff are expected to maintain scheduling flexibility, including a minimum commitment of own weekend per month, an perform other duties as assigned in support of departmental and organizational objectives. 


Education:  Bachelors preferred; associates in nursing required

Experience: Three years of experience in case management or utilization management preferred. Registered Nurse with at least one year clinical experience on a medical/surgical unit

Licenses/Certificates:  Alabama Registered Nurse License


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