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Utilization Review Social Worker Jobs (NOW HIRING)

UHS

Utilization Review Clinician

Augusta, GA · On-site

Website: The Utilization Review Clinician opportunity is a key member of the Lighthouse Case ... LMHC, LMFT, LAPC, LPC, LMSW, LCSW, LPN or RN preferred EEO Statement: All UHS subsidiaries are ...

UHS

Utilization Review Clinician

Augusta, GA · On-site

Website: The Utilization Review Clinician opportunity is a key member of the Lighthouse Case ... LMHC, LMFT, LAPC, LPC, LMSW, LCSW, LPN or RN preferred EEO Statement: All UHS subsidiaries are ...

UHS

Utilization Review Clinician

Augusta, GA · On-site

Website: The Utilization Review Clinician opportunity is a key member of the Lighthouse Case ... LMHC, LMFT, LAPC, LPC, LMSW, LCSW, LPN or RN preferred EEO Statement: All UHS subsidiaries are ...

UHS

Utilization Review Clinician

Augusta, GA · On-site

Website: The Utilization Review Clinician opportunity is a key member of the Lighthouse Case ... LMHC, LMFT, LAPC, LPC, LMSW, LCSW, LPN or RN preferred EEO Statement: All UHS subsidiaries are ...

UHS

Utilization Review Clinician

Augusta, GA

Website: The Utilization Review Clinician opportunity is a key member of the Lighthouse Case ... LMHC, LMFT, LAPC, LPC, LMSW, LCSW, LPN or RN preferred EEO Statement: All UHS subsidiaries are ...

BJC HealthCare

Clinical Social Worker

Alton, IL · On-site

Case Management, Utilization Review, Social Services: Provides admission and continued stay reviews ... Lic Clinical Social Worker Preferred Requirements Experience * 2-5 years Benefits and Legal ...

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How much do utilization review social worker jobs pay per hour?

As of Aug 30, 2026, the average hourly pay for utilization review social worker 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 a utilization review social worker?

A Utilization Review Social Worker evaluates patient care to ensure it meets medical necessity and insurance guidelines. They review treatment plans, coordinate with healthcare providers, and communicate with insurance companies to secure appropriate coverage. Their goal is to optimize healthcare resources while ensuring patients receive necessary care. They also help prevent unnecessary hospitalizations and advocate for patient needs within healthcare systems.

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

To thrive as a Utilization Review Social Worker, you need a solid background in social work, case management, and healthcare regulations, typically supported by an MSW degree and licensure (LCSW or equivalent). Familiarity with utilization management software, EMR/EHR systems, and knowledge of insurance protocols are often required. Strong analytical thinking, attention to detail, effective communication, and empathy are key soft skills for success in this role. These abilities ensure informed decision-making, efficient patient care coordination, and effective advocacy during the review process.

What are some common challenges utilization review social workers face in their day-to-day work?

Utilization Review Social Workers often need to balance patient advocacy with healthcare cost containment, which can require navigating complex insurance guidelines and policies. They frequently review medical records to determine medical necessity and may have to communicate difficult decisions to patients, families, or care teams. Managing a high caseload while meeting documentation and regulatory requirements can also be demanding. However, this role offers opportunities for professional growth, multidisciplinary collaboration, and making a positive impact on patient care outcomes.

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Utilization Review Social Worker jobs near you
Infographic showing various Utilization Review Social Worker 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 $87,946 per year, or $42.3 per hour.

Utilization Review Clinician

Augusta, GA • On-site

Wellington Regional Medical Center
Health Care and Social Assistance • 501 - 1,000 employees
Learn more about Wellington Regional Medical Centerexternal

Other

Medical, Dental, Vision, Retirement, PTO

This job post has expired 2 days ago. Applications are no longer accepted.

Job description

Utilization Review Clinician Opportunity

Lighthouse Care Center of Augusta has been providing psychiatric services to the CSRA for more than 15 years. Located in Augusta, GA, our 84-bed facility provides a therapeutic setting for those seeking treatment for mental illness. Lighthouse Care Center offers unique and individualized programming for adolescents and adults that sets us apart from many other treatment facilities, and our tenured team includes seasoned medical staff.

The Utilization Review Clinician opportunity is a key member of the Lighthouse Case Management team who will integrate and coordinate clinical content with a keen focus on patient care; ensuring that delivery of high-quality and cost-effective treatment is consistent with the mission, vision, and values of Universal Health Services and in accordance with government regulation, licensing, and accreditation requirements. Under the direction of the UR Manager, the Utilization Review Coordinator is responsible for conducting clinical review of data to determine eligibility respective to pre-certification and continued stay reviews.

Job duties/responsibilities include reviewing clinical content of medical records, participating in treatment team meetings, and collaborating with physicians, therapists, nurses, and pertinent staff on gathering the necessary data to communicate with insurance companies/authorizing entities to ensure initial precertification and continued authorization is achieved. Ensure input of pre-certifications and continued stay reviews into Midas, follow-up on unfinished pre-certifications from the day before, coordinate with the treatment team on any follow-ups necessary, verify insurance coverage at the first of the month, and post patient payments into MS4. Trained in all aspects relative to timely gathering of clinical criteria, communication of clinical criteria, and entry of supporting clinical criteria into computer-based systems, in addition to other job duties.

Benefit highlights include a referral bonus program, challenging and rewarding work environment, competitive compensation & generous paid time off, excellent medical, dental, vision, and prescription drug plans, 401(k) with company match and discounted stock plan, and career development opportunities within UHS and its 300+ subsidiaries!

Qualifications include a masters level education in social science field (social work, counseling, sociology, psychology). Must be license-eligible or licensed in Georgia (LAPC, LPC, LMSW, LCSW, LMFT, LMHC). Nurses with a current GA or multistate license encouraged to apply (LPN, RN). Must have 2 years of experience in a psychiatric health care setting, delivery of care to psychiatric and/or chemically dependent patients and utilization review. LMHC, LMFT, LAPC, LPC, LMSW, LCSW, LPN or RN preferred.

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