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Utilization Review Supervisor Jobs (NOW HIRING)

MedStar Health

RN Team Lead Utilization Review

Clinton, MD · On-site

$89K - $162K/yr

Utilization Review Supervisor Candidate must have acute care Utilization Review experience. Candidate must live in the DC/Baltimore region. General Summary of Position Supervises the daily activities ...

Oscar Health

Utilization Review Nurse

Miami, FL · Remote

$35 - $45.94/hr

You will report into the Supervisor, Utilization Review. Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois; Iowa; Kansas; Michigan;

Oscar Health

Utilization Review Nurse

Dallas, TX · Remote

$35 - $45.94/hr

You will report into the Supervisor, Utilization Review. Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois; Iowa; Kansas; Michigan;

KPC Health

Utilization Review Tech

Santa Ana, CA · On-site

Utilization Review Technician Under direction of the Utilization Review Technician Supervisor, the Utilization Review Technician coordinates with the Utilization Management Department while being ...

ARcare

Utilization Review Associate

Augusta, AR · On-site

Utilization Review Associate Job Type: Full-time, 40 hours per week required (hourly POSITION ... Company-paid renewal of applicable licenses and certifications , subject to supervisor and HR ...

ARcare

Utilization Review Associate

Augusta, AR · On-site

Utilization Review Associate Job Type: Full-time, 40 hours per week required (hourly POSITION ... Company-paid renewal of applicable licenses and certifications , subject to supervisor and HR ...

Oscar Health

Utilization Review Nurse

Atlanta, GA · Remote

$35 - $45.94/hr

You will report into the Supervisor, Utilization Review. Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois; Iowa; Kansas; Michigan;

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Utilization Review Supervisor information

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How much do utilization review supervisor jobs pay per year?

As of Aug 5, 2026, the average yearly pay for utilization review supervisor in the United States is $91,011.00, according to ZipRecruiter salary data. Most workers in this role earn between $59,500.00 and $109,500.00 per year, depending on experience, location, and employer.

What is a utilization review supervisor?

A Utilization Review Supervisor is a healthcare professional who oversees the utilization review process within a medical facility or insurance organization. Their primary responsibility is to ensure that patient care services are medically necessary, cost-effective, and compliant with regulatory standards. They supervise a team of utilization review specialists or nurses, monitor workflow, review complex cases, and communicate with medical staff and insurance providers. This role helps optimize resource use and improve patient outcomes while controlling healthcare costs.

What is the difference between Utilization Review Supervisor vs Utilization Review Coordinator?

AspectUtilization Review SupervisorUtilization Review Coordinator
CertificationsTypically requires a nursing license or relevant healthcare certificationOften requires similar healthcare credentials, such as RN or licensed healthcare professional
Work EnvironmentSupervises review teams in healthcare or insurance settingsPerforms case reviews and data collection, often in healthcare or insurance companies
Job ResponsibilitiesOversees utilization review processes, manages staff, ensures complianceConducts reviews, gathers data, and supports the review process

The Utilization Review Supervisor and Utilization Review Coordinator roles share similar credentials and work environments, but the supervisor oversees teams and manages processes, while the coordinator focuses on case reviews and data collection. Both positions are essential in healthcare and insurance industries for managing patient care and resource utilization.

Is utilization review a stressful job?

Utilization review supervisors often work in fast-paced healthcare environments where accuracy and efficiency are important, which can contribute to job stress. The role involves reviewing medical cases, managing deadlines, and ensuring compliance, which may lead to pressure, especially during high workload periods or complex cases.

What are the key skills and qualifications needed to thrive as a utilization review supervisor, and why are they important?

To thrive as a Utilization Review Supervisor, you need expertise in healthcare management, case review, and regulatory compliance, often supported by a nursing degree or healthcare-related certification. Familiarity with utilization management software, electronic health records (EHRs), and knowledge of insurance and accreditation standards is typically required. Exceptional leadership, analytical thinking, and communication skills help manage teams and facilitate collaboration across departments. These competencies are vital to ensure appropriate care utilization, regulatory adherence, and the effective operation of review processes.

What are some common challenges faced by utilization review supervisors, and how can they be addressed?

Utilization Review Supervisors often face challenges such as managing high caseloads, ensuring compliance with ever-changing regulations, and balancing the needs of patients with organizational goals. Effective communication with clinical staff and insurance providers is essential, as is staying current with policy updates. Supervisors can address these challenges by fostering strong teamwork, implementing clear protocols, and investing in ongoing training for their teams to ensure consistent, high-quality reviews.

What degree do I need for utilization review supervisor?

A utilization review supervisor typically needs at least a bachelor's degree in healthcare, nursing, health administration, or a related field. Many employers prefer candidates with a master's degree or relevant certifications such as the Certified Professional in Healthcare Quality (CPHQ) or Certified Case Manager (CCM). Experience in healthcare or insurance is also important for this role.
More about Utilization Review Supervisor jobs
What job categories do people searching Utilization Review Supervisor jobs look for? The top searched job categories for Utilization Review Supervisor jobs are:
Utilization Review Supervisor jobs near you
Infographic showing various Utilization Review Supervisor job openings in the United States as of July 2026, with employment types broken down into 1% As Needed, 81% Full Time, 14% Part Time, 1% Temporary, and 3% Contract. Highlights an 90% Physical, 3% Hybrid, and 7% Remote job distribution, with an average salary of $91,011 per year, or $43.8 per hour.

Utilization Review Supervisor - Full Time

Lake Charles Memorial Health System

Lake Charles, LA • On-site

Other

Posted 14 days ago

Lake Charles Memorial Health System rating

7.0

Company rating: 7.0 out of 10

Based on 25 frontline employees who took The Breakroom Quiz

Job description

DESCRIPTION OF POSITION:

  • The Utilization Review Supervisor oversees day to day functions of the department and staff. The Manager actively seeks areas for department to improve (i.e - reduction in denials) &/ or be more efficient.

SUPERVISION: Reports directly to the Practice Manager

RESPONSIBILITIES AND DUTIES:

  • Responsible for reviewing patients' utilization records to identify patterns and to make recommendations for improvement
  • Responsible for reviewing patient utilization data, trends, and patterns to identify areas of deficiency and suggest strategies to improve patient care.
  • Responsible for reviewing patient's utilization records to ensure accurate and timely billing for services provided.
  • Responsible for conducting utilization reviews in accordance with policies and procedures.
  • Responsible for reviewing the daily held claims report and oversee correction of filing claims.
  • Oversee documentation of providers and other employees to ensure medical stay meets medical necessity and continued stay criteria.
  • Submit daily Utilization Review reports in department huddles and monthly leadership meetings.
  • Oversee all utilization review and management activities in psychiatric services and report findings to Director of Psychiatric Services.

The above statements are only meant to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description.

EDUCATION AND WORK EXPERIENCE

  • Registered Nurse with 2 years minimum experience in the acute behavioral health setting.
  • Louisiana Nursing License or multi-state compact nursing license, Crisis Response Training, CPR
  • Require use of nursing skills and knowledge in order to provide care for patients in a hospital setting. In addition, utilization review nurses must be able to critically appraise care delivered to patients and make recommendations to improve the quality of care.
  • Ability to articulate observations and utilization management needs in a clear and concise manner.
  • Excellent communication and interpersonal skills.

Physical Demands/Work Environment

  • Work requires a variety of physical activities, including moving about within and outside of all hospital properties for long periods of time.
  • Must be able to respond quickly and effectively to emergency and non-emergent situations.
  • May be required to assist in controlling disorderly conduct or combative patients.
  • Must be able to exchange accurate information with patient, family, peers and medical personnel.
  • Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Experience Memorial is more than a slogan, its the care we provide our patients and its the commitment to our community and our team members. As a nationally certified Great Place to Work, at Lake Charles Memorial Health System you will have the opportunity to be a part of an organizational culture that supports not only exceptional patient care but also the well-being and professional growth of our employees. Join us and be a part of a team where your contributions are valued, your growth is nurtured, and your success is celebrated.

Working at Lake Charles Memorial Health System | Great Place To Work

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About Lake Charles Memorial Health System

Sourced by ZipRecruiter

Lake Charles Memorial Health System is the only locally owned, regional community healthcare system in Lake Charles. The health system employs more than 2700 full-time, part-time and PRN employees and is the largest health system in the area. Memorial is a true community health system, run by a board of local volunteers from all walks of business, industry and public service. It is one of an elite group of health systems that belongs to the people of Southwest Louisiana and serves everyone regardless of age, race, gender or financial status.

Industry

Health care and social assistance

Company size

1,001 - 5,000 Employees

Headquarters location

Lake Charles, LA, US

Year founded

1952

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