Utilization Review Clinician
Augusta, GA ยท On-site
Utilization Review Clinician Opportunity Lighthouse Care Center of Augusta has been providing ... LMHC, LMFT, LAPC, LPC, LMSW, LCSW, LPN or RN preferred.
New
Augusta, GA ยท On-site
Utilization Review Clinician Opportunity Lighthouse Care Center of Augusta has been providing ... LMHC, LMFT, LAPC, LPC, LMSW, LCSW, LPN or RN preferred.
New
Augusta, GA ยท On-site
Utilization Review Clinician Opportunity Lighthouse Care Center of Augusta has been providing ... LMHC, LMFT, LAPC, LPC, LMSW, LCSW, LPN or RN preferred.
New
... with physicians, therapist, nurses and pertinent staff on gathering the necessary data to ... utilization review. CERTIFICATIONS, LICENSES, REGISTRATION LMHC, LMFT, LAPC, LPC, LMSW, LCSW, LPN ...
... with physicians, therapist, nurses and pertinent staff on gathering the necessary data to ... utilization review. CERTIFICATIONS, LICENSES, REGISTRATION LMHC, LMFT, LAPC, LPC, LMSW, LCSW, LPN ...
Tuba City, AZ ยท On-site
Utilization Review * Discipline: Therapy * Start Date: 09/07/2026 * Duration: 13 weeks * 40 hours per week * Shift: 8 hours, days * Employment Type: Travel Reliable Nurse Staffing Job ID #64147202.
Tuba City, AZ ยท On-site
Utilization Review * Discipline: Therapy * Start Date: 09/07/2026 * Duration: 13 weeks * 40 hours per week * Shift: 8 hours, days * Employment Type: Travel Reliable Nurse Staffing Job ID #64147202.
Manhattan, NY ยท On-site
$65K - $75K/yr
Director of Utilization Review DEPARTMENT: Clinical LOCATION : George Rosenfield Center for ... Qualified Health Professional (LCSW, LMSW, LMHC, LMFT preferred) CASAC-T required with ability to ...
Quick apply
Manhattan, NY ยท On-site
$65K - $75K/yr
Director of Utilization Review DEPARTMENT: Clinical LOCATION : George Rosenfield Center for ... Qualified Health Professional (LCSW, LMSW, LMHC, LMFT preferred) CASAC-T required with ability to ...
... with physicians, therapist, nurses and pertinent staff on gathering the necessary data to ... utilization review. CERTIFICATIONS, LICENSES, REGISTRATION LMHC, LMFT, LAPC, LPC, LMSW, LCSW, LPN ...
... with physicians, therapist, nurses and pertinent staff on gathering the necessary data to ... utilization review. CERTIFICATIONS, LICENSES, REGISTRATION LMHC, LMFT, LAPC, LPC, LMSW, LCSW, LPN ...
Mountain View Hospital is looking for a Utilization Review Coordinator to join our team! JOB ... physical therapy to speech therapy, a Level III NICU, robust robotic surgery department and a ...
Mountain View Hospital is looking for a Utilization Review Coordinator to join our team! JOB ... physical therapy to speech therapy, a Level III NICU, robust robotic surgery department and a ...
Augusta, GA ยท On-site
Utilization Review Clinician Opportunity Lighthouse Care Center of Augusta has been providing ... therapists, nurses, and pertinent staff on gathering the necessary data to communicate with ...
New
Augusta, GA ยท On-site
Utilization Review Clinician Opportunity Lighthouse Care Center of Augusta has been providing ... therapists, nurses, and pertinent staff on gathering the necessary data to communicate with ...
New
Mountain View Hospital is looking for a Utilization Review Coordinator to join our team! JOB ... physical therapy to speech therapy, a Level III NICU, robust robotic surgery department and a ...
Mountain View Hospital is looking for a Utilization Review Coordinator to join our team! JOB ... physical therapy to speech therapy, a Level III NICU, robust robotic surgery department and a ...
Philadelphia, PA ยท On-site
PA RN License Required We are seeking an experienced Care Management Coordinator to join our Infusion Therapy team. This role is responsible for performing utilization management reviews to determine ...
Philadelphia, PA ยท On-site
PA RN License Required We are seeking an experienced Care Management Coordinator to join our Infusion Therapy team. This role is responsible for performing utilization management reviews to determine ...
Augusta, GA ยท On-site
... with physicians, therapist, nurses and pertinent staff on gathering the necessary data to ... utilization review. CERTIFICATIONS, LICENSES, REGISTRATION LMHC, LMFT, LAPC, LPC, LMSW, LCSW, LPN ...
Augusta, GA ยท On-site
... with physicians, therapist, nurses and pertinent staff on gathering the necessary data to ... utilization review. CERTIFICATIONS, LICENSES, REGISTRATION LMHC, LMFT, LAPC, LPC, LMSW, LCSW, LPN ...
Tulsa, OK ยท On-site
For over 65 years, Parkside's physicians, therapists, and staff have provided state of the art, ... The Utilization Review Specialist asses, plans, implements and evaluates the internal processes to ...
Tulsa, OK ยท On-site
For over 65 years, Parkside's physicians, therapists, and staff have provided state of the art, ... The Utilization Review Specialist asses, plans, implements and evaluates the internal processes to ...
Tulsa, OK ยท On-site
For over 65 years, Parkside's physicians, therapists, and staff have provided state of the art, ... The Utilization Review Specialist asses, plans, implements and evaluates the internal processes to ...
Tulsa, OK ยท On-site
For over 65 years, Parkside's physicians, therapists, and staff have provided state of the art, ... The Utilization Review Specialist asses, plans, implements and evaluates the internal processes to ...
Englewood, NJ ยท On-site
The Utilization Review (UR) Specialist is a critical member of the administrative team at Advanced ... Collaborate with clinicians, therapists, case managers, and medical staff to gather accurate and up ...
Englewood, NJ ยท On-site
The Utilization Review (UR) Specialist is a critical member of the administrative team at Advanced ... Collaborate with clinicians, therapists, case managers, and medical staff to gather accurate and up ...
Augusta, GA ยท On-site
... with physicians, therapist, nurses and pertinent staff on gathering the necessary data to ... utilization review. CERTIFICATIONS, LICENSES, REGISTRATION LMHC, LMFT, LAPC, LPC, LMSW, LCSW, LPN ...
New
Augusta, GA ยท On-site
... with physicians, therapist, nurses and pertinent staff on gathering the necessary data to ... utilization review. CERTIFICATIONS, LICENSES, REGISTRATION LMHC, LMFT, LAPC, LPC, LMSW, LCSW, LPN ...
New
This role reviews medical records to determine the medical necessity and appropriateness of post ... Speech Therapy * Athletic Training * Related healthcare field * Minimum of 2 years of Utilization ...
This role reviews medical records to determine the medical necessity and appropriateness of post ... Speech Therapy * Athletic Training * Related healthcare field * Minimum of 2 years of Utilization ...
This role reviews medical records to determine the medical necessity and appropriateness of post ... Speech Therapy * Athletic Training * Related healthcare field * Minimum of 2 years of Utilization ...
This role reviews medical records to determine the medical necessity and appropriateness of post ... Speech Therapy * Athletic Training * Related healthcare field * Minimum of 2 years of Utilization ...
Decatur, GA ยท On-site
The Utilization Review Specialist coordinates insurance authorizations for individual therapy and IOP services, ensuring clients receive appropriate and timely care. This role works closely with ...
Decatur, GA ยท On-site
The Utilization Review Specialist coordinates insurance authorizations for individual therapy and IOP services, ensuring clients receive appropriate and timely care. This role works closely with ...
Decatur, GA ยท On-site
Description The Utilization Review Specialist coordinates insurance authorizations for individual therapy and IOP services, ensuring clients receive appropriate and timely care. This role works ...
Decatur, GA ยท On-site
Description The Utilization Review Specialist coordinates insurance authorizations for individual therapy and IOP services, ensuring clients receive appropriate and timely care. This role works ...
What you will be doing? The Utilization Review (UR) Specialist is a critical member of the ... Collaborate with clinicians, therapists, case managers, and medical staff to gather accurate and up ...
Quick apply
What you will be doing? The Utilization Review (UR) Specialist is a critical member of the ... Collaborate with clinicians, therapists, case managers, and medical staff to gather accurate and up ...
Description The Utilization Review Specialist coordinates insurance authorizations for individual therapy and IOP services, ensuring clients receive appropriate and timely care. This role works ...
Description The Utilization Review Specialist coordinates insurance authorizations for individual therapy and IOP services, ensuring clients receive appropriate and timely care. This role works ...
$15.63 - $19.08
14% of jobs
$21.93 is the 25th percentile. Wages below this are outliers.
$19.08 - $22.53
14% of jobs
$22.53 - $25.98
17% of jobs
The median wage is $27.88 / hr.
$25.98 - $29.44
11% of jobs
$29.44 - $32.89
8% of jobs
$32.89 - $36.34
6% of jobs
$38.93 is the 75th percentile. Wages above this are outliers.
$36.34 - $39.79
7% of jobs
$39.79 - $43.25
7% of jobs
$43.25 - $46.70
5% of jobs
$46.70 - $50.15
5% of jobs
$50.15 - $53.61
5% of jobs
$15
$31
$53
A Utilization Review (UR) Therapist evaluates the medical necessity, appropriateness, and efficiency of mental health or substance use treatments. They review patient records, collaborate with providers, and ensure that care meets insurance requirements and clinical guidelines. Their goal is to balance quality patient care with cost-effective treatment, often working closely with insurance companies and healthcare teams to approve or appeal coverage decisions.
As a Utilization Review Therapist, your daily duties often include reviewing clinical documentation, determining the medical necessity of treatments, and coordinating with healthcare providers to ensure appropriate levels of care. You will interact frequently with insurance companies to facilitate authorizations and manage denials or appeals. Collaboration with other clinical staff is common, as you gather information and advocate for patient care. Occasionally, you may participate in interdisciplinary meetings or provide education on documentation standards and payer requirements.
To thrive as a Utilization Review Therapist, you need strong clinical assessment skills, a background in behavioral health or social work, and a relevant license such as LCSW, LMFT, or LPC. Familiarity with insurance guidelines, electronic medical record (EMR) systems, and utilization management software is often required. Excellent critical thinking, organization, and communication skills help you succeed in this role. These competencies ensure accurate treatment evaluations, compliance with regulations, and effective collaboration across clinical and administrative teams.

Other
Medical, Dental, Vision, Retirement, PTO
Posted 3 days ago
New
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.
Sourced by ZipRecruiter
Health care and social assistance
501 - 1,000 Employees
Wellington, FL, US
1986