Gadsden, AL · On-site
Riverview Regional Medical Center - Gadsden, AL We are seeking an Utilization Review Technician II , sometimes referred to as Utilization Management Technician II or Utilization Review Coordinator ...
Gadsden, AL · On-site
Riverview Regional Medical Center - Gadsden, AL We are seeking an Utilization Review Technician II , sometimes referred to as Utilization Management Technician II or Utilization Review Coordinator ...
Riverview Regional Medical Center - Gadsden, AL We are seeking an Utilization Review Technician II , sometimes referred to as Utilization Management Technician II or Utilization Review Coordinator ...
Riverview Regional Medical Center - Gadsden, AL We are seeking an Utilization Review Technician II , sometimes referred to as Utilization Management Technician II or Utilization Review Coordinator ...
Gadsden, AL · On-site
Riverview Regional Medical Center - Gadsden, AL We are seeking a n Utilization Review Technician II , sometimes referred to as Utilization Management Technician II or Utilization Review Coordinator ...
Gadsden, AL · On-site
Riverview Regional Medical Center - Gadsden, AL We are seeking a n Utilization Review Technician II , sometimes referred to as Utilization Management Technician II or Utilization Review Coordinator ...
Gadsden, AL · On-site
Riverview Regional Medical Center - Gadsden, AL We are seeking an Utilization Review Technician II , sometimes referred to as Utilization Management Technician II or Utilization Review Coordinator ...
Gadsden, AL · On-site
Riverview Regional Medical Center - Gadsden, AL We are seeking an Utilization Review Technician II , sometimes referred to as Utilization Management Technician II or Utilization Review Coordinator ...
Gadsden, AL · On-site
Riverview Regional Medical Center - Gadsden, AL We are seeking an Utilization Review Technician II , sometimes referred to as Utilization Management Technician II or Utilization Review Coordinator ...
Gadsden, AL · On-site
Riverview Regional Medical Center - Gadsden, AL We are seeking an Utilization Review Technician II , sometimes referred to as Utilization Management Technician II or Utilization Review Coordinator ...
Huntsville, AL · On-site
Utilization review is the assessment for medical necessity, both for admission to the hospital as well as continued stay. This function ensures that services are not only appropriate, but ensures ...
Huntsville, AL · On-site
Utilization review is the assessment for medical necessity, both for admission to the hospital as well as continued stay. This function ensures that services are not only appropriate, but ensures ...
Huntsville, AL · On-site
Utilization review is the assessment for medical necessity, both for admission to the hospital as well as continued stay. This function ensures that services are not only appropriate, but ensures ...
Huntsville, AL · On-site
Utilization review is the assessment for medical necessity, both for admission to the hospital as well as continued stay. This function ensures that services are not only appropriate, but ensures ...
Huntsville, AL · On-site
Utilization review is the assessment for medical necessity, both for admission to the hospital as well as continued stay. This function ensures that services are not only appropriate, but ensures ...
Huntsville, AL · On-site
Utilization review is the assessment for medical necessity, both for admission to the hospital as well as continued stay. This function ensures that services are not only appropriate, but ensures ...
Utilization review is the assessment for medical necessity, both for admission to the hospital as well as continued stay. This function ensures that services are not only appropriate, but ensures ...
Utilization review is the assessment for medical necessity, both for admission to the hospital as well as continued stay. This function ensures that services are not only appropriate, but ensures ...
The Utilization Review Nurse utilizes clinical knowledge to support the coordination and documentation and communication of medical services and/or benefits. The Utilization Nurse also serves on the ...
The Utilization Review Nurse utilizes clinical knowledge to support the coordination and documentation and communication of medical services and/or benefits. The Utilization Nurse also serves on the ...
The Utilization Review Nurse utilizes clinical knowledge to support the coordination and documentation and communication of medical services and/or benefits. The Utilization Nurse also serves on the ...
The Utilization Review Nurse utilizes clinical knowledge to support the coordination and documentation and communication of medical services and/or benefits. The Utilization Nurse also serves on the ...
The Utilization Review Nurse utilizes clinical knowledge to support the coordination and documentation and communication of medical services and/or benefits. The Utilization Nurse also serves on the ...
The Utilization Review Nurse utilizes clinical knowledge to support the coordination and documentation and communication of medical services and/or benefits. The Utilization Nurse also serves on the ...
Utilization review experience preferred Licensures, Certifications, and/or Registries * Current AL licensure as RN or LPN Knowledge, Skills, and Abilities * Knowledge of third-party payer ...
Utilization review experience preferred Licensures, Certifications, and/or Registries * Current AL licensure as RN or LPN Knowledge, Skills, and Abilities * Knowledge of third-party payer ...
Utilization review experience preferred Licensures, Certifications, and/or Registries * Current AL licensure as RN or LPN Knowledge, Skills, and Abilities * Knowledge of third-party payer ...
Utilization review experience preferred Licensures, Certifications, and/or Registries * Current AL licensure as RN or LPN Knowledge, Skills, and Abilities * Knowledge of third-party payer ...
Utilization review is the assessment for medical necessity, both for admission to the hospital as well as continued stay. This function ensures that services are not only appropriate, but ensures ...
New
Utilization review is the assessment for medical necessity, both for admission to the hospital as well as continued stay. This function ensures that services are not only appropriate, but ensures ...
New
Utilization review is the assessment for medical necessity, both for admission to the hospital as well as continued stay. This function ensures that services are not only appropriate, but ensures ...
Utilization review is the assessment for medical necessity, both for admission to the hospital as well as continued stay. This function ensures that services are not only appropriate, but ensures ...
Utilization review is the assessment for medical necessity, both for admission to the hospital as well as continued stay. This function ensures that services are not only appropriate, but ensures ...
Utilization review is the assessment for medical necessity, both for admission to the hospital as well as continued stay. This function ensures that services are not only appropriate, but ensures ...
Utilization review is the assessment for medical necessity, both for admission to the hospital as well as continued stay. This function ensures that services are not only appropriate, but ensures ...
Utilization review is the assessment for medical necessity, both for admission to the hospital as well as continued stay. This function ensures that services are not only appropriate, but ensures ...
Utilization review is the assessment for medical necessity, both for admission to the hospital as well as continued stay. This function ensures that services are not only appropriate, but ensures ...
Utilization review is the assessment for medical necessity, both for admission to the hospital as well as continued stay. This function ensures that services are not only appropriate, but ensures ...
Utilization review is the assessment for medical necessity, both for admission to the hospital as well as continued stay. This function ensures that services are not only appropriate, but ensures ...
Utilization review is the assessment for medical necessity, both for admission to the hospital as well as continued stay. This function ensures that services are not only appropriate, but ensures ...
$19.39 - $23.31
2% of jobs
$23.31 - $27.24
9% of jobs
$29.92 is the 25th percentile. Wages below this are outliers.
$27.24 - $31.16
21% of jobs
The median wage is $34.33 / hr.
$31.16 - $35.08
23% of jobs
$35.08 - $39
13% of jobs
$42.05 is the 75th percentile. Wages above this are outliers.
$39 - $42.92
10% of jobs
$42.92 - $46.84
8% of jobs
$46.84 - $50.77
5% of jobs
$50.77 - $54.69
5% of jobs
$54.69 - $58.61
2% of jobs
$58.61 - $62.53
2% of jobs
$19
$38
$62
A Utilization Review (UR) job involves assessing the medical necessity, efficiency, and appropriateness of healthcare services. UR professionals, often nurses or healthcare specialists, review patient records, insurance claims, and treatment plans to ensure they meet industry standards and payer requirements. They work with healthcare providers, insurance companies, and regulatory agencies to optimize care while controlling costs. Their goal is to balance quality patient care with cost-effective resource utilization.
A typical day in Utilization Review involves reviewing patient medical records, evaluating the necessity and appropriateness of proposed treatments or services, and documenting recommendations based on clinical criteria and insurance policies. Utilization Review specialists often collaborate closely with physicians, nurses, and insurance representatives to gather additional information and clarify cases. While much of the role is desk-based and may include remote work options, it requires regular communication with both clinical and administrative teams. This position offers variety and challenge, as no two cases are exactly alike, and there are often opportunities to advance into supervisory or quality improvement roles within the department.
To thrive in Utilization Review, professionals typically need a background in nursing or healthcare, strong clinical assessment capabilities, and a thorough understanding of medical guidelines and insurance regulations. Familiarity with electronic medical records (EMR) systems and utilization management software, and often certification such as Certified Utilization Review Specialist (CURN), are important. Excellent critical thinking, attention to detail, and strong communication skills enable effective case evaluation and collaboration with healthcare teams. These skills and qualifications ensure objective, accurate decisions that support cost-effective, quality patient care within compliance standards.
The most popular types of Utilization Review jobs in Alabama are:
For Utilization Review jobs in Alabama, the most frequently searched job titles are:
The top searched job categories for Utilization Review jobs in Alabama are:
Cities in Alabama with the most Utilization Review job openings:
Full-time
Medical, Dental, Vision, Life, Retirement, PTO
Posted 17 days ago
Department: Social Work Services
Shifts Available: Days
Employment Type: Full Time
Hours: 8-hour shift - 7:30am to 3:30pm
Location: Riverview Regional Medical Center - Gadsden, AL
We are seeking an Utilization Review Technician II, sometimes referred to as Utilization Management Technician II or Utilization Review Coordinator II. The Utilization Review Technician II supports the utilization review, appeals, and denial management process by coordinating communication and tracking payer-related activity. This role works closely with insurance providers, health plans, Utilization Review teams, the Business Office, and Case Managers to help ensure timely follow-up on authorizations, reviews, appeals, and denials. The position also assists with payer audits, Release of Information, discharge coordination, and other departmental needs.
ResponsibilitiesHere are some of the benefits of working at Prime Healthcare:
Full benefits at Prime Healthcare: https://www.primehealthcare.com/careers/benefits/
#LI-MP1
Employment StatusFull TimeShiftDaysEqual Employment OpportunityCompany is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf
Employment Type: FULL_TIME
