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Utilization Review Jobs in Alabama (NOW HIRING)

Southeast Health

Utilization Review Nurse

Dothan, AL · On-site

The Utilization Review case manager collaborates with all components of the healthcare system, managing appropriate use of acute care to aid in the achievement of quality outcomes, fiscal ...

Birmingham

Quality Review Coordinator

Birmingham, AL · On-site

ENVIRONMENT The Health Managed Department is responsible for developing, implementing and administering private business and government utilization review, medical review, cost containment ...

Workplace Options

Care Coordinator

Birmingham, AL · On-site

$18 - $24.25/hr

Participate in utilization review and quality assurance activities, as directed. Coordinate U.R. activities with the BHS physician review panel as appropriate, to include ensuring on-going and timely ...

Workplace Options

Care Coordinator

Birmingham, AL · On-site

$18 - $24.25/hr

Participate in utilization review and quality assurance activities, as directed. Coordinate U.R. activities with the BHS physician review panel as appropriate, to include ensuring on-going and timely ...

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All JobsUtilization Review JobsUtilization Review Jobs in Alabama

Utilization Review information

See Alabama salary details

$19

$38

$62

How much do utilization review jobs pay per hour?

As of Jul 20, 2026, the average hourly pay for utilization review in Alabama is $38.32, according to ZipRecruiter salary data. Most workers in this role earn between $30.29 and $43.99 per hour, depending on experience, location, and employer.

What jobs make $3,000 a day?

High-paying jobs that can reach $3,000 a day include specialized roles such as senior physicians, anesthesiologists, or surgeons, often requiring advanced certifications and extensive experience. Certain executive positions, like CEOs or investment bankers, may also earn this level of daily income, especially through bonuses or profit sharing. These roles typically involve high responsibility, expertise, and demanding schedules.

What jobs pay 4000 a week without a degree?

Utilization Review specialists typically do not earn $4,000 per week without a degree; most roles in this field require healthcare-related certifications or experience. High-paying jobs that can reach this level without a degree include certain sales positions, real estate brokers, or specialized trades like commercial pilots or skilled trades, which often rely on experience, licensing, or certifications rather than formal degrees. These roles may involve commission, bonuses, or overtime to achieve such weekly earnings.

What does a typical day look like for someone working in Utilization Review?

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.

What skills do you need for utilization review?

Utilization review professionals need strong analytical skills to assess medical necessity and appropriateness of care, attention to detail, and knowledge of healthcare regulations and insurance policies. Good communication skills are essential for coordinating with healthcare providers and explaining decisions. Familiarity with electronic health records (EHR) systems and relevant certifications, such as Certified Professional in Healthcare Quality (CPHQ), can also be beneficial.

What is a Utilization Review job?

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.

What are the key skills and qualifications needed to thrive in the Utilization Review position, and why are they important?

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.

How do I get into a utilization review?

To become a utilization review specialist, typically a healthcare professional such as a registered nurse, licensed social worker, or physician completes relevant education and gains experience in healthcare or insurance. Certification in utilization review or case management, such as the Certified Professional in Healthcare Quality (CPHQ), can improve job prospects. Strong analytical skills and knowledge of medical coding and insurance policies are also important.
What are the most commonly searched types of Utilization Review jobs in Alabama? The most popular types of Utilization Review jobs in Alabama are:
What are popular job titles related to Utilization Review jobs in Alabama? For Utilization Review jobs in Alabama, the most frequently searched job titles are:
What job categories do people searching Utilization Review jobs in Alabama look for? The top searched job categories for Utilization Review jobs in Alabama are:
What cities in Alabama are hiring for Utilization Review jobs? Cities in Alabama with the most Utilization Review job openings:
Utilization Review jobs near you
Infographic showing various Utilization Review job openings in Alabama as of July 2026, with employment types broken down into 96% Full Time, and 4% Part Time. Highlights an 100% In-person job distribution, with an average salary of $79,714 per year, or $38.3 per hour.
Utilization Review Nurse

Utilization Review Nurse

Southeast Health

Dothan, AL • On-site

Full-time

This job post has expired today. Applications are no longer accepted.

Job description

Southeast. Always the right career direction.
Job Description Summary
The Utilization Review Nurse screens medical records in accordance with contractual agreement and regulatory requirements for medical necessity on admission and continued stay in the acute care setting. The Utilization Review case manager collaborates with all components of the healthcare system, managing appropriate use of acute care to aid in the achievement of quality outcomes, fiscal responsibility, and patient satisfaction.
Job Description
Essential Functions
  • Performs admissions and continued stay reviews of all inpatients and outpatient/observation patients in a bed; at times, this may be retrospective.
  • Performs precertification on procedures ordered while patients are hospitalized.
  • Issues required Medicare/Medicaid notifications of medical necessity changes to patients while hospitalized.
  • Issues notifications of non-coverage letters to patients if received during hospital stay.
  • Documents clear billing notes into the Electronic Medical Record (EMR) payer communications navigator to avoid billing denials.
  • Performs medical necessity denial appeals.
  • Maintains a close, collaborative relationship with the medical staff to promote continuity of care and avoid delays in service.
  • Performs other duties as requested by primary manager that do not compromise moral code of conduct or protocols set in place for patient or employee safety
Supervised Positions
  • None

Qualifications
Minimum Education Required
  • Associates degree in Nursing
  • Current Registered Nurse license in the State of Alabama
Minimum Education Preferred
  • Bachelor's degree or higher in Nursing
Minimum Experience Required
  • Two (2) years acute care experience
  • Must pass Blue Cross Blue Shield Iterator Reliability Test with 90% within six (6) months of hire
Minimum Experience Preferred
  • Three (3) years acute care experience
  • One (1) year utilization review experience

Required Knowledge/ Skills/ Abilities
  • Maintain current licensure in the State of Alabama
  • Demonstrates appropriate utilization of the skills of the Registered Nurse as approved by the Alabama Board of Nursing
  • Ability to quickly adapt to changing circumstances in fast-paced environment
  • Actively accepts, understands, and practices appropriate standards of nursing practice.
  • Must demonstrate basic knowledge of discharge planning needs
  • Demonstrates advanced computer skills (ability to generate reports, graph trends).
  • Clinical knowledge and experience in the care of patients with multiple and complex diagnoses, disease process, and care needs.
  • Ability to prioritize work and meet deadlines.
  • Ability to problem solve in a proactive, creative manner, using sound judgment based on factual information and clinical knowledge.
  • Ability to develop leadership skills and to serve as a role model for clinical staff.
  • Ability to lead and actively participate in multidisciplinary teams.
  • Ability to work independently within a team structure.
  • Demonstrates responsibility for educational requirements as evidenced by reading all assigned related references, and attending all required educational meetings, or webinars, and completing annual Symplr requirements.
  • Demonstrates commitment to organizations five (5) priorities and Six Ground Rules
  • Person in this position is required to understand, agree upon and follow our Six Ground Rules:
    • No excuses.
    • We are a team.
    • Bring up your ideas.
    • Poor performance will be addressed.
    • 'That's not my job' is not acceptable
    • Manage Up.

Shift
DayShift Details
8:00 am - 4:30 pm
FTE
1
Type
Regular
Join one of Forbes 500 best mid-sized employers in America.
Equal Employment Employer
Southeast Health is committed to provide equal employment opportunity (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law. In addition, Southeast Health will provide reasonable accommodations for qualified individuals with disabilities.

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