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Utilization Review Jobs in Delaware (NOW HIRING)

SUN Behavioral Delaware

Intake Coordinator I

Georgetown, DE · On-site

$16.50 - $22.75/hr

Demonstrates understanding of utilization review process to include treatment criteria and precertification payor to obtain initial authorization of care and document same with pass to the ...

Acadia Healthcare

Admissions Counselor

New Castle, DE · On-site

$37K - $50K/yr

Clinical professional is responsible for facilitating admissions, clinical intake assessments, and utilization review processes to assure continuity for the most appropriate level of care for ...

Acadia Healthcare

Admissions Counselor

New Castle, DE · On-site

$37K - $50K/yr

Clinical professional is responsible for facilitating admissions, clinical intake assessments, and utilization review processes to assure continuity for the most appropriate level of care for ...

Pacs

$840 - $1.0K/wk

Participate in Patient Care Conferences, Utilization Review meetings and Rehabilitation Conferences as needed. Participate in in services training program for other staff in the facility. Record ...

Pacs

Participate in Patient Care Conferences, Utilization Review meetings and Rehabilitation Conferences as needed. Participate in in-services training program for other staff in the facility. Record ...

Pacs

$840 - $1.0K/wk

Participate in Patient Care Conferences, Utilization Review meetings and Rehabilitation Conferences as needed. Participate in in services training program for other staff in the facility. Record ...

Pacs

Physical Therapist

Arden, DE · On-site

$65 - $68/hr

Participates in Resident Care conferences, Utilization Review meetings, and Rehabilitation meetings as needed. * Provides in-services on training programs for other staff in the facility as needed.

UHS

HIM/MEDICAL RECORDS SPEC/TECH

Dover, DE · On-site

$37K - $50K/yr

Work closely with the Business Office and Utilization Review and provide information regarding the medical records and educate staff regarding coding changes and issues * Participate in all Precyse ...

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Utilization Review information

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How much do utilization review jobs pay per hour?

As of Jul 6, 2026, the average hourly pay for utilization review in Delaware is $42.32, according to ZipRecruiter salary data. Most workers in this role earn between $33.46 and $48.61 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 Delaware? The most popular types of Utilization Review jobs in Delaware are:
What are popular job titles related to Utilization Review jobs in Delaware? For Utilization Review jobs in Delaware, the most frequently searched job titles are:
What job categories do people searching Utilization Review jobs in Delaware look for? The top searched job categories for Utilization Review jobs in Delaware are:
What cities in Delaware are hiring for Utilization Review jobs? Cities in Delaware with the most Utilization Review job openings:
Utilization Review jobs near you
Infographic showing various Utilization Review job openings in Delaware as of June 2026, with employment types broken down into 71% Full Time, 22% Part Time, and 7% Contract. Highlights an 88% In-person, and 12% Remote job distribution, with an average salary of $88,022 per year, or $42.3 per hour.
Intake Coordinator I

Intake Coordinator I

SUN Behavioral Delaware

Georgetown, DE • On-site

$16.50 - $22.75/hr

Other

Posted 16 days ago

Sun Behavioral Health rating

5.3

Company rating: 5.3 out of 10

Based on 9 frontline employees who took The Breakroom Quiz

Job description

Position Summary:
Receives inquiry calls and assists the caller with scheduling a face-to-face assessment or provide triage to the appropriate community referral based on patient need. Assesses or ensures necessary assessment by a licensed, qualified mental health professional for patients who present for assessment. Upon assessment of the patient, coordinates with the physician to ensure appropriate treatment is provided either at the hospital or another appropriate provider in the community. Ensures appropriate screening of medical and behavioral emergency conditions. Completes all administrative processes of the admission for treatment including, as appropriate, the initial authorization of care with the insurance company/third-party payor.
Position Responsibilities:
Clinical / Technical Skills (40% of performance review)
  • Demonstrates excellent phone skills including inquiry calls, explanation of assessment processes, scheduling appointments and successful closure of a call while avoiding phone therapy.
  • States the procedure for managing a crisis call and identifies when to activate EMS services. Identifies safety and risk of each call.
  • Documents all inquiry calls, completely and legibly, to include all applicable information on Call Worksheet.
  • Makes appropriate referrals to community resources if not scheduling an assessment
  • States the process and reasoning for all follow up calls either to confirm an assessment, inquire about no-show status, or rescheduling an assessment to include documentation reflecting same.
  • Enters all inquiry calls into HCS with all data needed to further action or follow up
  • Shows competency and understanding of the review of the medical screen; as appropriate, notifies the RN for additional review and action.
  • States the working definition and procedure for managing medically and psychiatric emergencies according to EMTALA guidelines as well as hospital policies.
  • Identifies and triages emergent patients and prioritizes care based on same.
  • Completes the clinical screening and assessment tool (PASP) with concise, clear, and legible documentation.
  • As applicable, identifies the need for additional screening for substance use, nutrition needs, functional needs, and abuse for children/adolescents, school and development screening.
  • Demonstrates understanding of admission criteria for inpatient, partial hospitalization, intensive outpatient hospitalization and outpatient levels of care.
  • Documents any special needs related to spiritual or cultural needs.
  • Demonstrates a working knowledge of community mental health and substance use programs/referral to be offered for all patients not at imminent risk nor requiring services at a higher level of care as provided at the hospital.
  • By demonstrating competency and thorough clinical understanding, ensures that each patient is seen by a physician or has had a consult by a physician to obtain treatment recommendations and disposition.
  • Upon admission to a treatment program within the hospital, notifies the unit staff of the patients level of acuity, chief compliant and history of illness leading to admission, medical concerns and attending physician.
  • Demonstrates understanding of all hospital required paperwork for admission and completion of admission packets for each department as applicable.
  • Knowledge of state local laws, ordinances and practices governing involuntary hospitalization and ensure compliance with same.
  • Ensure correct information on EMTALA log to include all timelines and no blanks in documentation.
  • Understands the ability to accurately maintain the bed board reconciliation for patient placement upon admission.
  • Demonstrates understanding of utilization review process to include treatment criteria and precertification payor to obtain initial authorization of care and document same with pass to the Utilization Management team for concurrent reviews.
  • As applicable, contracts the managed care organization or third-party
  • Demonstrates an ability to be flexible, organized and function well in stressful situations.
  • Treats patients and their families with respect and dignity, ensures confidentiality of patients records.
  • Interacts professionally with patient/family and provides explanations and verbal reassurance as necessary.
  • Ensures that documentation meets current standards and policies.
  • Answers the telephone in a polite manner and communicates information to the appropriate staff/family member.
  • Perform other duties as required

Safety (15% of performance review)
  • Strives to create a safe, healing environment for patients and family members
  • Follows all safety rules while on the job.
  • Reports near misses, as well as errors and accidents promptly.
  • Corrects minor safety hazards.
  • Communicates with peers and management regarding any hazards identified in the workplace.
  • Attends all required safety programs and understands responsibilities related to general, department, and job specific safety.
  • Participates in quality projects, as assigned, and supports quality initiatives.
  • Supports and maintains a culture of safety and quality.

Teamwork (15% of performance review)
  • Works well with others in a spirit of teamwork and cooperation.
  • Responds willingly to colleagues and serves as an active part of the hospital team.
  • Builds collaborative relationships with patients, families, staff, and physicians.
  • The ability to retrieve, communicate, and present data and information both verbally and in writing as required
  • Demonstrates listening skills and the ability to express or exchange ideas by means of the spoken and written word.
  • Demonstrates adequate skills in all forms of communication.
  • Adheres to the Standards of Behavior

Integrity (15% of performance review)
  • Strives to always do the right thing for the patient, coworkers, and the hospital
  • Adheres to established standards, policies, procedures, protocols, and laws.
  • Applies the Mission and Values of SUN Behavioral Health to personal practice and commits to service excellence.
  • Supports and demonstrates fiscal responsibility through supply usage, ordering of supplies, and conservation of facility resources.
  • Completes required trainings within defined time periods, as established by job description, policies, or hospital leadership
  • Exemplifies professionalism through good attendance and positive attitude, at all times.
  • Maintains confidentiality of patient and staff information, following HIPAA and other privacy laws.
  • Ensures proper documentation in all position activities, following federal and state guidelines.

Compassion (15% of performance review)
  • Demonstrates accountability for ensuring the highest quality patient care for patients.
  • Willingness to be accepting of those in need, and to extend a helping hand
  • Desire to go above and beyond for others
  • Understanding and accepting of cultural diversity and differences

Education
  • Required: Meeting state requirements, a LVN, Bachelors or Masters degree in a mental health related field, with a minimum of two (2) years of supervised clinical experience. CPR and hospital-selected de-escalation technique certification.
  • Maintains education and development appropriate for position.

Experience
  • Required: One to three years of experience in a behavioral health setting.
  • Preferred: Previous assessment and evaluation experience in a behavioral health setting.

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