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Utilization Review Jobs in Kentucky (NOW HIRING)

Phenom People

RN Utilization Review PRN

Paris, KY · On-site

PRN, RN - Utilization Review Making Communities Healthier with Comprehensive Care... You can get to know who we are and what truly makes us different by our mission, 'Making Communities Healthier'

UHS

UR COORDINATOR (RN OR MSW)

Hopkinsville, KY · On-site

Responsibilities Utilization Review Coordinator Opportunity Cumberland Hall Hospital is a 97 bed, licensed, acute psychiatric hospital located in beautiful Hopkinsville, KY. Cumberland Hall features ...

UHS

UR COORDINATOR (RN OR MSW)

Hopkinsville, KY · On-site

Responsibilities Utilization Review Coordinator Opportunity Cumberland Hall Hospital is a 97 bed, licensed, acute psychiatric hospital located in beautiful Hopkinsville, KY. Cumberland Hall features ...

UHS

Utilization Coordinator PRN

Louisville, KY · On-site

$20/hr

Responsibilities The Brook Hospital Dupont located at 1405 Browns Ln is seeking a PRN Utilization Review Coordinator to join our team. Hourly pay: $20 Since 1985 The Brook Hospital has been offering ...

UHS

Utilization Coordinator PRN

Louisville, KY · On-site

$20/hr

Responsibilities The Brook Hospital Dupont located at 1405 Browns Ln is seeking a PRN Utilization Review Coordinator to join our team. Hourly pay: $20 Since 1985 The Brook Hospital has been offering ...

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All JobsUtilization Review JobsUtilization Review Jobs in Kentucky

Utilization Review information

See Kentucky salary details

$18

$36

$59

How much do utilization review jobs pay per hour?

As of Aug 6, 2026, the average hourly pay for utilization review in Kentucky is $36.72, according to ZipRecruiter salary data. Most workers in this role earn between $29.04 and $42.16 per hour, depending on experience, location, and employer.

Is utilization review work from home?

Utilization review jobs can often be performed remotely, especially with the increased adoption of telecommuting in healthcare and insurance industries. Many employers offer work-from-home options, provided the reviewer has the necessary certifications and access to electronic health records or claims systems. However, some positions may require on-site presence for meetings or audits.

What does a utilization review do?

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.

Is utilization review a stressful job?

Utilization review is a healthcare role that involves evaluating medical necessity and appropriateness of services, which can be stressful due to strict deadlines, high accuracy requirements, and the need to balance patient care with insurance policies. The job often requires strong attention to detail, communication skills, and the ability to handle complex cases under time pressure.

What is a utilization review?

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 utilization review?

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 or related degree such as nursing, health administration, or social work is required. Certification in case management or utilization review, such as the Certified Professional in Healthcare Quality (CPHQ), can enhance job prospects. Relevant skills include knowledge of medical coding, insurance policies, and strong analytical abilities.
What are the most commonly searched types of Utilization Review jobs in Kentucky? The most popular types of Utilization Review jobs in Kentucky are:
What are popular job titles related to Utilization Review jobs in Kentucky? For Utilization Review jobs in Kentucky, the most frequently searched job titles are:
What job categories do people searching Utilization Review jobs in Kentucky look for? The top searched job categories for Utilization Review jobs in Kentucky are:
What cities in Kentucky are hiring for Utilization Review jobs? Cities in Kentucky with the most Utilization Review job openings:
Utilization Review jobs near you
Infographic showing various Utilization Review job openings in Kentucky as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 14% Part Time, and 5% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $76,384 per year, or $36.7 per hour.

RN Utilization Review PRN

Phenom People

Paris, KY • On-site

Other

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 16 days ago

Job description

PRN, RN - Utilization Review

Making Communities Healthier with Comprehensive Care...

You can get to know who we are and what truly makes us different by our mission, 'Making Communities Healthier'. As health care evolves, Bourbon Community Hospital is transforming patient safety and quality care - pushing the limits and paving the way to establish new practices and set new standards. We believe in putting the patient at the center of everything we do. We are developing the most innovative patient experiences with our constant investment in continuing education and leadership development programs.

We want you on our team...Bourbon Community Hospital located in Paris, a 20 minute drive from Lexington, KY is searching for a PRN, RN - Utilization Review, who monitors adherence to the hospital's utilization review plan to ensure appropriate use of hospital services, hospital admissions and extended hospital stays.

We are committed to serving the needs of our community and our region with exceptional quality and we are passionately focused on our patients. We consider quality more than just a set of criteria. It is a way of life for Bourbon Community, encompassing everything we do. This is an exciting time to join our team as we continue to grow and expand with new services.

At Bourbon Community, we believe in building careers. That is why we offer an excellent tuition reimbursement program, competitive pay, a generous paid time off program, flexible spending account plan, choice of health insurance plans, dental, vision, life, disability plans, discounts in our café and various discounts in our community, traditional and Roth 401 (k) plans with a match, and free parking on our beautiful campus.

Simply put, our employees are the heart and soul of our organization.

Essential functions of position include, but are not limited to:

  • Establishes and maintains efficient methods of ensuring the medical necessity and appropriateness of all hospital admissions.
  • Performs concurrent reviews for patients to ensure that extended stays are medically justified and are so documented in patient's medical records.
  • Calculates the lengths of stay and continued-stay days for patients.
  • Maintains a liaison with the Social Service Department to facilitate timely discharge planning.

Minimum Education

Associate's degree - Required

Bachelor's degree - Preferred

Required Skills

Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action.

Certifications:

Handle With Care

Licenses:

RN in the state of Kentucky

Equal opportunity and affirmative action employers and are looking for diversity in candidates for employment: Minority/Female/Disabled/Protected Veteran

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