... for a Utilization Review Coordinator to coordinate patients' services across the continuum of care by promoting effective utilization, monitoring health resources and elaborating with ...
... for a Utilization Review Coordinator to coordinate patients' services across the continuum of care by promoting effective utilization, monitoring health resources and elaborating with ...
... for a Utilization Review Coordinator to coordinate patients' services across the continuum of care by promoting effective utilization, monitoring health resources and elaborating with ...
... for a Utilization Review Coordinator to coordinate patients' services across the continuum of care by promoting effective utilization, monitoring health resources and elaborating with ...
... for a Utilization Review Coordinator to coordinate patients' services across the continuum of care by promoting effective utilization, monitoring health resources and elaborating with ...
... for a Utilization Review Coordinator to coordinate patients' services across the continuum of care by promoting effective utilization, monitoring health resources and elaborating with ...
Specialist, Utilization Review
Columbus, OH ยท On-site
Previous utilization review experience in a psychiatric healthcare facility preferred. License: Current unencumbered clinical license strongly preferred. Additional Requirements: CPR certification ...
Specialist, Utilization Review
Columbus, OH ยท On-site
Previous utilization review experience in a psychiatric healthcare facility preferred. License: Current unencumbered clinical license strongly preferred. Additional Requirements: CPR certification ...
The Utilization Review Specialist is responsible for the authorizations and certifications process for Inpatient and Outpatient Services. This includes the precertification and recertification ...
The Utilization Review Specialist is responsible for the authorizations and certifications process for Inpatient and Outpatient Services. This includes the precertification and recertification ...
Experience with medical record review/utilization review/utilization management Additional Information Are you an experienced Registered Nurse with Utilization review experience looking for a new ...
Experience with medical record review/utilization review/utilization management Additional Information Are you an experienced Registered Nurse with Utilization review experience looking for a new ...
Utilization Review RN
Mason, OH ยท On-site
This is a utilization review position. Nurses will be responsible for collaborating with healthcare providers and members to promote quality member outcomes to optimize member benefits and to promote ...
Utilization Review RN
Mason, OH ยท On-site
This is a utilization review position. Nurses will be responsible for collaborating with healthcare providers and members to promote quality member outcomes to optimize member benefits and to promote ...
Provides administrative support to the Utilization Review Team and assists with eligibility verification, data entry, and coordination of information. Essential Functions: * Coordinates with external ...
Provides administrative support to the Utilization Review Team and assists with eligibility verification, data entry, and coordination of information. Essential Functions: * Coordinates with external ...
Job Address: 10123 Alliance Road, Suite 320 Blue Ash, OH 45242 New Vista Health and Wellness is currently recruiting a Utilization Review Coordinator for our team in Blue Ash OH! WHO WE ARE The New ...
Job Address: 10123 Alliance Road, Suite 320 Blue Ash, OH 45242 New Vista Health and Wellness is currently recruiting a Utilization Review Coordinator for our team in Blue Ash OH! WHO WE ARE The New ...
Utilization review, Resource management, Managing the continuum of care, and Clinical documentation management. Responsible for facilitating appropriate length of stay and reimbursement for all ...
Utilization review, Resource management, Managing the continuum of care, and Clinical documentation management. Responsible for facilitating appropriate length of stay and reimbursement for all ...
Utilization review, Resource management, Managing the continuum of care, and Clinical documentation management. Responsible for facilitating appropriate length of stay and reimbursement for all ...
Utilization review, Resource management, Managing the continuum of care, and Clinical documentation management. Responsible for facilitating appropriate length of stay and reimbursement for all ...
Utilization Review * Discipline: RN * Start Date: 07/20/2026 * Duration: 13 weeks * 40 hours per week * Shift: 8 hours * Employment Type: Travel Our client is looking to add a Registered Nurse to ...
Utilization Review * Discipline: RN * Start Date: 07/20/2026 * Duration: 13 weeks * 40 hours per week * Shift: 8 hours * Employment Type: Travel Our client is looking to add a Registered Nurse to ...
Utilization Review * Discipline: RN * Start Date: 08/24/2026 * Duration: 12 weeks * 40 hours per week * Shift: 8 hours * Employment Type: Travel Our client is looking to add a Registered Nurse to ...
Utilization Review * Discipline: RN * Start Date: 08/24/2026 * Duration: 12 weeks * 40 hours per week * Shift: 8 hours * Employment Type: Travel Our client is looking to add a Registered Nurse to ...
Travel Nurse RN - Utilization Review
Middleburg Heights, OH ยท On-site
$2.5K/wk
Specialty: Utilization Review * Discipline: RN * Start Date: 07/27/2026 * Duration: 13 weeks * 40 hours per week * Shift: 8 hours, days * Employment Type: Travel Contract duration in weeks 13 ...
Travel Nurse RN - Utilization Review
Middleburg Heights, OH ยท On-site
$2.5K/wk
Specialty: Utilization Review * Discipline: RN * Start Date: 07/27/2026 * Duration: 13 weeks * 40 hours per week * Shift: 8 hours, days * Employment Type: Travel Contract duration in weeks 13 ...
Care Review Nurse
Columbus, OH ยท On-site
Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Healthcare members ...
Care Review Nurse
Columbus, OH ยท On-site
Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Healthcare members ...
Utilization Review Nurse MAIN FUNCTION: The Utilization Management Nurse Reviewer (RN) serves as the Subject Matter Expert for the organization for patient admission status (inpatient and observation ...
Quick apply
Utilization Review Nurse MAIN FUNCTION: The Utilization Management Nurse Reviewer (RN) serves as the Subject Matter Expert for the organization for patient admission status (inpatient and observation ...
UTILIZATION SPECIALIST-E.D.
Hudson, OH ยท On-site
The utilization specialist in the Emergency Department (ED) will formulate a patient status recommendation for observation or inpatient status, after thorough review of patient assessments during the ...
UTILIZATION SPECIALIST-E.D.
Hudson, OH ยท On-site
The utilization specialist in the Emergency Department (ED) will formulate a patient status recommendation for observation or inpatient status, after thorough review of patient assessments during the ...
Well versed in Utilization Management - Must be able to determine elective vs urgent request with Prior Authorization Review * Provider Claims, Appeals and Denials - certain services require prior ...
Well versed in Utilization Management - Must be able to determine elective vs urgent request with Prior Authorization Review * Provider Claims, Appeals and Denials - certain services require prior ...
The utilization specialist in the Emergency Department (ED) will formulate a patient status recommendation for observation or inpatient status, after thorough review of patient assessments during the ...
The utilization specialist in the Emergency Department (ED) will formulate a patient status recommendation for observation or inpatient status, after thorough review of patient assessments during the ...
The utilization specialist in the Emergency Department (ED) will formulate a patient status recommendation for observation or inpatient status, after thorough review of patient assessments during the ...
The utilization specialist in the Emergency Department (ED) will formulate a patient status recommendation for observation or inpatient status, after thorough review of patient assessments during the ...
Utilization Review information
See Ohio salary details
$20.34 - $24.45
2% of jobs
$24.45 - $28.57
9% of jobs
$31.38 is the 25th percentile. Wages below this are outliers.
$28.57 - $32.68
21% of jobs
The median wage is $36.01 / hr.
$32.68 - $36.79
23% of jobs
$36.79 - $40.91
13% of jobs
$44.11 is the 75th percentile. Wages above this are outliers.
$40.91 - $45.02
10% of jobs
$45.02 - $49.13
8% of jobs
$49.13 - $53.25
5% of jobs
$53.25 - $57.36
5% of jobs
$57.36 - $61.48
2% of jobs
$61.48 - $65.59
2% of jobs
$20
$40
$65
How much do utilization review jobs pay per hour?
What jobs make $3,000 a day?
What jobs pay 4000 a week without a degree?
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?
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?
- Non Exempt No Experience Utilization Management Nurse
- Utilization Management
- Flex Schedule Remote Utilization Review Nurse
- Evening Optum Health Utilization Review
- Evening Utilization Review Nurse
- Cvs Health Utilization Management
- Seasonal Remote Hedis Review Nurse
- Remote Utilization Management
- Overnight Utilization Review Nurse
- Remote Utilization Management Pharmacist
- Insurance Utilization Review
- Speech Therapy Utilization Review
- Cigna Utilization Review Nurse
- Authorization Utilization Review Bcba
- Anthem Utilization Review Nurse
- Remote Aetna Utilization Review
- Weekend Utilization Review
- Contract Utilization Review
- Remote Cigna Utilization Review Nurse
- Optum Utilization Review Nurse

Full-time
Medical, Dental, Vision, Retirement, PTO
Posted 11 days ago
Job description
Healing Body and Mind.
NeuroPsychiatric Hospitals is a national leader in behavioral healthcare, specializing in patients with acute psychiatric and complex medical needs. Our hospitals use an interdisciplinary, multi-specialty approach that delivers high-quality, patient-centered care when it's needed most.
With locations in Indiana, Michigan, Texas, and Arizona, we're expanding access to our unique model of care across the United States. Join us and be part of a team dedicated to making a lasting difference in the lives of patients and families every day
Overview
North Valley Behavioral Hospital, a brand new psychiatric hospital within the NeuroPsychiatric Hospitals network, is looking for a Utilization Review Coordinator to coordinate patients' services across the continuum of care by promoting effective utilization, monitoring health resources and elaborating with multidisciplinary teams.
Benefits of joining NPH
- Competitive pay rates
- Medical, Dental, and Vision Insurance
- NPH 401(k) plan with up to 4% Company match
- Employee Assistance Program (EAP) Programs
- Generous PTO and Time Off Policy
- Special tuition offers through Capella University
- Work/life balance with great professional growth opportunities
- Employee Discounts through LifeMart
Responsibilities
- Filing documents as needed.
- Initial Precertification with payors.
- Concurrent Clinical review with payors.
- Document in the electronic system daily in real time.
- Admission audit.
- Ensures that CON's/RON's and CMS certifications are completed by provider.
- Consistently demonstrates professionalism with all internal and external customers as evidenced by positive customer and peer Communicates effectively with all staff and patients as evidenced by the establishment and maintenance of productive working relationships.
- Maintains knowledge of current trends and developments in the field by reading appropriate books; journals and other literature and attending related seminars or conferences.
- Maintains a professional approach with Assures protection and privacy of health information as attained through written, electronic or oral disclosures.
- Cooperates and maintains good rapport with nursing staff, medical staff, and other departments.
- Seeks guidance and remains knowledgeable of, and complies with, all applicable federal and state laws, as well as hospital polices that apply.
- Complies with hospital expectations regarding ethical behavior and standards of conduct.
- Complies with federal and hospital requirements in the areas of protected health information and patient information.
- Reconsiderations, assists with appeals as needed, arrange peer to peer level reviews, and report the outcomes to the VP of Care Management and Team.
- Provides education to nursing staff. leadership team, and providers regarding documentation.
- Actively works with the business office regarding resolution of appeals/denials and retrospective reviews.
Qualifications
Education: Bachelor's in Behavioral Health, Social Work, Counseling, Nursing or Psychology required. Master's degree preferred.
Experience: Minimum of 2 years of utilization review experience in a hospital setting required. Minimum of 2 years of case management experience, including discharge planning in a hospital setting required.
Licensure: Certified Case Manager (CCM) or Accredited Case Manager (ACM) preferred. Basic Life Support (BLS) and Handle with Care (HWC) obtained during orientation, if applicable.
Skills: Must have strong knowledge of medications and demonstrate exceptional time management, data entry, and communication skills. Must be detail oriented.#INDEEDLOW