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Utilization Review Jobs in Ontario (NOW HIRING)

ST JOHNS HEALTH

$22.68 - $27/hr

... as Utilization Review for the appropriate status of patients as well as collecting any legally required documentation. Customer Service and Communication · Meets the needs of all customers to ...

Compass Health Network

$36.29 - $39.29/hr

Provide licensure supervision and perform utilization review activities as assigned * Attend required trainings and maintain productivity expectations Master's degree in social work, marriage and ...

LRQA

Automotive Auditor Manager

Toronto, ON · On-site

Support audit planning, resource allocation, regional capacity management, and auditor utilization. * Review audit reports, nonconformities, corrective actions, and certification recommendations for ...

HOME CAREGIVERS PARTNERSHIP LLC

Participates in utilization review of medical records as assigned. * Gives total patient care as needed. * Takes on-call duty nights, weekends and holidays as assigned. * Completes and submits OASIS ...

HOME CAREGIVERS PARTNERSHIP LLC

Participates in utilization review of medical records as assigned. * Gives total patient care as needed. * Takes on-call duty nights, weekends and holidays as assigned. * Completes and submits OASIS ...

HOME CAREGIVERS PARTNERSHIP LLC

Participates in utilization review of medical records as assigned. * Gives total patient care as needed. * Takes on-call duty nights, weekends and holidays as assigned. * Completes and submits OASIS ...

Autodesk

... reviews * Model and optimize GPU economics, cloud compute costs, and inference economics, including GPU utilization, capacity, scaling behavior, cost efficiency, COGS, cost-to-serve dynamics, and ...

Magna

Paint Process Engineering Group Leader

Guelph, ON · On-site

CA$105K - CA$130K/yr

Lead team reviews of cycle times, overall efficiency, yield, utilization, and process performance. * Create and/or support weekly reporting and presentations summarizing overall yield, utilization ...

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All JobsUtilization Review JobsUtilization Review Jobs in Ontario

Utilization Review information

See Ontario salary details

$13

$39

$76

How much do utilization review jobs pay per hour?

As of Sep 6, 2026, the average hourly pay for utilization review in Ontario is $39.74, according to ZipRecruiter salary data. Most workers in this role earn between $28.12 and $44.95 per hour, depending on experience, location, and employer.

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 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.

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, like the Certified Professional in Healthcare Quality (CPHQ), can enhance job prospects, and strong analytical and communication skills are essential for success in the role.

Is utilization review a stressful job?

Utilization review is a healthcare role that involves evaluating medical necessity and appropriateness of services, often under strict deadlines and documentation requirements. The job can be stressful due to high workload, the need for accuracy, and managing complex cases, but stress levels vary based on work environment and individual coping skills.

What are the most commonly searched types of Utilization Review jobs in Ontario?

The most popular types of Utilization Review jobs in Ontario are:

What are popular job titles related to Utilization Review jobs in Ontario?

For Utilization Review jobs in Ontario, the most frequently searched job titles are:

What job categories do people searching Utilization Review jobs in Ontario look for?

The top searched job categories for Utilization Review jobs in Ontario are:

Utilization Review jobs near you
Infographic showing various Utilization Review job openings in Ontario as of August 2026, with employment types broken down into 1% As Needed, 75% Full Time, 20% Part Time, 1% Temporary, and 3% Contract. Highlights an 88% Physical, 3% Hybrid, and 9% Remote job distribution, with an average salary of $82,652 per year, or $39.7 per hour.

Patient Admissions Coordinator

ST JOHNS HEALTH

On-site

$22.68 - $27/hr

Full-time

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

Job description

JOB SUMMARY
Embraces the vision of Patient Financial Services: "To provide highly regarded and desirable Patient Financial
Services that are caring, honorable, and innovative." Under the direction of the Patient Financial Services Supervisor,
the Patient Admissions Coordinator maintains proficient emergency registration as well as various inpatient and
outpatient registration. Engages in efficient processing of assigned tasks and projects while providing an exceptional
level of customer service for all hospital customers. Provides multiple patient financial services in the form of: timely
and accurate patient registrations, existing patient system demographic, insurance data updates, basic payment
collections, and engagement in quality assurance and process accuracy.
 
ESSENTIAL FUNCTIONS
Registration
· Registers patients in a timely and effective manner, while maintaining a high level of attention to detail with data
entry. Audits visits for completeness. Ensures that paperwork and documentation are collected when appropriate; i.e.
ID, insurance, consent, physician order, name change information, advance directives, etc.
· Identifies compliance of orders, including CPT and ICD-10 codes, along with other requirements per policy. If an
order is identified as incomplete, contacts the physician's office to obtain the necessary information.
· Protects and ensures the confidentiality of patient information, especially when delivering paperwork to the
appropriate department.
· Follows federal, state, and any other legal guidelines such as EMTALA or HIPAA with regards to job functions.
· Coordinates with internal departments such as Utilization Review for the appropriate status of patients as well as
collecting any legally required documentation.
 
Customer Service and Communication
· Meets the needs of all customers to enhance communication, way-finding, and access to available services at St.
John's Health and affiliated facilities.
· Able to field questions and/or issues to the appropriate person or department. Communicates effectively, and
presents a confident and friendly demeanor with all customers internally and externally.
· Performs duties according to the Scope of Service for Patient Access.
· Continuously contributes to an extraordinary patient and customer experience throughout St. John's Health.
· Comfortable providing registration service for patients in pain, distress, or a traumatic situations; whether it be at the
main emergency entrance of bedside.
 
Financial Services
· Collect patient financial obligations such as copays or estimated liability at time of discharge/check out.
· Applies collected amounts to the appropriate patient account, ensures cash is given to the appropriate staff member
for bank deposit, and delivers receipts to the Cash Posting Team for reconciliation.
· Connects the patient with Financial Navigation for more complex financial discussions.
· Collect appropriate forms and patient signatures in relation to financial obligations, i.e. Patient Responsibility
Waiver, Important Message from Medicare/TRICARE, etc...
 
Teamwork
· Represents, facilitates, and elevates team success within Patient Financial Services, and St. John's Health as a
whole.
· Assists Supervisor or Manager with various special projects as needed.
· Collaborates with other departments such as Utilization Review, Case Management, Nursing Units, Patient
Assistance, etc., as needed, when additional information from the patient is necessary.
· Is clocked in and ready to take patients or carry out job responsibilities right at the start of shift. General expectation
is to be clocking in 5 minutes prior to shift.
 
Problem Solving and Improvement Activities
· Autonomously applies sound judgment to solve operational problems, appropriately following up with team
members and leadership to address. Participates in the launch, development, implementation, and control of
improvement projects.
· Adheres to and practices in St. John's Health Corporate Compliance Program, and participates in Performance
Improvement activities.
· Seeks and implements improvement projects directly related to patient admission functions.
 
Communication
· Support and backup the general switchboard function for St. John's Health. Call inbound to the hospital general line
should be handled in a professional and courteous manner and connected promptly with requested connection.
· Respond appropriately to all applicable emergency response situations (aka Code scenarios) such as local
disasters, bomb threats, fires, etc.
· Monitor alarm panel and respond appropriately and quickly to resolve. This may involve overhead paging, calling
appropriate staff or local emergency services.
 
JOB REQUIREMENTS
Minimum Education
Required: High School Degree or GED equivalent.
Preferred: Associates or Bachelors Degree, medical terminology certification or proven knowledge of medical terminology, other
relevant professional certifications.
 
Minimum Work Experience
Required: Must be able to read, write and speak English fluently. Prior Front Desk or Business Office experience. One year or
more of strong customer service experience.
Preferred: Prior healthcare experience.
 
FUNCTIONAL DEMANDS
Working Conditions
Varying shifts, primarily on weekends, within a 24/7 department. On-site hospital emergency access area position.
Frequent interruptions and stressful situations. Contact with patients, co-workers and community members under a
variety of circumstances. Must be on-site at the St. John's Health campus or other facilities to fulfill the responsibilities
of this role.
 
Physical Requirements
60 to 80% of day sitting and computer use. Medium phone usage. Intermittent standing and walking. Ability to
lift/push/pull 20 pounds.
 
Direct Reports: None
 
Reports to: Sr. Business Relationship Manager
 
Internal & External Contacts: Patients, patient's family members, members of the community, physicians, nurses, St. John's Health staff, Fire/EMS,
Law Enforcement Officers and vendors.
 
LEADERSHIP CAPABILITIES
Attention to Detail
• Completes tasks in a way that ensures there are no errors
• Methodically and patiently reviews work to identify any mistakes or discrepancies
• Creates and stores documentation in a way that is thorough and easy to access
 
Priority Setting
• Spends his/her time and the time of others on what's important
• Quickly zeros in on the critical few and puts the trivial many aside
 
Time Management
• Uses his/her time effectively and efficiently
• Concentrates his/her efforts on the more important priorities
• Gets more done in less time than others
 
Composure
• Avoids becoming defensive or irritated when times are tough
• Maintains balance when the unexpected happens
 
Interpersonal Skills
• Relates well to all kinds of people, up, down and sideways, inside and outside the organization
• Builds appropriate rapport
• Uses diplomacy and tact
 
Organizing
• Can coordinate multiple activities and resources at once to accomplish a goal
• Arranges information and files in a useful manner

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