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Utilization Review Jobs in Puerto Rico (NOW HIRING)

Ultimate Solutions

... utilization of best process. * At higher levels, may lead and direct the work of others. * Build ... Generates, executes, reviews, and complete qualification and validation protocols, summary reports ...

Pharmpix

PR · On-site

Investigate and resolve discrepancies related to utilization, eligibility, or payment amounts ... Compile documentation requested during internal or external reviews * Ensure outputs align with ...

Inkit

Senior Software Engineer

San Juan, PR · On-site

$120K - $158K/yr

Optimize application performance and resource utilization throughout the technology stack ... Provide mentorship and code reviews to help junior developers grow their skills * Champion software ...

chicosfas

Sales Associate - Soma

San Juan, PR

$13.75 - $18.75/hr

... utilization of customer book. Operational Excellence * Supports replenishment activities that keep ... When we do have an open position, we will review your application to determine if your ...

Consertus, Inc.

Associate in Grants

San Juan, PR · On-site

Review and evaluate contract documents to ensure adherence to federal regulations and funding ... Manage budgets and oversee fund allocation to ensure proper utilization of grant resources.

Acumenian

Associate in Grants

San Juan, PR

Review and evaluate contract documents to ensure adherence to federal regulations and funding ... Manage budgets and oversee fund allocation to ensure proper utilization of grant resources.

Acumenian

PR · On-site

Review and evaluate contract documents to ensure adherence to federal regulations and funding ... Manage budgets and oversee fund allocation to ensure proper utilization of grant resources.

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Utilization Review information

What jobs pay $10,000 a month without a degree?

Utilization Review roles typically do not pay $10,000 a month without relevant experience or certifications; most positions in this field pay lower salaries. High-paying jobs that can reach this level without a degree often include specialized sales, real estate, or entrepreneurship, but they usually require significant skills, networking, or business acumen. Achieving such income without a degree generally involves gaining expertise, certifications, or building a successful independent business.

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.

What is the least stressful healthcare job?

Utilization review is often considered a less stressful healthcare job because it typically involves reviewing medical cases and insurance claims in a predictable, office-based environment. It usually requires strong analytical skills and certification but involves less direct patient interaction and emergency situations compared to clinical roles.

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 obtains certification in utilization review or case management. Gaining experience in healthcare settings and understanding insurance policies and medical coding can also improve job prospects. Certification programs like the Certified Professional in Healthcare Quality (CPHQ) or Certified Case Manager (CCM) are often preferred by employers.
What are the most commonly searched types of Utilization Review jobs in Puerto Rico? The most popular types of Utilization Review jobs in Puerto Rico are:
What are popular job titles related to Utilization Review jobs in Puerto Rico? For Utilization Review jobs in Puerto Rico, the most frequently searched job titles are:
What job categories do people searching Utilization Review jobs in Puerto Rico look for? The top searched job categories for Utilization Review jobs in Puerto Rico are:
Utilization Review jobs near you
Infographic showing various Utilization Review job openings in Puerto Rico as of June 2026, with employment types broken down into 100% Full Time. Highlights an 60% In-person, and 40% Remote job distribution.
Process Engineer

Process Engineer

Ultimate Solutions

On-site

Other

Posted 10 days ago

Job description


Ultimate Solutions Corp. is a trusted provider of packaging industrial automation, serialization and compliance for the Life Science Industries in Puerto Rico, United States and Europe. Over a decade, the Ultimate team has delivered proven results in hundreds of projects and thousands of service hours to the global leaders of pharmaceutical, biotechnology, medical devices, and logistics markets.
Process Engineer
RESPONSIBILITES
  • Lead/support projects or initiatives, including but not limited to: new products, process and technology introductions.
  • Participates in projects involving other departments and activities.
  • Coordinates communications and interact within end users and machine manufacturers or suppliers.
  • Evaluates process trends (Ex. Yield, OEE) to drive improvements of business results.
  • Responsible for problem identification, root cause analysis, project management, financial analysis, efficiency or productivity improvement, and problem resolution.
  • Support process improvement projects that have the objectives of developing more cost efficient and quality enhanced processes.
  • Evaluate data generated through studies using statistical analytical methods.
  • Responsible for the development and/or revision of production standards and Manufacturing/Packaging process to assure utilization of best process.
  • At higher levels, may lead and direct the work of others.
  • Build and execute validation strategies.
  • Must possess a solid understanding of FDA Validation guidelines.
  • Implements policies and procedures to validate/qualify equipment, systems, and processes in accordance with regulatory requirements and company manufacturing standards.
  • Generate new specifications based on new regulations required by the implementation of a new manufacturing process.
  • Generates, executes, reviews, and complete qualification and validation protocols, summary reports and associated data for conformance to regulations, SOPs, specifications and other applicable acceptance criteria.
  • Prepares and coordinate qualification activities.
  • Communicate with the staff and management on ways of implementing plans and recommendations.
  • Responsible for designing, document and implementing manufacturing and/or packaging processes & equipment.
  • Familiar with a variety of field concepts, practices, and procedures.

EDUCATION
Bachelor's degree in Engineering (3 -5 years of experience)
REQUIREMENTS/SKILLS
  • Experience in Medical Device or Pharmaceutical industry is required
  • Project Management experience managing multi-sites project is a plus
  • GMP & ISO knowledge, understanding and experience
  • Computer skills and use of software application(s). Strong computer background (MS Office, MS Project Management, Word, Excel, Outlook, etc.)
  • Strong knowledge on statistics, problem solving and lean tools.
  • Effective interactions in a team environment
  • Team player, self-starter, persistent, tactful, and persuasive
  • Good organizational skills, detail-oriented & accurate, analytical skills
  • Effective verbal and written communication skills (writing and presentations)
  • Able to work with minimum or no supervision
  • Fully Bilingual (English and Spanish)
ADDITIONAL REQUIREMENTS
  • Must have knowledge in: Process Validations, Equipment Validations, Equipment Qualifications, Test Method Validations. Manufacturing Procedures generation, Component Qualification, QE, experience with documentation, reviewing and approving IQ, OQ, PQ.
  • Technical Writing Skills

Ultimate Solutions Corp is an equal opportunity employer.

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