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Utilization Review Jobs in Puerto Rico (NOW HIRING)

CERES

PR · On-site

$33 - $38/hr

Monitor productivity, quality, staffing levels, equipment utilization, and operational performance ... Review and approve employee time records, production reports, daily logs, and operational ...

Popular

Software Engineer

San Juan, PR · On-site

$75 - $110/hr

Participate actively in team meetings, code reviews, and knowledge‑sharing sessions. * Adhere to ... and utilization of Salesforce CRM. * Stay updated on Salesforce releases, best practices, and ...

Jj

Senior Manufacturing Engineer (One out of Two)

Anasco, PR · On-site

$89K - $122K/yr

The position is responsible for reviewing and implementing comprehensive project plans, ensuring ... Drive the optimization of process output and throughput, equipment utilization, equipment downtime ...

Inkit

Senior Software Engineer

San Juan, PR · On-site

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

Veterans Health Administration

$145K - $335K/yr

... after review of the EDRP application. Former EDRP participants ineligible to apply. Learn more ... utilization of health care resources. The Physiatrists Section Chief assists the ACOS for Rehab in ...

chicosfas

Sales Associate - Soma

San Juan, PR · On-site

$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 ...

Acumenian

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.

chicosfas

Sales Associate - Soma

San Juan, PR · On-site

$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.

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Utilization Review information

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 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 August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 14% Part Time, 1% Temporary, and 3% Contract. Highlights an 88% Physical, 3% Hybrid, and 9% Remote job distribution.

Budget Analyst (Senior Budget Analyst)

US Department of the Treasury

Caguas, PR • On-site

$106K/yr

Full-time

Posted 7 days ago

Key responsibilities

  • Review and analyze budget estimates, accounting information, resource proposals, expenditures, staffing requirements, and financial data to identify issues, reconcile funding requirements, and support budget recommendations.

  • Prepare budget justifications, financial analyses, narrative reports, briefing materials, spreadsheets, and other supporting documentation used in budget formulation, budget execution, and management decision-making.

  • Monitor and evaluate budget execution, expenditures, resource utilization, and financial activities to identify funding issues, recommend corrective actions, and support program objectives.

U.S. Department Of The Treasury rating

8.2

Company rating: 8.2 out of 10

Based on 13 frontline employees who took The Breakroom Quiz

312th of 856 rated public administrative organizations

Job description

WHAT IS THE LARGE BUSINESS & INTERNATIONAL DIVISION?
A description of the business units can be found at: https://www.jobs.irs.gov/about/who/business-divisions
  • Position(s) are to be filled in following area(s):
    • LBI - Office of Program and Business Solutions - PBS: Finance: Customer Support Budget

REVIEW THE ADDITIONAL INFORMATION BELOW FOR FURTHER DETAILSQualifications:

Federal experience is not required. Experience may have been gained in the public sector, private sector or through Volunteer Service. One year of experience refers to full-time work; part-timework is considered on a prorated basis. To ensure full credit for your work experience, please indicate dates of employment by month/day/year, and indicate number of hours worked per week, on your resume.
QUALIFICATION REQUIRMENTS: To qualify for this position, you must meet the qualification requirements outlined below:
SPECIALIZED EXPERIENCE GS-13: To be eligible for this position, you must have one (1) year of specialized experience at a level of difficulty and responsibility equivalent to the GS-12 grade level in the Federal service.
Specialized experience includes:

  • Experience interpreting and applying budget instructions, administrative memoranda, public laws, Executive Orders, Office of Management and Budget (OMB) circulars and bulletins, and regulatory guidance to support budget formulation, execution, and financial management activities.
  • Experience reviewing and analyzing budget estimates, accounting information, resource proposals, expenditures, staffing requirements, and financial data to identify issues, reconcile funding requirements, and support budget recommendations.
  • Experience preparing budget justifications, financial analyses, narrative reports, briefing materials, spreadsheets, and other supporting documentation used in budget formulation, budget execution, and management decision-making.
  • Experience monitoring and evaluating budget execution, expenditures, resource utilization, and financial activities to identify funding issues, recommend corrective actions, and support program objectives.
  • Experience coordinating budget activities with program officials and stakeholders, developing budget submissions, responding to budget inquiries, and supporting budget planning activities involving organizational priorities.
  • Experience using automated financial systems and software applications to develop, maintain, analyze, and report budget and financial information.

AND

You must also meet the following requirement(s):

  • TIME AFTER COMPETITIVE APPOINTMENT (TACA): Current civilian employees must have completed at least 90 days of federal civilian service since their latest non-temporary appointment from a competitive referral certificate, known as time after competitive appointment. For this requirement, a competitive appointment is one where you applied to and were appointed from an announcement open to "All US Citizens".
  • TIME IN GRADE (TIG): For positions above the GS-05,applicants must meet applicable time-in-grade requirements to be considered eligible. One year (52 weeks) at the next lower grade level is required to meet the time-in-grade requirements for the grade you are applying for. For positions at the GS-5, you cannot advance to the GS-05 if you have held a GS-02 in the past 52 weeks. There is no TIG restriction for GS-02, 03, or 04 positions.

For more information on qualifications please refer to OPM's Qualifications Standards.

Education:A college or university degree generally must be from an accredited (or pre-accredited) college or university recognized by the U.S. Department of Education. For a list of schools which meet these criteria, please refer to Department of Education Accreditation page.
FOREIGN EDUCATION: Education completed in foreign colleges or universities may be used to meet the requirements. You must show proof the education credentials have been deemed to be at least equivalent to that gained in conventional U.S. education program. It is your responsibility to provide such evidence when applying. Click here (Section 3, Explanation of Terms) or here for Foreign Education Credentialing instructions.
We recommend choosing an evaluator from a member organization of one of the following national associations of credential evaluation services: National Association of Credential Evaluation Services (NACES) or Association of International Credentials Evaluators (AICE).Employment Type: OTHER

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