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Utilization Review Jobs in Puerto Rico (NOW HIRING)

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.

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.

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 ...

PR · On-site

Oversee vendor qualification and validation service providers Digital Enablement & AI Utilization ... review * Ensure responsible and compliant use of AI technologies in alignment with cGMP, data ...

PR · On-site

$75K - $102K/yr

Lead end-to-end compensation processes, including salary reviews, incentives, and promotions * Own ... Analyze cost drivers, claims, and utilization trends * Develop reporting and dashboards for ...

Review standard recipes, portion control, yields, and pricing to ensure proper margins. * Verify ... and utilization of financial resources. Demonstrating and Applying Accounting Knowledge ...

Controls Technologist (Shift C)

Aibonito, PR

$28.50 - $37.50/hr

Review specifications of blue prints of mechanical and electrical components of machines. * Must ... Must repair and provide maintenance to equipment, machinery by the utilization of sophisticated ...

Monitor daily production, manpower, equipment utilization, and costs for the assigned segment ... Support the review and implementation of construction means and methods, temporary works, and ...

Sales Associate - Soma

San Juan, PR

$9 - $12.25/hr

... communication through utilization of customer book. Operational Excellence • Supports ... When we do have an open position, we will review your application to determine if your ...

Sr Engineer

Juncos, PR

$101K - $139K/yr

Supervise, coordinate and review work of a small staff of engineers, associates and/or technicians ... The company's continued success depends on the full and effective utilization of qualified ...

Ensures team maintains consistent client communication through utilization of customer book ... When we do have an open position, we will review your application to determine if your ...

Review financial results, validate accuracy, and investigate material variances vs. budget and ... Partner with regional finance and leadership to forecast cash needs and optimize cash utilization ...

New

Ensures team maintains consistent client communication through utilization of customer book ... When we do have an open position, we will review your application to determine if your ...

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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:
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.

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 26 days ago


Job description

About Us...

Consertus is a global capital program management and advisory firm that combines deep human expertise with advanced digital tools to deliver smarter, faster, and more sustainable outcomes. Headquartered in Miami, Florida, and supported by a team of more than 1,000 professionals worldwide, we help clients plan, execute, and optimize large-scale capital programs.

Our integrated services span digital, advisory, and delivery, empowering organizations to navigate complexity, manage risk, and achieve strategic goals in sectors including aviation, transportation, transit, water, healthcare, energy, education, government, commercial, life sciences, and technology.

At Consertus, we celebrate individual strengths, foster strong relationships, and promote flexibility in how and where we work. Join us to grow your career, develop your skills, and make a lasting impact as we transform how the world is built.

Discover how Consertus is driving transformative change for our clients, our people, and the communities we serve atwww.consertus.com

About this Role...

We are looking for a detail-oriented Associate in Grants to join our team and help manage the full lifecycle of grant programs from planning and preparation through post-award administration. This role requires strong organizational skills, knowledge of compliance requirements, and the ability to collaborate effectively with internal teams, grantees, and sub-grantees.

You will oversee grant documentation, ensure adherence to funding regulations and reporting requirements, and support the identification and development of new grant opportunities. If you thrive in a structured yet dynamic environment and are passionate about supporting impactful funding initiatives, this is the role for you.

Key Responsibilities:

  • Manage and monitor grant programs to ensure compliance with contractual requirements, funding regulations, and achievement of established goals and objectives.
  • Review and evaluate contract documents to ensure adherence to federal regulations and funding guidelines.
  • Oversee programs and projects throughout the full lifecycle planning process, ensuring timely execution and compliance
  • Provide training and guidance to grantees and sub-grantees regarding federal funding requirements and regulatory standards.
  • Develop and maintain program progress reports, including statistical analysis, charts, presentations, and follow-up documentation.
  • Manage budgets and oversee fund allocation to ensure proper utilization of grant resources.
  • Coordinate the preparation, development, and submission of grant proposals in alignment with funding requirements.
  • Maintain and manage an internal grant calendar to ensure timely submission of applications, reports, and compliance documentation.

Qualifications/Requirements:

  • A bachelor's degree in business administration, or related subject.
  • 2-5 years of experience
  • Strong written and verbal communication skills in English and Spanish.
  • Extremely proficiency with Microsoft Office
  • Demonstrated experience dealing with confidential and proprietary information
  • Ability to coordinate meetings and functions

What's In It For You:

  • Medical, dental, and vision insurance for employees and their dependents
  • Retirement savings plan with company matching
  • Paid time off, including vacation, sick leave, and holidays
  • And others

How to Apply:

If you're passionate about grant management and ensuring compliance in funding programs, we'd love to hear from you. Apply today!

Equal Employment Opportunity Statement:

Consertus is proud to be an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We welcome applicants from all backgrounds and identities, and we do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity or expression, national origin, disability, age, veteran status, or any other protected status.