Assists UM Department with utilization review processes, including the collection and analysis of various computer-based data related to Utilization Review, Care Coordination, and Commercial ...
Assists UM Department with utilization review processes, including the collection and analysis of various computer-based data related to Utilization Review, Care Coordination, and Commercial ...
Utilization Review Assistant
Odessa, TX · On-site
Assists UM Department with utilization review processes, including the collection and analysis of various computer-based data related to Utilization Review, Care Coordination, and Commercial ...
Utilization Review Assistant
Odessa, TX · On-site
Assists UM Department with utilization review processes, including the collection and analysis of various computer-based data related to Utilization Review, Care Coordination, and Commercial ...
The Utilization Review Specialist will have access to confidential records including youth files, foster care/adoption records, foster/adopt parent information and biological family history. Must ...
The Utilization Review Specialist will have access to confidential records including youth files, foster care/adoption records, foster/adopt parent information and biological family history. Must ...
The Utilization Review Specialist will have access to confidential records including youth files, foster care/adoption records, foster/adopt parent information and biological family history. Must ...
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The Utilization Review Specialist will have access to confidential records including youth files, foster care/adoption records, foster/adopt parent information and biological family history. Must ...
The Utilization Review Specialist will have access to confidential records including youth files, foster care/adoption records, foster/adopt parent information and biological family history. Must ...
The Utilization Review Specialist will have access to confidential records including youth files, foster care/adoption records, foster/adopt parent information and biological family history. Must ...
The Utilization Review Specialist/Outcomes Specialist conducts concurrent and retrospective review functions in support of the hospital Utilization Review Program and makes appropriate referrals to ...
The Utilization Review Specialist/Outcomes Specialist conducts concurrent and retrospective review functions in support of the hospital Utilization Review Program and makes appropriate referrals to ...
Utilization Review Specialist
Odessa, TX · On-site
The Utilization Review Specialist/Outcomes Specialist conducts concurrent and retrospective review functions in support of the hospital Utilization Review Program and makes appropriate referrals to ...
Utilization Review Specialist
Odessa, TX · On-site
The Utilization Review Specialist/Outcomes Specialist conducts concurrent and retrospective review functions in support of the hospital Utilization Review Program and makes appropriate referrals to ...
Utilization Review Nurse
Big Spring, TX · On-site
Job Summary The Utilization Review (UR) Nurse has acute knowledge and skills in areas of utilization management (UM), medical necessity, and patient status determination. This individual supports the ...
Utilization Review Nurse
Big Spring, TX · On-site
Job Summary The Utilization Review (UR) Nurse has acute knowledge and skills in areas of utilization management (UM), medical necessity, and patient status determination. This individual supports the ...
Utilization Review Nurse
Big Spring, TX · On-site
Job Summary The Utilization Review (UR) Nurse has acute knowledge and skills in areas of utilization management (UM), medical necessity, and patient status determination. This individual supports the ...
Utilization Review Nurse
Big Spring, TX · On-site
Job Summary The Utilization Review (UR) Nurse has acute knowledge and skills in areas of utilization management (UM), medical necessity, and patient status determination. This individual supports the ...
Hours: 8:30-5:30, Monday - Friday At Houston Methodist, the Utilization Review Nurse (URN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and concurrent ...
Hours: 8:30-5:30, Monday - Friday At Houston Methodist, the Utilization Review Nurse (URN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and concurrent ...
Utilization Review Nurse
Dallas, TX · On-site
$90K - $98K/yr
As a Utilization Review Nurse (UR Nurse) , you'll play an important role in helping us offer customized, self-funded insurance options to our clients and members. The UR Nurse is responsible for ...
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Utilization Review Nurse
Dallas, TX · On-site
$90K - $98K/yr
As a Utilization Review Nurse (UR Nurse) , you'll play an important role in helping us offer customized, self-funded insurance options to our clients and members. The UR Nurse is responsible for ...
Utilization Review Nurse
Plano, TX · Remote
This position is responsible for performing initial, concurrent review activities; discharge care ... Provides information regarding utilization management requirements and operational procedures to ...
Utilization Review Nurse
Plano, TX · Remote
This position is responsible for performing initial, concurrent review activities; discharge care ... Provides information regarding utilization management requirements and operational procedures to ...
Utilization Review Registered Nurse Texas Institute for Surgery LL SURG - Dallas, TX 75231 Description The Utilization Review Registered Nurse is responsible for ensuring appropriate patient status ...
Utilization Review Registered Nurse Texas Institute for Surgery LL SURG - Dallas, TX 75231 Description The Utilization Review Registered Nurse is responsible for ensuring appropriate patient status ...
The Utilization Review Registered Nurse is responsible for ensuring appropriate patient status, medical necessity, and payer compliance through prospective, concurrent, and retrospective review. This ...
The Utilization Review Registered Nurse is responsible for ensuring appropriate patient status, medical necessity, and payer compliance through prospective, concurrent, and retrospective review. This ...
Registered Nurse Utilization Review
Austin, TX · Remote
$78K - $110K/yr
Reviewed admissions and service requests for medical necessity, reimbursement compliance, and utilization management, while providing case management support for complex cases. * Collaborated with ...
Registered Nurse Utilization Review
Austin, TX · Remote
$78K - $110K/yr
Reviewed admissions and service requests for medical necessity, reimbursement compliance, and utilization management, while providing case management support for complex cases. * Collaborated with ...
The Utilization Review Registered Nurse is responsible for ensuring appropriate patient status, medical necessity, and payer compliance through prospective, concurrent, and retrospective review. This ...
The Utilization Review Registered Nurse is responsible for ensuring appropriate patient status, medical necessity, and payer compliance through prospective, concurrent, and retrospective review. This ...
The Clinical Quality and Utilization Review Specialist partners closely with physicians, advanced practice providers (APPs), and interdisciplinary teams to support evidence-based decision-making ...
The Clinical Quality and Utilization Review Specialist partners closely with physicians, advanced practice providers (APPs), and interdisciplinary teams to support evidence-based decision-making ...
The Clinical Quality and Utilization Review Specialist partners closely with physicians, advanced practice providers (APPs), and interdisciplinary teams to support evidence-based decision-making ...
The Clinical Quality and Utilization Review Specialist partners closely with physicians, advanced practice providers (APPs), and interdisciplinary teams to support evidence-based decision-making ...
Our inpatient behavioral health hospital is seeking a PRN Utilization Review Coordinator. This position is responsible for working with insurance companies and managed care systems for the initial ...
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Our inpatient behavioral health hospital is seeking a PRN Utilization Review Coordinator. This position is responsible for working with insurance companies and managed care systems for the initial ...
The Clinical Quality and Utilization Review Specialist partners closely with physicians, advanced practice providers (APPs), and interdisciplinary teams to support evidence-based decision-making ...
The Clinical Quality and Utilization Review Specialist partners closely with physicians, advanced practice providers (APPs), and interdisciplinary teams to support evidence-based decision-making ...
Utilization Review information
See Texas salary details
$19.93 - $23.96
2% of jobs
$23.96 - $27.99
9% of jobs
$30.75 is the 25th percentile. Wages below this are outliers.
$27.99 - $32.03
21% of jobs
The median wage is $35.29 / hr.
$32.03 - $36.06
23% of jobs
$36.06 - $40.09
13% of jobs
$43.22 is the 75th percentile. Wages above this are outliers.
$40.09 - $44.12
10% of jobs
$44.12 - $48.15
8% of jobs
$48.15 - $52.18
5% of jobs
$52.18 - $56.21
5% of jobs
$56.21 - $60.24
2% of jobs
$60.24 - $64.28
2% of jobs
$19
$39
$64
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?
- Contract Utilization Review Nurse
- Evening Optum Health Utilization Review
- Utilization Review Physician
- Optum Health Utilization Review
- Remote Utilization Management
- Weekend Physician Advisor Utilization Review
- Evening Utilization Review Nurse
- Overnight Utilization Review Nurse
- Cvs Health Utilization Management
- Remote Utilization Review Rn
- Authorization Utilization Review Bcba
- Contract Utilization Review
- Director Of Utilization Review
- Nurse Practitioner Utilization Review
- Remote Utilization Review
- Remote International Utilization Review Nurse
- Utilization Review Nurse Compact License
- Aetna Utilization Review Nurse
- Insurance Utilization Review
- Anthem Utilization Review Nurse

Medical Center Health System rating
8.2
Based on 31 frontline employees who took The Breakroom Quiz
54th of 886 rated healthcare providers
Job description
Position Summary:
Assists UM Department with utilization review processes, including the collection and analysis of various computer-based data related to Utilization Review, Care Coordination, and Commercial Insurance.
Qualifications:
A. Education:
Must have a high school diploma or equivalent.
B. Training and Experience:
Must have a minimum of one-year work experience in an acute care medical facility.
C. Job Knowledge:
Familiar with medical terminology, utilization review, community resource a plus. Basic computer skills required. Be able to communicate effectively verbally and in writing.
Unusual Physical Demands and Working Conditions:
Should be familiar with healthcare operations. Experience with the collection and management of data preferred. Familiar with medical terminology, utilization review, and/or medical insurance preferred.
Ability to communicate effectively and professionally, both verbally and in writing.
What Medical Center Health System employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom
About Medical Center Health System
Sourced by ZipRecruiter
Industry
Health care and social assistance
Company size
1,001 - 5,000 Employees
Headquarters location
Odessa, TX, US
Year founded
1949