Utilization Review Clinician
Augusta, GA · On-site
Website: The Utilization Review Clinician opportunity is a key member of the Lighthouse Case Management team who will integrate and coordinate clinical content with a keen focus on patient care ...
Augusta, GA · On-site
Website: The Utilization Review Clinician opportunity is a key member of the Lighthouse Case Management team who will integrate and coordinate clinical content with a keen focus on patient care ...
Augusta, GA · On-site
Website: The Utilization Review Clinician opportunity is a key member of the Lighthouse Case Management team who will integrate and coordinate clinical content with a keen focus on patient care ...
Augusta, GA · On-site
Website: The Utilization Review Clinician opportunity is a key member of the Lighthouse Case Management team who will integrate and coordinate clinical content with a keen focus on patient care ...
Augusta, GA · On-site
Website: The Utilization Review Clinician opportunity is a key member of the Lighthouse Case Management team who will integrate and coordinate clinical content with a keen focus on patient care ...
Augusta, GA · On-site
Website: The Utilization Review Clinician opportunity is a key member of the Lighthouse Case Management team who will integrate and coordinate clinical content with a keen focus on patient care ...
Augusta, GA · On-site
Website: The Utilization Review Clinician opportunity is a key member of the Lighthouse Case Management team who will integrate and coordinate clinical content with a keen focus on patient care ...
The Director of Utilization Review is a key member of the Lighthouse Case Management Team who will integrate and coordinate a patient centric therapeutic strategy with a keen focus on clinical ...
The Director of Utilization Review is a key member of the Lighthouse Case Management Team who will integrate and coordinate a patient centric therapeutic strategy with a keen focus on clinical ...
The Director of Utilization Review is a key member of the Lighthouse Case Management Team who will integrate and coordinate a patient centric therapeutic strategy with a keen focus on clinical ...
The Director of Utilization Review is a key member of the Lighthouse Case Management Team who will integrate and coordinate a patient centric therapeutic strategy with a keen focus on clinical ...
The Director of Utilization Review is a key member of the Lighthouse Case Management Team who will integrate and coordinate a patient centric therapeutic strategy with a keen focus on clinical ...
The Director of Utilization Review is a key member of the Lighthouse Case Management Team who will integrate and coordinate a patient centric therapeutic strategy with a keen focus on clinical ...
The Director of Utilization Review is a key member of the Lighthouse Case Management Team who will integrate and coordinate a patient centric therapeutic strategy with a keen focus on clinical ...
The Director of Utilization Review is a key member of the Lighthouse Case Management Team who will integrate and coordinate a patient centric therapeutic strategy with a keen focus on clinical ...
The Director of Utilization Review is a key member of the Lighthouse Case Management Team who will integrate and coordinate a patient centric therapeutic strategy with a keen focus on clinical ...
The Director of Utilization Review is a key member of the Lighthouse Case Management Team who will integrate and coordinate a patient centric therapeutic strategy with a keen focus on clinical ...
Augusta, GA · On-site
Utilization Review Nurse . Under the direction of the Director of Utilization Management. Website: Job Duties/ Responsibilities: * Review clinical content of medical records * Participate in ...
Augusta, GA · On-site
Utilization Review Nurse . Under the direction of the Director of Utilization Management. Website: Job Duties/ Responsibilities: * Review clinical content of medical records * Participate in ...
Augusta, GA · On-site
Utilization Review Nurse . Under the direction of the Director of Utilization Management. Website: Job Duties/ Responsibilities: * Review clinical content of medical records * Participate in ...
Augusta, GA · On-site
Utilization Review Nurse . Under the direction of the Director of Utilization Management. Website: Job Duties/ Responsibilities: * Review clinical content of medical records * Participate in ...
Augusta, GA · On-site
Utilization Review Nurse . Under the direction of the Director of Utilization Management. Website: Job Duties/ Responsibilities: * Review clinical content of medical records * Participate in ...
Augusta, GA · On-site
Utilization Review Nurse . Under the direction of the Director of Utilization Management. Website: Job Duties/ Responsibilities: * Review clinical content of medical records * Participate in ...
Aiken, SC · On-site
$1.4K - $1.8K/wk
Serves as Utilization Review and/or Advisory Board Member as requested by Administrator/Director * Contributes to physical therapy related CQI, as requested * Participates in interdisciplinary ...
Aiken, SC · On-site
$1.4K - $1.8K/wk
Serves as Utilization Review and/or Advisory Board Member as requested by Administrator/Director * Contributes to physical therapy related CQI, as requested * Participates in interdisciplinary ...
Aiken, SC · On-site
$1.4K - $1.8K/wk
Serves as Utilization Review and/or Advisory Board Member as requested by Administrator/Director. * Contributes to physical therapy related CQI, as requested * Participates in interdisciplinary ...
Aiken, SC · On-site
$1.4K - $1.8K/wk
Serves as Utilization Review and/or Advisory Board Member as requested by Administrator/Director. * Contributes to physical therapy related CQI, as requested * Participates in interdisciplinary ...
Aiken, SC · On-site
Serves as Utilization Review and/or Advisory Board Member as requested by the Administrator/Director. * Maintains knowledge base of HomeCare Speech-Language Pathology procedures and regulations as ...
Aiken, SC · On-site
Serves as Utilization Review and/or Advisory Board Member as requested by the Administrator/Director. * Maintains knowledge base of HomeCare Speech-Language Pathology procedures and regulations as ...
Aiken, SC · On-site
Serves as Utilization Review and/or Advisory Board Member as requested by the Administrator/Director * Maintains knowledge base of HomeCare Speech-Language Pathology procedures and regulations as ...
Aiken, SC · On-site
Serves as Utilization Review and/or Advisory Board Member as requested by the Administrator/Director * Maintains knowledge base of HomeCare Speech-Language Pathology procedures and regulations as ...
Aiken, SC · On-site
Serves as Utilization Review and/or Advisory Board Member as requested by Administrator/Director of Services * Maintains knowledge base of home care social services procedures and regulations as well ...
Aiken, SC · On-site
Serves as Utilization Review and/or Advisory Board Member as requested by Administrator/Director of Services * Maintains knowledge base of home care social services procedures and regulations as well ...
Aiken, SC · On-site
Serves as Utilization Review and/or Advisory Board Member as requested by Administrator/Director of Services. * Maintains knowledge base of home care social services procedures and regulations as ...
Aiken, SC · On-site
Serves as Utilization Review and/or Advisory Board Member as requested by Administrator/Director of Services. * Maintains knowledge base of home care social services procedures and regulations as ...
Collaborates effectively with the utilization review nurse, patient's physicians and the interdisciplinary care team to provide a comprehensive assessment of the patient's medical care needs ...
Collaborates effectively with the utilization review nurse, patient's physicians and the interdisciplinary care team to provide a comprehensive assessment of the patient's medical care needs ...
Collaborates effectively with the utilization review nurse, patient's physicians and the interdisciplinary care team to provide a comprehensive assessment of the patient's medical care needs ...
Collaborates effectively with the utilization review nurse, patient's physicians and the interdisciplinary care team to provide a comprehensive assessment of the patient's medical care needs ...
Collaborates effectively with the utilization review nurse, patient's physicians and the interdisciplinary care team to provide a comprehensive assessment of the patient's medical care needs ...
Collaborates effectively with the utilization review nurse, patient's physicians and the interdisciplinary care team to provide a comprehensive assessment of the patient's medical care needs ...
$20.11 - $24.18
2% of jobs
$24.18 - $28.25
9% of jobs
$31.03 is the 25th percentile. Wages below this are outliers.
$28.25 - $32.31
21% of jobs
The median wage is $35.61 / hr.
$32.31 - $36.38
23% of jobs
$36.38 - $40.45
13% of jobs
$43.61 is the 75th percentile. Wages above this are outliers.
$40.45 - $44.51
10% of jobs
$44.51 - $48.58
8% of jobs
$48.58 - $52.65
5% of jobs
$52.65 - $56.72
5% of jobs
$56.72 - $60.78
2% of jobs
$60.78 - $64.85
2% of jobs
$20
$39
$64
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.
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.
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.
The most popular types of Utilization Review jobs in Augusta, GA are:
For Utilization Review jobs in Augusta, GA, the most frequently searched job titles are:
The top searched job categories for Utilization Review jobs in Augusta, GA are:
Cities near Augusta, GA with the most Utilization Review job openings:

Full-time
Medical, Dental, Vision, Retirement, PTO
Re-posted 13 days ago
Review clinical content of medical records and participate in treatment team meetings to gather data for insurance authorization.
Coordinate with the treatment team to ensure timely input of pre-certifications and continued stay reviews into the system, verify insurance coverage, and follow up on pending authorizations.
Communicate clinical criteria and support documentation for pre-certification and continued stay reviews to insurance companies and authorizing entities.
6.9
Based on 254 frontline employees who took The Breakroom Quiz
454th of 898 rated healthcare providers
Lighthouse Care Center of Augusta is seeking a dedicated, compassionate Utilization Review Clinician to add to our growing team.
Lighthouse Care Center of Augusta has been providing psychiatric services to the CSRA for more than 15-years. Located in Augusta, GA our 84-bed facility provides a therapeutic setting for those seeking treatment for mental illness. Lighthouse Care Center offers unique and individualized programming for adolescents and adults that sets us apart from many other treatment facilities, and our tenured team includes seasoned medical staff.
Website: https://www.LighthouseCareCenters.com
The Utilization Review Clinician opportunity is a key member of the Lighthouse Case Management team who will integrate and coordinate clinical content with a keen focus on patient care; ensuring that delivery of high-quality and cost-effective treatment is consistent with the mission, vision, and values of Universal Health Services and in accordance with government regulation, licensing and accreditation requirements. Under the direction of the UR Manager, the Utilization Review Clinician is responsible for conducting clinical review of data to determine eligibility respective to pre-certification and continued stay reviews.
Job Duties/ Responsibilities:
Benefit Highlights:
About Universal Health Services:
One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500® corporation, annual revenues during 2025 were $17.4 billion. In 2026, UHS was again recognized as one of Fortune World’s Most Admired Companies™ and in 2025, was listed in Forbes ranking of America’s Largest Public Companies. Headquartered in King of Prussia, PA, UHS has approximately 101,500 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 40 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom. For additional information visit www.uhs.com.
From Fortune, ©2025, 2026 Fortune Media IP Limited. All rights reserved. Used under license.
Education and Experience:
Certifications, License, Registration:
LMHC, LMFT, LAPC, LPC, LMSW, LCSW, LPN or RN preferred
EEO Statement:
All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.
Avoid and Report Recruitment Scams
We are aware of a scam whereby imposters are posing as Recruiters from UHS, and our subsidiary hospitals and facilities. Beware of anyone requesting financial or personal information.
At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc.
If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.
Qualifications:Education and Experience:
Certifications, License, Registration:
LMHC, LMFT, LAPC, LPC, LMSW, LCSW, LPN or RN preferred
EEO Statement:
All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.
Avoid and Report Recruitment Scams
We are aware of a scam whereby imposters are posing as Recruiters from UHS, and our subsidiary hospitals and facilities. Beware of anyone requesting financial or personal information.
At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc.
If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.
Education:UNAVAILABLEEmployment Type: FULL_TIMEGet the full story on Breakroom
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Universal Health Services (UHS) is a major player in the healthcare industry, based in King of Prussia, Pennsylvania, U.S. Founded in 1978, UHS offers hospital and healthcare services. Their diverse services range from acute care hospitals, behavioral health facilities and ambulatory centers nationwide. The company's mission of enhancing the health and well-being of their patients is reflected in their commitment to 'Helping Individuals Live Longer, Healthier and Happier Lives'. Universal Health Services' consistent growth and success in their industry have been recognized on numerous occasions, including being ranked amongst the Fortune 500 list of largest companies.
Health care and social assistance
10,000+ Employees
King of Prussia, PA, US