Coordinates the utilization management functions of a patient caseload through collaboration with the interdisciplinary treatment team and performance of reviews, with external review organizations ...
Coordinates the utilization management functions of a patient caseload through collaboration with the interdisciplinary treatment team and performance of reviews, with external review organizations ...
Coordinates the utilization management functions of a patient caseload through collaboration with the interdisciplinary treatment team and performance of reviews, with external review organizations ...
Coordinates the utilization management functions of a patient caseload through collaboration with the interdisciplinary treatment team and performance of reviews, with external review organizations ...
Coordinates the utilization management functions of a patient caseload through collaboration with the interdisciplinary treatment team and performance of reviews, with external review organizations ...
Coordinates the utilization management functions of a patient caseload through collaboration with the interdisciplinary treatment team and performance of reviews, with external review organizations ...
Coordinates the utilization management functions of a patient caseload through collaboration with the interdisciplinary treatment team and performance of reviews, with external review organizations ...
Coordinates the utilization management functions of a patient caseload through collaboration with the interdisciplinary treatment team and performance of reviews, with external review organizations ...
Coordinates the utilization management functions of a patient caseload through collaboration with the interdisciplinary treatment team and performance of reviews, with external review organizations ...
Coordinates the utilization management functions of a patient caseload through collaboration with the interdisciplinary treatment team and performance of reviews, with external review organizations ...
Coordinates the utilization management functions of a patient caseload through collaboration with the interdisciplinary treatment team and performance of reviews, with external review organizations ...
Coordinates the utilization management functions of a patient caseload through collaboration with the interdisciplinary treatment team and performance of reviews, with external review organizations ...
Coordinates the utilization management functions of a patient caseload through collaboration with the interdisciplinary treatment team and performance of reviews, with external review organizations ...
Coordinates the utilization management functions of a patient caseload through collaboration with the interdisciplinary treatment team and performance of reviews, with external review organizations ...
Coordinates the utilization management functions of a patient caseload through collaboration with the interdisciplinary treatment team and performance of reviews, with external review organizations ...
Coordinates the utilization management functions of a patient caseload through collaboration with the interdisciplinary treatment team and performance of reviews, with external review organizations ...
Coordinates the utilization management functions of a patient caseload through collaboration with the interdisciplinary treatment team and performance of reviews, with external review organizations ...
Coordinates the utilization management functions of a patient caseload through collaboration with the interdisciplinary treatment team and performance of reviews, with external review organizations ...
Coordinates the utilization management functions of a patient caseload through collaboration with the interdisciplinary treatment team and performance of reviews, with external review organizations ...
Coordinates the utilization management functions of a patient caseload through collaboration with the interdisciplinary treatment team and performance of reviews, with external review organizations ...
Utilization Management Dept. PRN Any Variable Lexington Health is a comprehensive network of care ... Reviews physician medical record documentation and consults with physicians regarding completeness.
Utilization Management Dept. PRN Any Variable Lexington Health is a comprehensive network of care ... Reviews physician medical record documentation and consults with physicians regarding completeness.
Utilization Management Dept. PRN Any Variable Lexington Health is a comprehensive network of care ... Reviews physician medical record documentation and consults with physicians regarding completeness.
Utilization Management Dept. PRN Any Variable Lexington Health is a comprehensive network of care ... Reviews physician medical record documentation and consults with physicians regarding completeness.
Utilization Management Dept. PRN Any Variable Lexington Health is a comprehensive network of care ... Reviews physician medical record documentation and consults with physicians regarding completeness.
Utilization Management Dept. PRN Any Variable Lexington Health is a comprehensive network of care ... Reviews physician medical record documentation and consults with physicians regarding completeness.
Registered Nurse Case Manager / Utilization Review Nurse Calling all Registered Nurse Case Managers. Have immediate openings for Registered Nurse Case Managers and Utilization Review Nurses in ...
Registered Nurse Case Manager / Utilization Review Nurse Calling all Registered Nurse Case Managers. Have immediate openings for Registered Nurse Case Managers and Utilization Review Nurses in ...
Utilization Review Employment Type : Full Time City : Columbia State : SC Pay Range : 55,000 - 60,000 We are seeking a dedicated Managed Care Coordinator to join our team. This role involves ...
Utilization Review Employment Type : Full Time City : Columbia State : SC Pay Range : 55,000 - 60,000 We are seeking a dedicated Managed Care Coordinator to join our team. This role involves ...
The Clinical Reimbursement / MDS Specialist will be responsible for performing chart audits, systems development and implementation of programs that apply to the Resident Assessment Instrument (RAI ...
The Clinical Reimbursement / MDS Specialist will be responsible for performing chart audits, systems development and implementation of programs that apply to the Resident Assessment Instrument (RAI ...
The Clinical Reimbursement / MDS Specialist will be responsible for performing chart audits, systems development and implementation of programs that apply to the Resident Assessment Instrument (RAI ...
The Clinical Reimbursement / MDS Specialist will be responsible for performing chart audits, systems development and implementation of programs that apply to the Resident Assessment Instrument (RAI ...
Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services. * Facilitates the achievement ...
Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services. * Facilitates the achievement ...
Remote Behavioral Medical Director, Eastern Region
Columbia, SC · On-site +1
$236K - $449K/yr
Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services, ensuring timely and quality ...
Remote Behavioral Medical Director, Eastern Region
Columbia, SC · On-site +1
$236K - $449K/yr
Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services, ensuring timely and quality ...
Physician Reviewer-Radiology (Part Time)
Columbia, SC · On-site
$95 - $100/hr
Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as ...
Physician Reviewer-Radiology (Part Time)
Columbia, SC · On-site
$95 - $100/hr
Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as ...
Utilization Review information
See Columbia, SC salary details
$19.79 - $23.80
2% of jobs
$23.80 - $27.80
9% of jobs
$30.54 is the 25th percentile. Wages below this are outliers.
$27.80 - $31.80
21% of jobs
The median wage is $35.04 / hr.
$31.80 - $35.80
23% of jobs
$35.80 - $39.81
13% of jobs
$42.92 is the 75th percentile. Wages above this are outliers.
$39.81 - $43.81
10% of jobs
$43.81 - $47.81
8% of jobs
$47.81 - $51.82
5% of jobs
$51.82 - $55.82
5% of jobs
$55.82 - $59.82
2% of jobs
$59.82 - $63.83
2% of jobs
$19
$39
$63
How much do utilization review jobs pay per hour?
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?
Is utilization review a stressful job?
What are the most commonly searched types of Utilization Review jobs in Columbia, SC?
The most popular types of Utilization Review jobs in Columbia, SC are:
What are popular job titles related to Utilization Review jobs in Columbia, SC?
For Utilization Review jobs in Columbia, SC, the most frequently searched job titles are:
- Remote Utilization Review Nurse
- No Experience Utilization Review Nurse
- Remote Utilization Review Rn
- Part Time Utilization Review Nurse
- Temporary Utilization Review Nurse
- Per Diem Remote Chart Review Nurse
- Night Utilization Review Nurse
- Remote Utilization Review Social Worker
- Flex Schedule Remote Utilization Review Nurse
- Remote Hedis Review Nurse
What job categories do people searching Utilization Review jobs in Columbia, SC look for?
The top searched job categories for Utilization Review jobs in Columbia, SC are:
- Lpn Utilization Review
- Remote Lpn Utilization Review
- Online Utilization Review
- Insurance Utilization Review
- Full Time Cigna Utilization Review Nurse
- Case Manager Utilization Review Nurse
- Remote Bcba Utilization Review
- Remote Optum Utilization Review
- Temporary Aetna Utilization Review Nurse
- Remote Utilization Review
What cities near Columbia, SC are hiring for Utilization Review jobs?
Cities near Columbia, SC with the most Utilization Review job openings:

Utilization Review Coordinator
West Columbia, SC • On-site
6.9
Based on 254 frontline employees who took The Breakroom Quiz
454th of 893 rated healthcare providers
People enjoy working here
Recommended by students
Respectful managers
Full-time
Medical, Dental, Vision, Retirement, PTO
Re-posted 8 days ago
Job description
Three Rivers Behavioral Health is a 136-bed treatment facility that specializes in quality behavioral health and substance abuse services for adolescents and adults. We offer a full continuum of care through an integrated system of inpatient, partial hospitalization and intensive outpatient programs. Conveniently located between I-20 (Exit 61) and I-26 (Exit 110) in West Columbia, SC, our team of 300+ high quality employees describe working here as " family atmosphere," "supportive leadership," and "life-changing." Progressive professionals in the fields of psychiatry, medicine, nursing, social services, and activity therapy serve hundreds of adults and adolescents each month with the common goal of creating new beginnings. Healthcare professionals have a unique opportunity to affect lives for the better each and every day. Choose Three Rivers and start your life-changing journey today.
Job Duties/Responsibilities:
- This position provides precertification and verification of benefits for incoming patients.
- Coordinates the utilization management functions of a patient caseload through collaboration with the interdisciplinary treatment team and performance of reviews, with external review organizations/managed care companies.
- Discuss with patient various forms and obtain signatures from the patients.
- Complete insurance verification from various payors and obtain correct information to complete precertification as well as appeals.
BENEFITS:
Career development opportunities across UHS and our 300+ locations!
Diverse programming to expand your experience
Competitive Compensation & Generous Paid Time Off
Excellent Medical, Dental, Vision and Prescription Drug Plans
Employee Assistance Program
401(K) with company match and discounted stock plan
Pet Insurance
SoFi Student Loan Refinancing Program
Tuition Assistance
Employee Referral Program
More information is available on our Benefits Guest Website: benefits.uhsguest.com
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 were $15.8 billion in 2024. UHS was again recognized as one of the World’s Most Admired Companies by Fortune; listed in Forbes ranking of America’s Largest Public Companies. Headquartered in King of Prussia, PA, UHS has approximately 99,000 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 all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com
Qualifications
Job Requirements:
- Education: Masters’ degree in a recognized mental health field or Registered Nurse.
- Experience:
- Minimum of two years psychiatric experience in chart analysis and in the utilization review field. Excellent oral and written communication skills required in order to communicate in a clear and concise manner with patients, physicians, staff and payors.
- Knowledge of external review organizations, payor sources, financial planning and contracting (i.e., managed care, Medicare, Medicaid, etc.)
- Must be able to work in a fast-paced environment with frequent interruptions.
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.
We believe that diversity and inclusion among our teammates is critical to our success.
Avoid and Report Recruitment Scams
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:Job Requirements:
- Education: Masters’ degree in a recognized mental health field or Registered Nurse.
- Experience:
- Minimum of two years psychiatric experience in chart analysis and in the utilization review field. Excellent oral and written communication skills required in order to communicate in a clear and concise manner with patients, physicians, staff and payors.
- Knowledge of external review organizations, payor sources, financial planning and contracting (i.e., managed care, Medicare, Medicaid, etc.)
- Must be able to work in a fast-paced environment with frequent interruptions.
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.
We believe that diversity and inclusion among our teammates is critical to our success.
Avoid and Report Recruitment Scams
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_TIMEAbout Universal Health Services
Sourced by ZipRecruiter
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.
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
King of Prussia, PA, US
Website
What Universal Health Services employees say
Pay
Benefits
Hours and flexibility
Workplace
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