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Utilization Review Jobs in Conway, SC (NOW HIRING)

MUSC

Utilization Management Nurse-1

Murrells Inlet, SC · On-site

Conducts utilization reviews to determine if patients are receiving care appropriate to illness or condition. Entity MUSC Community Physicians (MCP) Worker Type Employee Worker Sub-Type​ Regular ...

Encompass Health

Case Manager

Murrells Inlet, SC

$17.50 - $22.50/hr

The CCM performs ongoing utilization review and acts as a liaison to the payor while assuring that cost effective treatment is provided by the team. The CCM assures that regulations regarding patient ...

HCA HealthONE Swedish

RN Case Manager

Myrtle Beach, SC · On-site

Perform utilization review activities and monitor appropriate resource utilization. * Educate patients and families regarding treatment plans, discharge instructions, and available support services.

Mission Hospital

RN Case Manager

Myrtle Beach, SC · On-site

Certification in Case Management or Utilization Review is preferred. * InterQual experience is preferred. Benefits Grand Strand Medical Center , offers a total rewards package that supports the ...

Oak St. Health

Grad Pharmacist

Myrtle Beach, SC · On-site

$13.25 - $16.50/hr

... drug utilization review (DUR), pharmacy professional standards such as corresponding responsibility and red flag detection. While in the pharmacy, you will assist the pharmacy team to ensure that ...

Oak St. Health

Grad Pharmacist

Little River, SC · On-site

$15.75 - $19.50/hr

... drug utilization review (DUR), pharmacy professional standards such as corresponding responsibility and red flag detection. While in the pharmacy, you will assist the pharmacy team to ensure that ...

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All JobsUtilization Review JobsUtilization Review Jobs in Conway, SC

Utilization Review information

See Conway, SC salary details

$19

$39

$63

How much do utilization review jobs pay per hour?

As of Aug 24, 2026, the average hourly pay for utilization review in Conway, SC is $39.15, according to ZipRecruiter salary data. Most workers in this role earn between $30.91 and $44.95 per hour, depending on experience, location, and employer.

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 Conway, SC?

The most popular types of Utilization Review jobs in Conway, SC are:

What are popular job titles related to Utilization Review jobs in Conway, SC?

For Utilization Review jobs in Conway, SC, the most frequently searched job titles are:

What job categories do people searching Utilization Review jobs in Conway, SC look for?

The top searched job categories for Utilization Review jobs in Conway, SC are:

What cities near Conway, SC are hiring for Utilization Review jobs?

Cities near Conway, SC with the most Utilization Review job openings:

Utilization Review jobs near you
Infographic showing various Utilization Review job openings in Conway, SC as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 15% Part Time, 1% Temporary, 2% Contract, and 1% Nights. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution, with an average salary of $81,428 per year, or $39.1 per hour.

Utilization Management Nurse-1

Medical University of South Carolina

Murrells Inlet, SC • On-site

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 16 days ago

Job description

Job Description Summary
MUSC Community Physicians (MCP) is an entity within the Medical University of South Carolina (MUSC) that provides healthcare to patients within the rural health network throughout the state of South Carolina.
Conducts utilization reviews to determine if patients are receiving care appropriate to illness or condition.
Entity
MUSC Community Physicians (MCP)
Worker Type
Employee
Worker Sub-Type
Regular
Cost Center
CC005921 MCP - Utilization Management
Pay Rate Type
Hourly
Pay Grade
Health-28
Scheduled Weekly Hours
32
Work Shift
Job Description
Conducts utilization reviews to determine if patients are receiving care appropriate to illness or condition. Monitors patient charts and records to evaluate care concurrent with the patients treatment. Reviews treatment plans and status of approvals from insurers. Collects and complies data as required and according to applicable policies and regulations. Consults with physicians as needed.
Bachelor's degree in Nursing from an accredited school of nursing and three years’ work experience as a Registered Nurse required. Prior leadership experience preferred. One year of case management and/or utilization management work experience preferred. Staff hired prior to July 1, 2013 will be grandfathered in regards to education requirement. Must possess excellent verbal and written communication skills. Familiarity with InterQual or Milliman and Robinson screening criteria desired. Licensure as a registered nurse by the state of South Carolina or compact state required.
Additional Job Description
Benefits:
  • Health, dental, vision, and life insurance
  • Employer Sponsored Retirement Plan
  • Paid time off and extended sick leave
  • Paid Parental Leave
  • Disability insurance plan options
  • Continuous professional and clinical training
  • Competitive pay
  • Annual Merit Increase
  • Wellbeing resources
  • Tuition Reimbursement
  • Employee perks and discounts
  • Employee referral program
  • Flexible schedule options
  • Certification incentive program

If you like working with energetic enthusiastic individuals, you will enjoy your career with us!
The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need.
Medical University of South Carolina participates in the federal E-Verify program to confirm the identity and employment authorization of all newly hired employees. For further information about the E-Verify program, please click here: http://www.uscis.gov/e-verify/employees

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