RN Specialist
Fairhope, AL · On-site
Working knowledge of quality assurance, utilization review or risk management * Clinical specialty or management certification
Fairhope, AL · On-site
Working knowledge of quality assurance, utilization review or risk management * Clinical specialty or management certification
Fairhope, AL · On-site
Working knowledge of quality assurance, utilization review or risk management * Clinical specialty or management certification
$32.50 - $43/hr
Assists in maintaining resident care standards by supervising and directing activities of subordinate nurses engaged in quality assurance, infection control, and utilization review activities.
$32.50 - $43/hr
Assists in maintaining resident care standards by supervising and directing activities of subordinate nurses engaged in quality assurance, infection control, and utilization review activities.
$47 - $55.25/hr
... Drug Utilization Review) and ensure accurate documentation in pharmacy systems Monitor, receive, and manage pharmacy inventory effectively and compliantly Work collaboratively with pharmacy ...
$47 - $55.25/hr
... Drug Utilization Review) and ensure accurate documentation in pharmacy systems Monitor, receive, and manage pharmacy inventory effectively and compliantly Work collaboratively with pharmacy ...
$47 - $55.25/hr
... Drug Utilization Review) and ensure accurate documentation in pharmacy systems Monitor, receive, and manage pharmacy inventory effectively and compliantly Work collaboratively with pharmacy ...
$47 - $55.25/hr
... Drug Utilization Review) and ensure accurate documentation in pharmacy systems Monitor, receive, and manage pharmacy inventory effectively and compliantly Work collaboratively with pharmacy ...
$47 - $55.25/hr
... Drug Utilization Review) and ensure accurate documentation in pharmacy systems Monitor, receive, and manage pharmacy inventory effectively and compliantly Work collaboratively with pharmacy ...
$47 - $55.25/hr
... Drug Utilization Review) and ensure accurate documentation in pharmacy systems Monitor, receive, and manage pharmacy inventory effectively and compliantly Work collaboratively with pharmacy ...
$47 - $55.25/hr
... Drug Utilization Review) and ensure accurate documentation in pharmacy systems Monitor, receive, and manage pharmacy inventory effectively and compliantly Work collaboratively with pharmacy ...
$47 - $55.25/hr
... Drug Utilization Review) and ensure accurate documentation in pharmacy systems Monitor, receive, and manage pharmacy inventory effectively and compliantly Work collaboratively with pharmacy ...
$117K - $140K/yr
Measures quality and appropriateness of drug utilization review and adverse drug reactions. * Prepares formulary abstracts for review by Medication Use Committee for possible inclusion in the ...
$117K - $140K/yr
Measures quality and appropriateness of drug utilization review and adverse drug reactions. * Prepares formulary abstracts for review by Medication Use Committee for possible inclusion in the ...
$117K - $140K/yr
Measures quality and appropriateness of drug utilization review and adverse drug reactions. * Prepares formulary abstracts for review by Medication Use Committee for possible inclusion in the ...
$117K - $140K/yr
Measures quality and appropriateness of drug utilization review and adverse drug reactions. * Prepares formulary abstracts for review by Medication Use Committee for possible inclusion in the ...
$30.50 - $36.75/hr
Participate in Medicare meetings and utilization review processes * Maintain compliance with federal, state, and facility guidelines * Assist with care plan development and resident assessments
Quick apply
$30.50 - $36.75/hr
Participate in Medicare meetings and utilization review processes * Maintain compliance with federal, state, and facility guidelines * Assist with care plan development and resident assessments
Participate in utilization review activities by providing clinical information necessary for prior authorizations, continued stay reviews, and payer communication. * Maintain documentation in ...
Participate in utilization review activities by providing clinical information necessary for prior authorizations, continued stay reviews, and payer communication. * Maintain documentation in ...
Participate in utilization review activities by providing clinical information necessary for prior authorizations, continued stay reviews, and payer communication. * Maintain documentation in ...
Quick apply
Participate in utilization review activities by providing clinical information necessary for prior authorizations, continued stay reviews, and payer communication. * Maintain documentation in ...
Mobile, AL · On-site
$117K - $140K/yr
... drug utilization; work is performed under limited supervision by an administrative position and is reviewed for compliance with established practices and procedures; performs consultations and ...
Mobile, AL · On-site
$117K - $140K/yr
... drug utilization; work is performed under limited supervision by an administrative position and is reviewed for compliance with established practices and procedures; performs consultations and ...
Loxley, AL · On-site
$47 - $55.25/hr
... Utilization Review) and ensure accurate documentation in pharmacy systems • Monitor, receive, and manage pharmacy inventory effectively and compliantly • Work collaboratively with pharmacy ...
Loxley, AL · On-site
$47 - $55.25/hr
... Utilization Review) and ensure accurate documentation in pharmacy systems • Monitor, receive, and manage pharmacy inventory effectively and compliantly • Work collaboratively with pharmacy ...
Loxley, AL · On-site
$47 - $55.25/hr
... Utilization Review) and ensure accurate documentation in pharmacy systems • Monitor, receive, and manage pharmacy inventory effectively and compliantly • Work collaboratively with pharmacy ...
Loxley, AL · On-site
$47 - $55.25/hr
... Utilization Review) and ensure accurate documentation in pharmacy systems • Monitor, receive, and manage pharmacy inventory effectively and compliantly • Work collaboratively with pharmacy ...
Mobile, AL · On-site
$117K - $140K/yr
... drug utilization; work is performed under limited supervision by an administrative position and is reviewed for compliance with established practices and procedures; performs consultations and ...
Mobile, AL · On-site
$117K - $140K/yr
... drug utilization; work is performed under limited supervision by an administrative position and is reviewed for compliance with established practices and procedures; performs consultations and ...
Mobile, AL · On-site
$16.50 - $20.50/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 ...
Mobile, AL · On-site
$16.50 - $20.50/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 ...
$16.50 - $20.50/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 ...
$16.50 - $20.50/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 ...
Review and approve project budgets, schedules, contracts, staffing plans, and significant project ... Monitor project financial and operational performance, including backlog, utilization ...
Review and approve project budgets, schedules, contracts, staffing plans, and significant project ... Monitor project financial and operational performance, including backlog, utilization ...
Review and approve project budgets, schedules, contracts, staffing plans, and significant project ... Monitor project financial and operational performance, including backlog, utilization ...
Review and approve project budgets, schedules, contracts, staffing plans, and significant project ... Monitor project financial and operational performance, including backlog, utilization ...
Review and approve project budgets, schedules, contracts, staffing plans, and significant project ... Monitor project financial and operational performance, including backlog, utilization ...
Quick apply
Review and approve project budgets, schedules, contracts, staffing plans, and significant project ... Monitor project financial and operational performance, including backlog, utilization ...
$21.23 - $25.52
2% of jobs
$25.52 - $29.82
9% of jobs
$32.76 is the 25th percentile. Wages below this are outliers.
$29.82 - $34.11
21% of jobs
The median wage is $37.59 / hr.
$34.11 - $38.41
23% of jobs
$38.41 - $42.70
13% of jobs
$46.04 is the 75th percentile. Wages above this are outliers.
$42.70 - $46.99
10% of jobs
$46.99 - $51.29
8% of jobs
$51.29 - $55.58
5% of jobs
$55.58 - $59.87
5% of jobs
$59.87 - $64.17
2% of jobs
$64.17 - $68.46
2% of jobs
$21
$41
$68
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.
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.
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.

6.9
Based on 58 frontline employees who took The Breakroom Quiz
455th of 890 rated healthcare providers
Serves as an expert resource providing advanced practice, theories, and techniques gained through education, training, and experience to maximize quality patient/service outcomes.
Minimum Qualifications:Get the full story on Breakroom
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Growing out of a Desire to ensure Medical access for Southern Alabama and its surrounding Communities, Infirmary Health exists as the largest Not for Profit, Non Governmental Healthcare provider in Alabama. Based in Mobile and Baldwin Counties, Infirmary Health’s hospitals and Acute care Facilities have been recognized as National Leaders in Innovative and Compassionate Care for patients using state of the art Medical Technology, no matter the Medical need. Infirmary Health’s goal is to provide the best possible Healthcare services to our patients through utilizing Technological Advances, Comprehensive Treatment, and Quality Care standards. As the largest nonprofit healthcare provider , Our Mission is to put your LIFE First and become the First choice for Healthcare in the Region. Let us help you and your family on the path to good health.
Health care and social assistance
5,001 - 10,000 Employees
Mobile, AL, US
1910