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Utilization Review Jobs in Monroe, LA (NOW HIRING)

FMOLHS

Patient Financial Advisor

Monroe, LA · On-site

$16.50 - $18/hr

... or review prior account information to obtain insurance coverage. Notifies departments of ... Maintains daily contact with Utilization Management, Business Office, patient Registration, Medical ...

FMOLHS

Pharmacist PRN Premium (Retail)

Monroe, LA

$56 - $67.25/hr

Reviews and interprets patient prescriptions and profiles in order to prevent overdoses ... Drug Utilization Evaluations, and cost-effective therapeutic interchanges. * Able to assess a ...

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Utilization Review information

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How much do utilization review jobs pay per hour?

As of Aug 25, 2026, the average hourly pay for utilization review in Monroe, LA is $40.67, according to ZipRecruiter salary data. Most workers in this role earn between $32.16 and $46.73 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 Monroe, LA?

The most popular types of Utilization Review jobs in Monroe, LA are:

What are popular job titles related to Utilization Review jobs in Monroe, LA?

For Utilization Review jobs in Monroe, LA, the most frequently searched job titles are:

What job categories do people searching Utilization Review jobs in Monroe, LA look for?

The top searched job categories for Utilization Review jobs in Monroe, LA are:

What cities near Monroe, LA are hiring for Utilization Review jobs?

Cities near Monroe, LA with the most Utilization Review job openings:

Utilization Review jobs near you
Infographic showing various Utilization Review job openings in Monroe, LA as of August 2026, with employment types broken down into 1% As Needed, 65% Full Time, 31% Part Time, 2% Contract, and 1% Nights. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution, with an average salary of $84,599 per year, or $40.7 per hour.

Director Case Management

West Monroe, LA • On-site

Glenwood Regional Medical Center
Health Care and Social Assistance • 501 - 1,000 employees

4.3

Company rating: 4.3 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

1,039th of 1,064 rated hospitals

Good training

Learn more about Glenwood Regional Medical Centerexternal

Full-time

Re-posted 9 days ago

Job description

POSITION SUMMARY
Responsible for the direction of staff and fiscal resources of the Case Management Dept. Oversight of the hospital Case Management program.
  • Provides direction and planning for physician advisor, and staff to establish priorities identifying trends. Develop short- and long-term goals for cost containment and reduction of LOS and utilization of hospital resources.
  • Provides direction and planning for physician advisor, and staff to establish priorities identifying trends. Develop short- and long-term goals for cost containment and reduction of LOS and utilization of hospital resources.
  • Develops structures and processes to facilitate participation by physicians, pharmacists, nurses, Social Workers and other health professionals in multidisciplinary care planning, care delivery, and discharge planning.
  • Directs utilization review activities for the hospital, interfacing with external payers and review companies to determine appropriate medical necessity of admissions and continued hospitalization.
  • Resolves conflicts related to discharge planning with patients/families, external agenand payers.
  • Facilitates transition of patients/families across the continuum by establishing relationships with appropriate providers and community services
  • Ensures compliance with DNV standards for the Continuity of Care function.
  • Participates as a member of DNV Task Force.
  • Establishes effective relationships with external agencies providing services to the organization (such as vendors, care providers, etc.)
  • Effectively audits and monitors areas of responsibility for compliance issues. Promptly follows up on compliance issues. Creates an environment that encourages staff to report/resolve complicated issues.
  • Employee is dependable and completes other assigned duties on schedule and these duties do not have to be redone.

QUALIFICATIONS
  • Must be a graduate of an Accredited School of Nursing with a current La State Board License
  • RN Case Management experience in an acute care setting preferred. Previous supervisory experience preferred.
  • A current Louisiana license is required.
  • Computer skills preferred.

Please indicate whether you have ever been convicted of a crime, including any misdemeanors and/or DUI/DWI. (Criminal conviction(s) will not automatically exclude you from consideration for employment).

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