Utilization Specialist
Conway, AR · On-site
Proactively monitor utilization of services for patients to optimize reimbursement for the facility. ESSENTIAL FUNCTIONS: * Act as liaison between managed care organizations and the facility ...
Utilization Specialist
Conway, AR · On-site
Proactively monitor utilization of services for patients to optimize reimbursement for the facility. ESSENTIAL FUNCTIONS: * Act as liaison between managed care organizations and the facility ...
Utilization Specialist
Conway, AR · On-site
Proactively monitor utilization of services for patients to optimize reimbursement for the facility. Responsibilities ESSENTIAL FUNCTIONS: * Act as liaison between managed care organizations and the ...
Utilization Specialist
Conway, AR · On-site
Proactively monitor utilization of services for patients to optimize reimbursement for the facility. Responsibilities ESSENTIAL FUNCTIONS: * Act as liaison between managed care organizations and the ...
Utilization Specialist
Conway, AR · On-site
Proactively monitor utilization of services for patients to optimize reimbursement for the facility. Responsibilities ESSENTIAL FUNCTIONS: * Act as liaison between managed care organizations and the ...
Utilization Specialist
Conway, AR · On-site
Proactively monitor utilization of services for patients to optimize reimbursement for the facility. Responsibilities ESSENTIAL FUNCTIONS: * Act as liaison between managed care organizations and the ...
Utilization Review Associate
Searcy, AR · On-site
Utilization Review Associate Job Type: Full-time (Monday-Friday, 8:00 AM - 5:00 PM) Travel: 0-25% POSITION SUMMARY Assist with planning and coordinating the duties of Utilization Review. This ...
Utilization Review Associate
Searcy, AR · On-site
Utilization Review Associate Job Type: Full-time (Monday-Friday, 8:00 AM - 5:00 PM) Travel: 0-25% POSITION SUMMARY Assist with planning and coordinating the duties of Utilization Review. This ...
Case Management or Utilization Review Experience preferred. Works efficiently with others and demonstrates tact, discretion and diplomacy. Ability to operate technical equipment as acquired through ...
Case Management or Utilization Review Experience preferred. Works efficiently with others and demonstrates tact, discretion and diplomacy. Ability to operate technical equipment as acquired through ...
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 ...
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 ...
Case Management or Utilization Review Experience preferred. Works efficiently with others and demonstrates tact, discretion and diplomacy. Ability to operate technical equipment as acquired through ...
Case Management or Utilization Review Experience preferred. Works efficiently with others and demonstrates tact, discretion and diplomacy. Ability to operate technical equipment as acquired through ...
The Utilization Review (UR) RN Care Manager is responsible for utilizing pre-established, evidence based screening criteria to validate the appropriateness of patient admissions, provide screening ...
New
The Utilization Review (UR) RN Care Manager is responsible for utilizing pre-established, evidence based screening criteria to validate the appropriateness of patient admissions, provide screening ...
New
Help maintain a quality control system to assure effective utilization of hospital facilities and services. Assist in the promotion and maintenance of high quality care through review of clinical ...
Quick apply
Help maintain a quality control system to assure effective utilization of hospital facilities and services. Assist in the promotion and maintenance of high quality care through review of clinical ...
Help maintain a quality control system to assure effective utilization of hospital facilities and services. Assist in the promotion and maintenance of high quality care through review of clinical ...
Help maintain a quality control system to assure effective utilization of hospital facilities and services. Assist in the promotion and maintenance of high quality care through review of clinical ...
Utilization Management Shift: Day Working Hours: 8-5P Summary: The Physician Advisor is a key member of the healthcare organization's leadership team and is charged with meeting the organization ...
Utilization Management Shift: Day Working Hours: 8-5P Summary: The Physician Advisor is a key member of the healthcare organization's leadership team and is charged with meeting the organization ...
Utilization Management Shift: Day Working Hours: 8-5P Summary: The Physician Advisor is a key member of the healthcare organization's leadership team and is charged with meeting the organization ...
Utilization Management Shift: Day Working Hours: 8-5P Summary: The Physician Advisor is a key member of the healthcare organization's leadership team and is charged with meeting the organization ...
This remote Drug Utilization Review Pharmacist role is ideal for pharmacists who enjoy clinical analysis and want to improve outcomes at scale. Key responsibilities include conducting prospective ...
This remote Drug Utilization Review Pharmacist role is ideal for pharmacists who enjoy clinical analysis and want to improve outcomes at scale. Key responsibilities include conducting prospective ...
UR Specialist Supervisor
Little Rock, AR · On-site
Utilization Management Shift: Day Working Hours: Mon -Friday 0800-1700 Summary: Working/Supervisor position responsible for the leadership and supervision of the Utilization Review (UR) Specialists ...
UR Specialist Supervisor
Little Rock, AR · On-site
Utilization Management Shift: Day Working Hours: Mon -Friday 0800-1700 Summary: Working/Supervisor position responsible for the leadership and supervision of the Utilization Review (UR) Specialists ...
Overview Provides discharge planning and utilization review services in compliance with patients discharge planning needs and the hospital's utilization review program. SAFETY SENSITIVE POSITION:
Overview Provides discharge planning and utilization review services in compliance with patients discharge planning needs and the hospital's utilization review program. SAFETY SENSITIVE POSITION:
Case Manager PRN
Conway, AR · On-site
Overview Provides discharge planning and utilization review services in compliance with patients discharge planning needs and the hospital's utilization review program. SAFETY SENSITIVE POSITION:
Case Manager PRN
Conway, AR · On-site
Overview Provides discharge planning and utilization review services in compliance with patients discharge planning needs and the hospital's utilization review program. SAFETY SENSITIVE POSITION:
Remote Clinical Review Pharmacist
Springdale, AR · On-site
$104K - $125K/yr
Collaborate with physicians, nurses, and utilization-management teams on complex cases. * Document recommendations and decisions according to health-plan and regulatory requirements. * Participate in ...
Remote Clinical Review Pharmacist
Springdale, AR · On-site
$104K - $125K/yr
Collaborate with physicians, nurses, and utilization-management teams on complex cases. * Document recommendations and decisions according to health-plan and regulatory requirements. * Participate in ...
Prepares productivity reporting and presentations for hospital and corporate leadership and supports system initiatives related to labor productivity, workforce utilization, position control, and ...
Prepares productivity reporting and presentations for hospital and corporate leadership and supports system initiatives related to labor productivity, workforce utilization, position control, and ...
Working under the direction of multiple Project Managers, the Scheduler maintains the company's manpower schedule, coordinates workforce assignments, tracks employee utilization, and provides real ...
Working under the direction of multiple Project Managers, the Scheduler maintains the company's manpower schedule, coordinates workforce assignments, tracks employee utilization, and provides real ...
Working under the direction of multiple Project Managers, the Scheduler maintains the company's manpower schedule, coordinates workforce assignments, tracks employee utilization, and provides real ...
Working under the direction of multiple Project Managers, the Scheduler maintains the company's manpower schedule, coordinates workforce assignments, tracks employee utilization, and provides real ...
Utilization information
See Arkansas salary details
$17.69 - $21.27
2% of jobs
$21.27 - $24.85
9% of jobs
$27.29 is the 25th percentile. Wages below this are outliers.
$24.85 - $28.42
21% of jobs
The median wage is $31.32 / hr.
$28.42 - $32
23% of jobs
$32 - $35.58
13% of jobs
$38.36 is the 75th percentile. Wages above this are outliers.
$35.58 - $39.16
10% of jobs
$39.16 - $42.74
8% of jobs
$42.74 - $46.31
5% of jobs
$46.31 - $49.89
5% of jobs
$49.89 - $53.47
2% of jobs
$53.47 - $57.05
2% of jobs
$17
$34
$57
How much do utilization jobs pay per hour?
As of Aug 22, 2026, the average hourly pay for utilization in Arkansas is $34.96, according to ZipRecruiter salary data. Most workers in this role earn between $27.64 and $40.14 per hour, depending on experience, location, and employer.
What is a utilization specialist?
Utilization specialists are professionals who review and evaluate the necessity, appropriateness, and efficiency of the use of healthcare services, procedures, and facilities. They work closely with healthcare providers, insurance companies, and patients to ensure that care is delivered according to established guidelines and that resources are used effectively. Their goal is to help manage costs while ensuring patients receive the appropriate level of care.
What are some of the common challenges faced by utilization review specialists when assessing medical necessity of services?
Utilization Review Specialists often encounter the challenge of balancing patient advocacy with cost-effective care. They must stay updated on evolving insurance policies and clinical guidelines, which can be complex and change frequently. Additionally, coordinating with physicians and healthcare staff to obtain necessary documentation and clarifying treatment plans can be time-consuming. Strong communication skills and attention to detail are essential to ensure timely and accurate reviews, while also maintaining positive working relationships with clinical teams.
What are the key skills and qualifications needed to thrive as a utilization review specialist, and why are they important?
To thrive as a Utilization Review Specialist, you need a background in healthcare (often as an RN or LPN/LVN), strong analytical skills, and knowledge of insurance and medical necessity criteria. Familiarity with utilization management software, ICD-10/CPT coding, and regulatory guidelines like Medicare and Medicaid is typically required. Excellent attention to detail, critical thinking, and effective communication skills set top performers apart in this role. These abilities are crucial to accurately evaluating patient care needs, ensuring regulatory compliance, and optimizing resource use within healthcare organizations.
What is the difference between Utilization vs Resource Coordinator?
| Aspect | Utilization | Resource Coordinator |
|---|---|---|
| Primary Focus | Measuring and optimizing how staff time is used | Managing and assigning resources for projects |
| Required Credentials | Often no specific credentials, but industry experience helps | Typically requires organizational or project management skills |
| Work Environment | Corporate, healthcare, or consulting firms | Project teams, staffing agencies, or departments |
| Common Usage | Tracking staff utilization rates | Allocating resources to projects or tasks |
Utilization focuses on measuring how effectively staff time is used, often to improve productivity. Resource Coordinator involves actively managing and assigning resources to ensure project needs are met. While related, utilization is more about analysis, and resource coordination is about execution and management.
How to become a utilization reviewer?
To become a utilization reviewer, candidates typically need a background in healthcare, nursing, or a related field, along with knowledge of medical coding and insurance policies. Relevant certifications such as Certified Professional Coder (CPC) or Certified Medical Reimbursement Specialist (CMRS) can enhance job prospects. Strong analytical skills and attention to detail are essential for reviewing medical records and determining appropriate service utilization.
What are the most commonly searched types of Utilization jobs in Arkansas?
The most popular types of Utilization jobs in Arkansas are:
Acadia Healthcare rating
6.2
Based on 190 frontline employees who took The Breakroom Quiz
696th of 891 rated healthcare providers
Job description
PURPOSE STATEMENT:
Proactively monitor utilization of services for patients to optimize reimbursement for the facility.
ESSENTIAL FUNCTIONS:
- Act as liaison between managed care organizations and the facility professional clinical staff.
- Conduct reviews, in accordance with certification requirements, of insurance plans or other managed care organizations (MCOs) and coordinate the flow of communication concerning reimbursement requirements.
- Monitor patient length of stay and extensions and inform clinical and medical staff on issues that may impact length of stay.
- Gather and develop statistical and narrative information to report on utilization, non-certified days (including identified causes and appeal information), discharges and quality of services, as required by the facility leadership or corporate office.
- Conduct quality reviews for medical necessity and services provided.
- Facilitate peer review calls between facility and external organizations.
- Initiate and complete the formal appeal process for denied admissions or continued stay.
- Assist the admissions department with pre-certifications of care.
- Provide ongoing support and training for staff on documentation or charting requirements, continued stay criteria and medical necessity updates.
OTHER FUNCTIONS:
- Perform other functions and tasks as assigned.
EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:
- Required Education: High school diploma or equivalent.
- Preferred Education: Associate's, Bachelor's, or Master’s degree in Social Work, Behavioral or Mental Health, Nursing, or a related health field.
- Experience: Clinical experience is required, or two or more years' experience working with the facility's population. Previous experience in utilization management is preferred
LICENSES/DESIGNATIONS/CERTIFICATIONS:
- Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides services; or current clinical professional license or certification, as required, within the state where the facility provides services.
- CPR and de-escalation and restraint certification required (training available upon hire and offered by facility.
- First aid may be required based on state or facility requirements.
ADDITIONAL REGULATORY REQUIREMENTS:
While this job description is intended to be an accurate reflection of the requirements of the job, management reserves the right to add or remove duties from particular jobs when circumstances
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About Acadia Healthcare
Sourced by ZipRecruiter
Acadia Healthcare is a leading provider in the healthcare and hospital industry, based in Franklin, Tennessee, United States. The company is recognised for its commitment to creating a behavioural health network that provides accessible, high-quality treatment options for individuals suffering from mental health issues, addiction, eating disorders, and PTSD. Acadia Healthcare was founded in 2005, with the mission to create a world-class organization that sets the standard of excellence in the treatment of specialty behavioural health and addiction disorders.
Industry
Hospitals
Company size
10,000+ Employees
Headquarters location
Franklin, TN, US
Year founded
2005