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Weekday Optum Utilization Review Jobs in California

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Weekday Optum Utilization Review information

What is the difference between Weekday Optum Utilization Review vs Weekday Optum Claims Reviewer?

AspectWeekday Optum Utilization ReviewWeekday Optum Claims Reviewer
Primary RoleAssess medical necessity and appropriateness of healthcare servicesReview and process insurance claims for accuracy and compliance
CredentialsTypically requires nursing or healthcare-related certificationsUsually requires insurance or claims processing experience, with some certifications preferred
Work EnvironmentOffice-based, healthcare settings, remote optionsOffice or remote, insurance company environment
Industry UsageHealthcare insurance, utilization managementInsurance claims processing, customer service

While both roles are integral to healthcare insurance operations, Weekday Optum Utilization Review focuses on evaluating the medical necessity of services, whereas Weekday Optum Claims Reviewer handles claims processing and verification. Understanding these differences helps job seekers target the right position based on their skills and credentials.

What are the most commonly searched types of Optum Utilization Review jobs in California?

The most popular types of Optum Utilization Review jobs in California are:

What are popular job titles related to Weekday Optum Utilization Review jobs in California?

For Weekday Optum Utilization Review jobs in California, the most frequently searched job titles are:

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The top searched job categories for Weekday Optum Utilization Review jobs in California are:

What cities in California are hiring for Weekday Optum Utilization Review jobs?

Cities in California with the most Weekday Optum Utilization Review job openings:

Weekday Optum Utilization Review jobs near you
Infographic showing various Weekday Optum Utilization Review job openings in California as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 15% Part Time, and 4% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution.

Licensed Social Worker Case Manager / PRN

Select Specialty Hospital - San Diego

San Diego, CA • On-site

$52/hr

Full-time, Part-time, Per diem

Life, Retirement

Re-posted 16 days ago

Select Specialty Hospital rating

7.6

Company rating: 7.6 out of 10

Based on 92 frontline employees who took The Breakroom Quiz

259th of 1,064 rated hospitals

Job description

Overview

Select Specialty Hospital

Critical Illness Recovery Hospital (LTACH)

 Case Manager (PRN)

*Licensed Social Workers Only*

Pay: $52/hr

Previous discharge planning experience highly preferred.

SHIFT:

*Availability to work a minimum of 2 shifts per month on an "as needed" basis - shifts would be scheduled on weekdays, from appoximately 8a.m.-5p.m.*

Our hospital is a critical illness recovery hospital committed to providing world-class inpatient post-ICU services to chronic, critically ill patients who require extended healing and recovery. We help patients during some of the most vulnerable, painful moments of their lives - and our team plays a central role in providing compassionate, excellent care every step of the way.

Responsibilities

We are looking for valued employees who will be Champions of the Select Medical Way, which includes putting the patient first, helping to improve quality of life for the community in which you live and work, continuing to develop and explore new ideas, providing high-quality care and doing well by doing what is right.

The Case Manager is responsible for utilization reviews and resource management, discharge planning, treatment plan management and financial management, while also completing medical record documentation. You will report directly to the Director of Case Management and provide social work services, as necessary, per state guidelines.

  • Develops and implements a patient specific, safe and timely discharge plan.
  • Performs verification of utilization criteria reviews.
  • Builds relationships and coordinate with payor sources to assure proper reimbursement for hospital provided services, promote costs attentive care via focus on resource management within the plan of care.
  • Demonstrates compliance with facility-wide Utilization Management policies and procedures.
  • Coordinates UR compliance with Quality Management to assure all licensure and accrediting requirements are fulfilled.
  • Maintains fiscal responsibilities. Assures the department is identifying and negotiating the fullest possible reimbursement to maximize insurance benefit coverage for the patient. Reviews insurance verification forms to minimize risk.
  • Facilitates multi-disciplinary team meetings including physicians, nurses, respiratory therapists and rehabilitation therapists.
Qualifications

How you will be successful in this environment:

We are seeking results-driven team players. Qualified candidates must be passionate about providing superior quality in all that they do.

Minimum requirements:

  • Current licensure
  • Adequate experience in an acute medical case management setting and confidence to manage and direct a plan of care for chronically critically ill populations

Preferred qualifications that will make you successful:

  • Specific experience in Care Management and Discharge Planning is preferred.
  • Working knowledge of the insurance industry and government reimbursement.
  • Availability to work a minimum of 2 shifts per month on an "as needed" basis - shifts would be scheduled on weekdays, from appoximately 8a.m.-5p.m.
Additional Data

Why Join Us:

  • Start Strong: Extensive orientation program to ensure a smooth transition into our setting.
  • Opportunity for Advancement: Demonstrate your skills and dedication which could lead to potential full-time opportunities
  • Foster Well-being: We offer benefits which support the financial, work/life and emotional well-being of you and your family members.  Part time/Per Diem positions are eligible for 401k based on reaching 1,000 hours within their first anniversary or subsequent calendar year. We also offer our employee assistance program to part time employees.
  • Your Impact Matters: Join a team of over 44,000 committed to providing exceptional patient care

Equal opportunity employer, including disabled veterans

Employment Type: OTHER

What Select Specialty Hospital employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Select Specialty Hospital logo

About Select Specialty Hospital

Sourced by ZipRecruiter

Select Specialty Hospital is a top-tier healthcare services provider situated in Mechanicsburg, PA, US. Operating under the wider umbrella of the healthcare industry, Select Specialty Hospital is a part of a network of specialized acute care hospitals energized to provide superior, patient-centered treatment. Since its establishment, it has been a pioneer in providing long-term acute care (LTAC) services to patients transitioning from intensive care or requiring concentrated care for ongoing recovery.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Mechanicsburg, PA, US

Social media

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