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Weekday Optum Utilization Review Jobs (NOW HIRING)

UnitedHealth Group

Case Manager Optum Oveido

Oviedo, FL · On-site

$60K - $107K/yr

Optum is a clinician-led care organization that is changing the way clinicians work and live. As a ... Care management, utilization review or discharge planning experience * HMO experience * Ability to ...

UnitedHealth Group

Case Manager Optum Oveido

Oviedo, FL

$60K - $107K/yr

Optum is a clinician-led care organization that is changing the way clinicians work and live. As a ... Care management, utilization review or discharge planning experience * HMO experience * Ability to ...

Optum

UM Trainer - Utilization Management

Eden Prairie, MN · On-site

$72K - $130K/yr

Optum is a global organization that delivers care, aided by technology to help millions of people ... Experience as a utilization management reviewer * Experience with utilization management platforms ...

Optum

Care Manager RN - Per Diem

Portland, ME · On-site

$28.27 - $50.48/hr

Opportunities at Northern Light Health , in strategic partnership with Optum. Whether you are ... Maintains a working knowledge of care management, care coordination changes, utilization review ...

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$42

$68

How much do weekday optum utilization review jobs pay per hour?

As of Jun 7, 2026, the average hourly pay for weekday optum utilization review in the United States is $42.28, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 per hour, depending on experience, location, and employer.

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.

More about Weekday Optum Utilization Review jobs
What cities are hiring for Weekday Optum Utilization Review jobs? Cities with the most Weekday Optum Utilization Review job openings:
What are the most commonly searched types of Optum Utilization Review jobs? The most popular types of Optum Utilization Review jobs are:
What states have the most Weekday Optum Utilization Review jobs? States with the most job openings for Weekday Optum Utilization Review jobs include:
What job categories do people searching Weekday Optum Utilization Review jobs look for? The top searched job categories for Weekday Optum Utilization Review jobs are:
Weekday Optum Utilization Review jobs near you
Infographic showing various Weekday Optum Utilization Review job openings in the United States as of May 2026, with employment types broken down into 98% Full Time, and 2% Part Time. Highlights an 90% Physical, 1% Hybrid, and 9% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

Utilization Mgmt Coord - Behavioral Health, PRN, Macon

Piedmont Healthcare Inc.

Macon, GA • On-site

Other

Posted 24 days ago

Piedmont Healthcare rating

7.0

Company rating: 7.0 out of 10

Based on 449 frontline employees who took The Breakroom Quiz

404th of 869 rated healthcare providers

Job description

Overview
The purpose of this position is to ensure that admitted patients have the appropriate level of care, patient status, authorization status, plan of care and meet medical necessity for the behavioral health services. This role monitors that the patient is progressing in their plan of care and meet medical necessity for continued stay. This role ensure that patient's payor has the clinical information with which to authorize the behavioral health service and continued stay service to include covered days and associated services.
Responsibilities
The purpose of this position is to ensure that admitted patients have the appropriate level of care, patient status, authorization status, plan of care and meet medical necessity for the behavioral health services. This role monitors that the patient is progressing in their plan of care and meet medical necessity for continued stay. This role ensure that patient's payor has the clinical information with which to authorize the behavioral health service and continued stay service to include covered days and associated services.
**ALL PRN'S MUST BE AVAILABLE FOR 6 SHIFTS PER MONTH (3 WEEKDAY SHIFTS AND 3 WEEKEND SHIFTS). DAY SHIFTS ONLY. MUST WORK 1 HOLIDAY IN SPRING/SUMMER AND 1 HOLIDAY IN FALL/WINTER**
Qualifications
Education
  • Bachelor's Degree from an accredited nursing school, B.A/ B.S or Required or
  • Bachelor's Degree in Social Work Required or
  • Master's degree Preferred
Work Experience
  • 2 years of experience in an acute, post-acute, managed care, psychiatric, or revenue cycle Required
  • Previous experience with InterQual and/or MCG guidelines Required
  • Previous experience in Utilization Management and/or Appeals Required
  • Previous Epic experience or Meditech/MIDAS experience Required
  • Previous experience in prior authorization process Required
  • Utilization Review or Care Management experience Preferred
Licenses and Certifications
  • Current unrestricted registered nurse (RN) license or LMSW/LCSW, in the state of Georgia. Required or
  • LPC/LMFT also acceptable Required
Additional Licenses and Certifications
  • Case Management Certification (CCM) or American Case Management Association (ACMA) certification Preferred

Business Unit : Company Name
Piedmont Healthcare Corporate

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