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Weekend Utilization Review Jobs in Delaware (NOW HIRING)

UHS

Lead UR Coordinator

Dover, DE · On-site

Perform internal utilization reviews as indicated. * Identify, document, and report any and all instances of adult or child abuse and neglect to the appropriate parties including a member of ...

UHS

Lead UR Coordinator

Dover, DE · On-site

Maintain and update logs of review and maintain other appropriate records of the Utilization Review department. * Communicate pertinent third party payors issues to doctor and treatment team.

Christiana Care Health Services

Communication from Talent Acquisition Team about specific next steps, including: video interview and clinical references Applications to be sent for review by residency coordinators Offers to be made ...

UHS

HIM/MEDICAL RECORDS SPEC/TECH

Dover, DE · On-site

$37K - $50K/yr

Work closely with the Business Office and Utilization Review and provide information regarding the ... weekends and holidays) Qualifications Minimum: * High School Diploma * Must be a nationally ...

UHS

HIM/MEDICAL RECORDS SPEC/TECH

Dover, DE · On-site

$37K - $50K/yr

Work closely with the Business Office and Utilization Review and provide information regarding the ... weekends and holidays) Qualifications Minimum: * High School Diploma * Must be a nationally ...

UHS

HIM/MEDICAL RECORDS SPEC/TECH

Dover, DE

$37K - $50K/yr

Work closely with the Business Office and Utilization Review and provide information regarding the ... weekends and holidays) Qualifications Minimum: * High School Diploma * Must be a nationally ...

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Weekend Utilization Review information

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$21

$42

$69

How much do weekend utilization review jobs pay per hour?

As of Jun 29, 2026, the average hourly pay for weekend utilization review in Delaware is $42.32, according to ZipRecruiter salary data. Most workers in this role earn between $33.46 and $48.61 per hour, depending on experience, location, and employer.

What does a typical weekend shift look like for a Utilization Review professional?

Weekend Utilization Review professionals typically work independently, reviewing patient cases for medical necessity, appropriateness of care, and compliance with payer guidelines during non-standard business hours. You will analyze patient charts, interact with clinical staff, and document findings, often collaborating remotely with other care coordinators or medical teams. While much of the role is desk-based, quick decision-making and effective communication are essential due to faster-paced weekend workflows. This schedule can offer greater autonomy and flexibility, but may also require prioritizing tasks and managing multiple cases efficiently to ensure continuous patient care.

What is a Weekend Utilization Review job?

A Weekend Utilization Review job involves assessing patient care and medical services during weekends to ensure they meet medical necessity and insurance guidelines. Professionals in this role review clinical documentation, coordinate with healthcare providers, and determine appropriate levels of care for patients. They typically work for hospitals, insurance companies, or other healthcare organizations. Strong analytical skills, medical knowledge, and familiarity with regulatory requirements are essential for success in this role.

What are the key skills and qualifications needed to thrive in the Weekend Utilization Review position, and why are they important?

Success as a Weekend Utilization Review professional requires a strong background in nursing or healthcare, critical thinking skills, and a thorough understanding of medical necessity criteria, such as InterQual or Milliman guidelines. Familiarity with electronic medical records (EMR) systems and utilization management software is highly beneficial, and RN or healthcare-related licensure is often required. Exceptional communication, attention to detail, and the ability to work independently on weekends are crucial soft skills. Mastering these areas allows efficient and accurate reviews of patient care, supporting optimal healthcare resource allocation outside of standard work hours.

What are the most commonly searched types of Utilization Review jobs in Delaware? The most popular types of Utilization Review jobs in Delaware are:
What are popular job titles related to Weekend Utilization Review jobs in Delaware? For Weekend Utilization Review jobs in Delaware, the most frequently searched job titles are:
What job categories do people searching Weekend Utilization Review jobs in Delaware look for? The top searched job categories for Weekend Utilization Review jobs in Delaware are:
What cities in Delaware are hiring for Weekend Utilization Review jobs? Cities in Delaware with the most Weekend Utilization Review job openings:
Weekend Utilization Review jobs near you
Infographic showing various Weekend Utilization Review job openings in Delaware as of June 2026, with employment types broken down into 73% Full Time, and 27% Part Time. Highlights an 100% In-person job distribution, with an average salary of $88,022 per year, or $42.3 per hour.
Utilization Management Specialist I - Full-Time

Utilization Management Specialist I - Full-Time

SUN Behavioral Delaware

Georgetown, DE • On-site

Full-time

Posted 13 days ago

Key responsibilities

  • Coordinates case management strategies and care for patients from pre-hospitalization through discharge.

  • Assists with authorization of hospital admissions, processes retroactive reviews and appeals, and communicates with insurance companies to ensure coverage.

  • Documents and updates patient status, denial logs, and care transitions, and participates in daily meetings and performance improvement activities.

Sun Behavioral Health rating

5.3

Company rating: 5.3 out of 10

Based on 9 frontline employees who took The Breakroom Quiz

Job description

Position Summary:
Responsible for the coordination of case management strategies pursuant to the Case Management process. Assists and coordinates care of the patient from pre-hospitalization through discharges. Responsible for assisting with authorization of admissions to hospital. Processes retroactive reviews and appeals, copies needed documentation and writes retro/appeal letters for insurance companies to ensure coverage for patient admissions. Conducts follow up calls with insurance companies to ensure coverage for patient admissions. Participates in performance improvement activities. Attends 80% of staff meetings. Coordinates care for patient through communication with Physicians, Nurse Practitioners, Clinical Services, Nursing, Assessment and Referrals Department.
Position Responsibilities:
Clinical / Technical Skills (40% of performance review)
  • Provides thorough documentation and timely updates regarding patient status on log sheets that are prepared for daily meetings concerning admissions, reviews and discharges; including case s with limited benefits, cases in peer review/denial and /or unplanned discharges
  • Coordinates with managed care companies or other third-party payors regarding peer reviews, retrospective reviews and appeals. Document s and updates the denial log to reflect same.
  • Consults Business Office and/or admission staff as needed to clarify data and ensure authorization processes are complete.
  • Documents in HCS the results of admission and concurrent reviews.
  • Stays informed about changes in Medicare and Medicaid.
  • Ability to stage local laws, ordinances and practices governing involuntary hospitalization and ensure compliance with same.
  • Reviews the quality of documentation for each level of care to ensure clinical effectiveness and appropriateness of treatment.
  • Maintains an active involvement and awareness of all patient admissions, discharges and transfers to alternate levels of care. Oversees continuity of care for each level of care transition.
  • Develops and maintains processes to minimize denials and communication of same to CFO and Business Office Director.
  • Reports results of daily treatment team meetings all discharges and status of high-risk case such as limited benefits, peer reviews, denials or unplanned discharges.
  • Timely retroactive reviews and appeals within current month
  • Strong knowledge of external review organizations (i.e.: Medicare/Managed Care/Medicaid) with knowledge of payor resources and planning.
  • Types and mails all correspondence in a timely manner.
  • Answers the telephone in a polite manner, Communicates information to the appropriate staff.
  • Interacts with patients/families in a professional manner. Provides explanations regarding statements, insurance coverage.
  • Support discharge planning and utilization review when necessary
  • Perform other duties as required

Safety (15% of performance review)
  • Strives to create a safe, healing environment for patients and family members
  • Follows all safety rules while on the job.
  • Reports near misses, as well as errors and accidents promptly.
  • Corrects minor safety hazards.
  • Communicates with peers and management regarding any hazards identified in the workplace.
  • Attends all required safety programs and understands responsibilities related to general, department, and job specific safety.
  • Participates in quality projects, as assigned, and supports quality initiatives.
  • Supports and maintains a culture of safety and quality.

Teamwork (15% of performance review)
  • Works well with others in a spirit of teamwork and cooperation.
  • Responds willingly to colleagues and serves as an active part of the hospital team.
  • Builds collaborative relationships with patients, families, staff, and physicians.
  • The ability to retrieve, communicate, and present data and information both verbally and in writing as required
  • Demonstrates listening skills and the ability to express or exchange ideas by means of the spoken and written word.
  • Demonstrates adequate skills in all forms of communication.
  • Adheres to the Standards of Behavior

Integrity (15% of performance review)
  • Strives to always do the right thing for the patient, coworkers, and the hospital
  • Adheres to established standards, policies, procedures, protocols, and laws.
  • Applies the Mission and Values of SUN Behavioral Health to personal practice and commits to service excellence.
  • Supports and demonstrates fiscal responsibility through supply usage, ordering of supplies, and conservation of facility resources.
  • Completes required trainings within defined time periods, as established by job description, policies, or hospital leadership
  • Exemplifies professionalism through good attendance and positive attitude, at all times.
  • Maintains confidentiality of patient and staff information, following HIPAA and other privacy laws.
  • Ensures proper documentation in all position activities, following federal and state guidelines.

Compassion (15% of performance review)
  • Demonstrates accountability for ensuring the highest quality patient care for patients.
  • Willingness to be accepting of those in need, and to extend a helping hand
  • Desire to go above and beyond for others
  • Understanding and accepting of cultural diversity and differences

Education
  • Required: High school diploma or GED. CPR and hospital-selected de-escalation technique certification.
  • Preferred: Associates or Bachelors degree.
  • Maintains education and development appropriate for position.
  • May substitute experience for education

Experience
  • Required: One year of experience in a behavioral healthcare setting.
  • Preferred: Previous experience in a Utilization Management department or as a Mental Health Tech
  • May substitute education for experience

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