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Weekend Utilization Review Jobs in Philadelphia, PA

Penn Medicine

Utilization Review Nurse

West Chester, PA · On-site

The Utilization Review Nurse will provide utilization review for authorization, concurrent review and discharge review services using InterQual criteria guidelines to validate medical necessity and ...

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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 Aug 16, 2026, the average hourly pay for weekend utilization review in Philadelphia, PA is $42.67, according to ZipRecruiter salary data. Most workers in this role earn between $33.70 and $48.99 per hour, depending on experience, location, and employer.

What does a weekend utilization review professional do?

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?

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?

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 Philadelphia, PA?

The most popular types of Utilization Review jobs in Philadelphia, PA are:

What are popular job titles related to Weekend Utilization Review jobs in Philadelphia, PA?

For Weekend Utilization Review jobs in Philadelphia, PA, the most frequently searched job titles are:

What job categories do people searching Weekend Utilization Review jobs in Philadelphia, PA look for?

The top searched job categories for Weekend Utilization Review jobs in Philadelphia, PA are:

What cities near Philadelphia, PA are hiring for Weekend Utilization Review jobs?

Cities near Philadelphia, PA with the most Weekend Utilization Review job openings:

Weekend Utilization Review jobs near you
Infographic showing various Weekend Utilization Review job openings in Philadelphia, PA as of August 2026, with employment types broken down into 100% Full Time. Highlights an 92% In-person, and 8% Remote job distribution, with an average salary of $88,746 per year, or $42.7 per hour.

Utilization Review Specialist

Diversified Treatment Alternative Centers

Chadds Ford, PA • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 12 days ago

Job description

Utilization Review (UR) Specialist

Location: Chadds Ford, Pennsylvania (Hybrid / Remote Eligible)
Job Type: Full-Time
Schedule: Monday – Friday


Overview

Diversified Treatment Alternative Centers (DTAC) is seeking a detail-oriented and experienced Utilization Review (UR) Specialist to support our behavioral health programs.

This role plays a critical part in ensuring services are medically necessary, appropriately authorized, and compliant with payer, state, and regulatory requirements while supporting timely reimbursement and quality care delivery.


Why Join DTAC

  • Flexible hybrid or remote work options
  • Collaborative, cross-functional team environment
  • Meaningful work supporting behavioral health services
  • Stable organization focused on quality and growth
  • Opportunities for professional development


Position Summary

The Utilization Review Specialist manages the full lifecycle of authorizations and eligibility verification. This role collaborates closely with Clinical, Admissions, and Revenue Cycle teams to ensure compliance, minimize denials, and support accurate billing and reimbursement.


Key Responsibilities

  • Conduct initial, concurrent, and continued stay utilization reviews
  • Submit, track, and manage authorizations and reauthorizations
  • Communicate authorization updates with clinical and admissions teams
  • Maintain accurate documentation in EHR and billing systems
  • Perform ongoing eligibility verification for active clients
  • Identify coverage changes and communicate impacts to appropriate teams
  • Review clinical documentation for medical necessity and compliance
  • Collaborate with clinicians to address documentation gaps
  • Support denial prevention and revenue cycle optimization
  • Assist with appeals and utilization-related inquiries
  • Participate in audits, quality improvement initiatives, and compliance reviews
  • Stay current with payer requirements and regulatory updates


Qualifications

Required:

  • Bachelor’s degree in Healthcare Administration, Nursing, Social Work, Psychology, or related field
  • Minimum of 1–3 years of experience in utilization review, case management, or behavioral health revenue cycle
  • Strong understanding of medical necessity and authorization processes
  • Excellent attention to detail and analytical skills
  • Strong written and verbal communication skills

Preferred:

  • Experience with Pennsylvania and Ohio behavioral health payers
  • Familiarity with EHR systems and billing workflows
  • Experience supporting audits, compliance reviews, or appeals


Requirements

  • Ability to manage multiple priorities and deadlines
  • Strong collaboration across clinical, billing, and administrative teams
  • Commitment to compliance with regulatory and payer requirements
  • Ability to work hybrid or remotely depending on organizational needs


Benefits

  • 401(k)
  • Health, Dental, and Vision Insurance
  • Health Savings Account
  • Paid Time Off
  • Life and Disability Insurance
  • Employee Assistance Program
  • Referral Program


Work Location

This position is based in Chadds Ford, PA (19317) with hybrid or remote work options available based on business needs.


Apply Today

If you are a detail-driven professional with experience in utilization review or behavioral health operations, we encourage you to apply and join DTAC’s team.


Equal Opportunity Employer

Diversified Treatment Alternative Centers is committed to providing equal employment opportunities and maintaining an inclusive workplace in accordance with all applicable laws.