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Utilization Review Jobs Near Me

syfs

UR Manager

Columbus, OH

For billing and hospitalization utilization review purposes, the reviewer will identify and certify the acute hospitallength of stay authorized for each case. Initiate and maintain medical records ...

Sheakley

RN Case Manager

Columbus, OH · On-site

Work closely with Utilization Review team in coordinating C-9 (treatment plan)/vocational rehab plans ongoing until completion * Assess quality and clinical risk issues on a concurrent basis; report ...

Sheakley

RN Case Manager

Columbus, OH · On-site

Work closely with Utilization Review team in coordinating C-9 (treatment plan)/vocational rehab plans ongoing until completion * Assess quality and clinical risk issues on a concurrent basis; report ...

Acadia Healthcare

Outpatient Navigator

Columbus, OH

$18.25 - $25/hr

Utilization Review/Management (UM) to secure necessary authorizations. Support with ongoing UM, as needed, including, but not limited to pre-certifications, renewal authorizations, denial appeals ...

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As of Jul 31, 2026, the average hourly pay for 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.
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Utilization Review jobs near you
A map of the United States highlighting the number of Utilization Review job openings by state according to ZipRecruiter. The image is accompanied by a detailed chart listing the number of Utilization Review job openings in each state, with California having the most at 2 and Hawaii the least at 0.

Specialist, Utilization Review

Lifepoint Health

Columbus, OH • On-site

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 14 days ago

LifePoint Health rating

6.0

Company rating: 6.0 out of 10

Based on 268 frontline employees who took The Breakroom Quiz

746th of 885 rated healthcare providers

Job description


Your experience matters
At Columbus Springs-East, we are committed to empowering and supporting a diverse and determined workforce who can drive quality, scalability, and significant impact across our hospitals and communities. In your role, you'll support those that are in our facilities who are interfacing and providing care to our patients and community members. We believe that our collective efforts will shape a healthier future for the communities we serve.
What we offer
Fundamental to providing great care is supporting and rewarding our team. In addition to your base compensation, this position also offers:
  • Comprehensive medical, dental, and vision plans, plus flexible-spending and health- savings accounts
  • Competitive paid time off and extended illness bank package for full-time employees
  • Income-protection programs, such as life, accident, critical-injury insurance, short- and long-term disability, and identity theft coverage
  • Tuition reimbursement, loan assistance, and 401(k) matching
  • Employee assistance program including mental, physical, and financial wellness
  • Professional development and growth opportunities

How you'll contribute
Utilization Review Specialist facilitates clinical reviews on all patient admissions and continued stays. UR analyzes patient records to determine legitimacy of admission, treatment, and length of stay and interfaces with managed care organizations, external reviewers and other payers. UR advocates on behalf of patients with substance abuse, dual diagnosis, psychiatric or emotional disorders to managed care providers for necessary treatment. UR contacts external case managers/managed care organizations for certification of insurance benefits throughout the patient's stay and assists the treatment team in understanding the insurance company's requirements for continued stay and discharge planning.
Qualifications and requirements
Education: Bachelor's degree required. Master's degree preferred.
Experience: Previous utilization review experience in a psychiatric healthcare facility preferred.
License: Current unencumbered clinical license strongly preferred.
Additional Requirements: CPR certification and Crisis Prevention Training (CPI) preferred
Essential Functions:
  • Displays knowledge of clinical criteria, managed care requirements for inpatient and outpatient authorization and advocates on behalf of the patient to secure coverage for needed service.
    Completes pre and re-certifications for inpatient and outpatient services. Reports appropriate denial, and authorization information to designated resource.
    Actively communicates with interdisciplinary team to acquire pertinent information and give updates on authorizations.
    Participate in treatment teams to ensure staff have knowledge of coverage and to collect information for communication with agencies.
    Works with DON to ensure documentation requirements are met.
    Ensure appeals are completed thoroughly and on a timely basis.
    Interface with managed care organizations, external reviews, and other payers.
    Communicate with physicians to schedule peer to peer reviews.
    Accurately report denials.

SUPERVISORY RESPONSIBILITIES:
Manage the work of others, including planning, assigning, scheduling and reviewing work, ensures quality standards. Responsible for hiring, terminating, training and developing, reviewing performance and administering corrective action for staff.
About Us
Columbus Springs - East is a 72 bed hospital located in Columbus, OH, and is part of Lifepoint Health, a diversified healthcare delivery network committed to making communities healthier® with acute care, rehabilitation, and behavioral health facilities from coast to coast. From your first day to your next career milestone-your experience matters
EEOC Statement
Columbus Springs - East is committed to providing Equal Employment Opportunities for all applicants and employees and complies with all applicable laws prohibiting discrimination against any employee or applicant for employment because of color, race, sex, age, religion, national origin, disability, genetic information, gender identity, sexual orientation, veterans' status or any other basis protected by applicable federal, state or local law.
About Us
Lifepoint Health is a leader in community-based care and driven by a mission of Making Communities Healthier. Our diversified healthcare delivery network spans 29 states and includes 63 community hospital campuses, 32 rehabilitation and behavioral health hospitals, and more than 170 additional sites of care across the healthcare continuum, such as acute rehabilitation units, outpatient centers and post-acute care facilities. We believe that success is achieved through talented people. We want to create places where employees want to work, with opportunities to pursue meaningful and satisfying careers that truly make a difference in communities across the country.
About the Team
We employ and provide care to people from all walks of life. We are committed to promoting healing, providing hope, preserving dignity and producing value with an inclusive workforce in which diversity is leveraged, respected, and reflective of the patients, family members, customers and team members we serve.

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About LifePoint Health

Sourced by ZipRecruiter

Lifepoint Health serves patients, clinicians, communities and partners across the healthcare continuum. Our diversified healthcare delivery network extends from coast to coast, consisting of community hospitals, rehabilitation and behavioral health hospitals, and additional sites of care.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Brentwood, TN, US

Year founded

1999

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