UR contacts external case managers/managed care organizations for certification of insurance ... Previous utilization review experience in a psychiatric healthcare facility preferred. License:
UR contacts external case managers/managed care organizations for certification of insurance ... Previous utilization review experience in a psychiatric healthcare facility preferred. License:
UR contacts external case managers/managed care organizations for certification of insurance ... Previous utilization review experience in a psychiatric healthcare facility preferred. License:
UR contacts external case managers/managed care organizations for certification of insurance ... Previous utilization review experience in a psychiatric healthcare facility preferred. License:
Conducts utilization reviews of behavioral health cases to determine medical necessity ... Assists with retrospective reviews and denial management to maintain appropriate and cost-effective ...
Conducts utilization reviews of behavioral health cases to determine medical necessity ... Assists with retrospective reviews and denial management to maintain appropriate and cost-effective ...
Drug Utilization Review Pharmacist - Ensure Safe and Effective Use of Medications A confidential managed care organization is seeking a skilled Drug Utilization Review (DUR) Pharmacist to support ...
Drug Utilization Review Pharmacist - Ensure Safe and Effective Use of Medications A confidential managed care organization is seeking a skilled Drug Utilization Review (DUR) Pharmacist to support ...
Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Healthcare members ...
Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Healthcare members ...
Utilization Review LVN/RN
Columbus, OH · On-site
Well versed in Utilization Management - Must be able to determine elective vs urgent request with Prior Authorization Review * Provider Claims, Appeals and Denials - certain services require prior ...
Utilization Review LVN/RN
Columbus, OH · On-site
Well versed in Utilization Management - Must be able to determine elective vs urgent request with Prior Authorization Review * Provider Claims, Appeals and Denials - certain services require prior ...
SUMMARY The Utilization Management Specialist is responsible for coordinating and managing all ... Monitors and reviews MCO portals to track authorization status, pending requests, approvals ...
Quick apply
SUMMARY The Utilization Management Specialist is responsible for coordinating and managing all ... Monitors and reviews MCO portals to track authorization status, pending requests, approvals ...
UR Coordinator, Full Time
$24 - $32/hr
Experience in utilization review, case management, medical records, or healthcare billing strongly preferred * Strong understanding of insurance authorization processes (Medicare, Medicaid, and ...
UR Coordinator, Full Time
$24 - $32/hr
Experience in utilization review, case management, medical records, or healthcare billing strongly preferred * Strong understanding of insurance authorization processes (Medicare, Medicaid, and ...
UR/UM) 50% Provides Direct Supervision of care managers, social workers, utilization review case managers, extenders, supervisors and ancillary support staff at locations as applicable. 1. ...
UR/UM) 50% Provides Direct Supervision of care managers, social workers, utilization review case managers, extenders, supervisors and ancillary support staff at locations as applicable. 1. ...
UR/UM) 50% Provides Direct Supervision of care managers, social workers, utilization review case managers, extenders, supervisors and ancillary support staff at locations as applicable. 1. ...
UR/UM) 50% Provides Direct Supervision of care managers, social workers, utilization review case managers, extenders, supervisors and ancillary support staff at locations as applicable. 1. ...
Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Healthcare members ...
Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Healthcare members ...
UR Manager
Columbus, OH · On-site
For billing and hospitalization utilization review purposes, the reviewer will identify and certify ... Maintain compliancy with regulation changes affecting utilization management. PositionRequirements ...
UR Manager
Columbus, OH · On-site
For billing and hospitalization utilization review purposes, the reviewer will identify and certify ... Maintain compliancy with regulation changes affecting utilization management. PositionRequirements ...
High School Diploma/GED Required Experience: 0-2 years of experience in a Utilization Review Department in a Managed Care Environment. Previous Hospital or Healthcare clerical, audit or billing ...
High School Diploma/GED Required Experience: 0-2 years of experience in a Utilization Review Department in a Managed Care Environment. Previous Hospital or Healthcare clerical, audit or billing ...
Helping to manage an over $ 7million/ year hospital utilization contract * Reviewing necessary medical record reviews and making a determination on hospital appeals. * Supervising and training RNs, ...
Helping to manage an over $ 7million/ year hospital utilization contract * Reviewing necessary medical record reviews and making a determination on hospital appeals. * Supervising and training RNs, ...
Outpatient Navigator
$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 ...
Outpatient Navigator
$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 ...
Helping to manage an over $ 7million/ year hospital utilization contract * Reviewing necessary medical record reviews and making a determination on hospital appeals. * Supervising and training RNs, ...
Helping to manage an over $ 7million/ year hospital utilization contract * Reviewing necessary medical record reviews and making a determination on hospital appeals. * Supervising and training RNs, ...
Serve as the primary clinical administrator for Case Management/ Utilization Review applications such as: * MCG- Milliman Care Guidelines * R1- Physician Advisor * Payer Portal Administrator
New
Serve as the primary clinical administrator for Case Management/ Utilization Review applications such as: * MCG- Milliman Care Guidelines * R1- Physician Advisor * Payer Portal Administrator
New
RN Case Manager
Columbus, OH · On-site
Work closely with Utilization Review team in coordinating C-9 (treatment plan)/vocational rehab ... Case Management Team Lead * Assess documentation of medical records for completeness on a ...
Quick apply
RN Case Manager
Columbus, OH · On-site
Work closely with Utilization Review team in coordinating C-9 (treatment plan)/vocational rehab ... Case Management Team Lead * Assess documentation of medical records for completeness on a ...
RN Case Manager
Columbus, OH · On-site
Work closely with Utilization Review team in coordinating C-9 (treatment plan)/vocational rehab ... Case Management Team Lead * Assess documentation of medical records for completeness on a ...
Quick apply
RN Case Manager
Columbus, OH · On-site
Work closely with Utilization Review team in coordinating C-9 (treatment plan)/vocational rehab ... Case Management Team Lead * Assess documentation of medical records for completeness on a ...
Serve as the primary clinical administrator for Case Management/ Utilization Review applications such as: * MCG- Milliman Care Guidelines * R1- Physician Advisor * Payer Portal Administrator
New
Quick apply
Serve as the primary clinical administrator for Case Management/ Utilization Review applications such as: * MCG- Milliman Care Guidelines * R1- Physician Advisor * Payer Portal Administrator
New
Utilization Review Manager information
See salary details
$39K - $50.7K
9% of jobs
$59.3K is the 25th percentile. Wages below this are outliers.
$50.7K - $62.4K
22% of jobs
$62.4K - $74K
11% of jobs
The median wage is $81.2K / yr.
$74K - $85.7K
14% of jobs
$85.7K - $97.4K
12% of jobs
$104.7K is the 75th percentile. Wages above this are outliers.
$97.4K - $109.1K
13% of jobs
$109.1K - $120.8K
13% of jobs
$120.8K - $132.5K
5% of jobs
$132.5K - $144.1K
2% of jobs
$144.1K - $155.8K
0% of jobs
$155.8K - $167.5K
0% of jobs
$39K
$91K
$167.5K
How much do utilization review manager jobs pay per year?
As of Aug 2, 2026, the average yearly pay for utilization review manager in the United States is $91,011.00, according to ZipRecruiter salary data. Most workers in this role earn between $59,500.00 and $109,500.00 per year, depending on experience, location, and employer.
What are popular job titles related to Utilization Review Manager jobs? For Utilization Review Manager jobs, the most frequently searched job titles are:
- Full Time Optum Health Utilization Review
- Full Time Physician Advisor Utilization Review
- Flexible Cvs Utilization Management Nurse
- Evening Optum Health Utilization Review
- Remote Utilization Management
- Freelance Utilization Review Nurse
- Part Time Utilization Review Nurse
- Flex Schedule Remote Utilization Review Nurse
- Utilization Review Physician
- No Experience Utilization Review Nurse
What job categories do people searching Utilization Review Manager jobs look for? The top searched job categories for Utilization Review Manager jobs are:
- Discharge Planner Utilization Review
- Psychiatric Utilization Review
- Aetna Utilization Review Nurse
- Full Time Weekend Utilization Review
- Utilization Review
- Remote Aetna Utilization Review Nurse
- Seasonal Remote Utilization Review
- Utilization Review Supervisor
- Temporary Aetna Utilization Review Nurse
- Authorization Utilization Review Bcba
What cities are hiring for Utilization Review Manager jobs? Cities with the most Utilization Review Manager job openings:
What states have the most Utilization Review Manager jobs? States with the most job openings for Utilization Review Manager jobs include:
What are the most commonly searched types of Utilization Review jobs? The most popular types of Utilization Review jobs are:
Full-time
Medical, Dental, Vision, Retirement, PTO
Re-posted 16 days ago
LifePoint Health rating
6.0
Based on 270 frontline employees who took The Breakroom Quiz
748th of 887 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.
What LifePoint Health employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom
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