Utilization Review Specialist Job Summary: The Utilization Review (UR) Specialist is responsible for ensuring that clients receiving substance use disorder (SUD) treatment services meet clinical ...
Utilization Review Specialist Job Summary: The Utilization Review (UR) Specialist is responsible for ensuring that clients receiving substance use disorder (SUD) treatment services meet clinical ...
Previous utilization review experience in a psychiatric healthcare facility preferred. License: Current unencumbered clinical license strongly preferred. Additional Requirements: CPR certification ...
Previous utilization review experience in a psychiatric healthcare facility preferred. License: Current unencumbered clinical license strongly preferred. Additional Requirements: CPR certification ...
Previous utilization review experience in a psychiatric healthcare facility preferred. License: Current unencumbered clinical license strongly preferred. Additional Requirements: CPR certification ...
Previous utilization review experience in a psychiatric healthcare facility preferred. License: Current unencumbered clinical license strongly preferred. Additional Requirements: CPR certification ...
Conducts utilization reviews of behavioral health cases to determine medical necessity, appropriateness of care, and adherence to clinical guidelines. * Communicates with healthcare teams and third ...
Conducts utilization reviews of behavioral health cases to determine medical necessity, appropriateness of care, and adherence to clinical guidelines. * Communicates with healthcare teams and third ...
Care Review Nurse
Columbus, OH · On-site
Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Healthcare members ...
Care Review Nurse
Columbus, OH · On-site
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 ...
Monitors and reviews MCO portals to track authorization status, pending requests, approvals ... WORK ENVIRONMENT Standard office environment with occasional evenings/weekends for events. Hybrid ...
New
Quick apply
Monitors and reviews MCO portals to track authorization status, pending requests, approvals ... WORK ENVIRONMENT Standard office environment with occasional evenings/weekends for events. Hybrid ...
New
UR Coordinator, Full Time
Columbus, OH · On-site
$24 - $32/hr
About the Role RiverVista is seeking a detail-oriented and knowledgeable Utilization Review (UR) Coordinator to support clinical documentation, insurance authorization processes, and regulatory ...
UR Coordinator, Full Time
Columbus, OH · On-site
$24 - $32/hr
About the Role RiverVista is seeking a detail-oriented and knowledgeable Utilization Review (UR) Coordinator to support clinical documentation, insurance authorization processes, and regulatory ...
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 ...
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 ...
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 ...
Quick apply
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 ...
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 ...
Quick apply
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 ...
RN Case Manager - Prior Authorization
Columbus, OH · On-site
$30/hr
Utilization review, prior authorization, or managed care experience preferred. * Active OH RN Licensure * Experienced with either Interqual or Milliman Licenses/Certifications: Current RN, required.
RN Case Manager - Prior Authorization
Columbus, OH · On-site
$30/hr
Utilization review, prior authorization, or managed care experience preferred. * Active OH RN Licensure * Experienced with either Interqual or Milliman Licenses/Certifications: Current RN, required.
As aNetwork Performance/Utilization Manager, your primary responsibilitiesmay include: * Advise clients on network strategy, provider capacity,utilizationtrends, access challenges, and market ...
As aNetwork Performance/Utilization Manager, your primary responsibilitiesmay include: * Advise clients on network strategy, provider capacity,utilizationtrends, access challenges, and market ...
Utilization review and or discharge planning experience preferred * Excellent verbal and written communication skills * Excellent computer skills. * LMH is accredited by DNV and TJC, and as such, may ...
Utilization review and or discharge planning experience preferred * Excellent verbal and written communication skills * Excellent computer skills. * LMH is accredited by DNV and TJC, and as such, may ...
Utilization review and or discharge planning experience preferred * Excellent verbal and written communication skills * Excellent computer skills. * LMH is accredited by DNV and TJC, and as such, may ...
Utilization review and or discharge planning experience preferred * Excellent verbal and written communication skills * Excellent computer skills. * LMH is accredited by DNV and TJC, and as such, may ...
As aNetwork Performance/Utilization Manager, your primary responsibilitiesmay include: * Advise clients on network strategy, provider capacity,utilizationtrends, access challenges, and market ...
As aNetwork Performance/Utilization Manager, your primary responsibilitiesmay include: * Advise clients on network strategy, provider capacity,utilizationtrends, access challenges, and market ...
Utilization review and or discharge planning experience preferred * Excellent verbal and written communication skills * Excellent computer skills. * LMH is accredited by DNV and TJC, and as such, may ...
Utilization review and or discharge planning experience preferred * Excellent verbal and written communication skills * Excellent computer skills. * LMH is accredited by DNV and TJC, and as such, may ...
Utilization review and or discharge planning experience preferred * Excellent verbal and written communication skills * Excellent computer skills. * LMH is accredited by DNV and TJC, and as such, may ...
Quick apply
Utilization review and or discharge planning experience preferred * Excellent verbal and written communication skills * Excellent computer skills. * LMH is accredited by DNV and TJC, and as such, may ...
RN - Case Management
Dublin, OH · On-site
The Clinical Case Manager is responsible for utilization reviews, resource management, discharge planning, treatment plan management, and financial management, while also completing medical record ...
RN - Case Management
Dublin, OH · On-site
The Clinical Case Manager is responsible for utilization reviews, resource management, discharge planning, treatment plan management, and financial management, while also completing medical record ...
Inpatient Therapist, Behavioral Health
$56K - $76K/yr
Inpatient Therapist, Behavioral Health Full-time, Weekends Your experience matters Columbus Springs ... Works well with the interdisciplinary team including physicians, utilization review and nursing ...
Inpatient Therapist, Behavioral Health
$56K - $76K/yr
Inpatient Therapist, Behavioral Health Full-time, Weekends Your experience matters Columbus Springs ... Works well with the interdisciplinary team including physicians, utilization review and nursing ...
Weekend Utilization Review information
See salary details
$21.39 - $25.72
2% of jobs
$25.72 - $30.05
9% of jobs
$33.01 is the 25th percentile. Wages below this are outliers.
$30.05 - $34.38
21% of jobs
The median wage is $37.88 / hr.
$34.38 - $38.70
23% of jobs
$38.70 - $43.03
13% of jobs
$46.39 is the 75th percentile. Wages above this are outliers.
$43.03 - $47.36
10% of jobs
$47.36 - $51.68
8% of jobs
$51.68 - $56.01
5% of jobs
$56.01 - $60.34
5% of jobs
$60.34 - $64.66
2% of jobs
$64.66 - $68.99
2% of jobs
$21
$42
$68
How much do weekend utilization review jobs pay per hour?
As of Jul 30, 2026, the average hourly pay for weekend 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 are popular job titles related to Weekend Utilization Review jobs? For Weekend Utilization Review jobs, the most frequently searched job titles are:
- Evening Optum Health Utilization Review
- No Experience Utilization Review Nurse
- Full Time Physician Advisor Utilization Review
- Utilization Review Physician
- Weekend Physician Advisor Utilization Review
- Non Exempt No Experience Utilization Management Nurse
- Utilization Review Therapist
- Utilization Review Nurse
- Night Shift Remote Utilization Review Nurse
- Remote Chart Review Nurse
What job categories do people searching Weekend Utilization Review jobs look for? The top searched job categories for Weekend Utilization Review jobs are:
- Utilization Review 1099
- Utilization Review No Experience
- Psychiatric Utilization Review
- Remote Hca Utilization Review
- Lpn Utilization Review Work From Home
- Utilization Review
- Commission Authorization Utilization Review Bcba
- Nurse Practitioner Utilization Review
- Remote Aetna Utilization Review Nurse
- Remote Occupational Therapy Utilization Review
What cities are hiring for Weekend Utilization Review jobs? Cities with the most Weekend Utilization Review job openings:
What states have the most Weekend Utilization Review jobs? States with the most job openings for Weekend Utilization Review jobs include:
What are the most commonly searched types of Utilization Review jobs? The most popular types of Utilization Review jobs are:
Other
This job post has expired today. Applications are no longer accepted.
Job description
Position: Utilization Review Specialist
Job Summary: The Utilization Review (UR) Specialist is responsible for ensuring that clients receiving substance use disorder (SUD) treatment services meet clinical criteria for admission, continued stay, and discharge. This role supports compliance with payer requirements, maintains proper documentation, and collaborates with clinical and administrative teams to maximize reimbursement while ensuring high-quality, medically necessary care.
Reports to: VP of Revenue Cycle Management
Duties and Responsibilities:
Duties include, but are not limited to:
- Conduct initial and concurrent reviews to determine medical necessity using established criteria
- Submit authorization requests and clinical documentation to insurance providers in a timely manner
- Monitor authorizations and ensure services rendered align with approved levels of care
- Track and manage authorization expirations and initiate reauthorization requests as needed
- Review clinical records for completeness, accuracy, and compliance with payer and regulatory standards
- Ensure treatment plans, progress notes, and discharge summaries support medical necessity
- Provide feedback to clinical staff to improve documentation quality
- Maintain adherence to HIPAA and confidentiality regulations
- Serve as the primary liaison between the organization and insurance companies for utilization review matters
- Participate in peer-to-peer reviews when required
- Address denials by gathering supporting documentation and submitting appeals
- Stay current with payer guidelines and regulatory changes affecting SUD services
- Collaborate with clinical, admissions, billing, and case management teams to ensure continuity of care and proper utilization of services
- Participate in multidisciplinary team meetings to discuss patient progress and level-of-care needs
- Communicate authorization status and payer requirements to relevant staff
- Maintain accurate records of authorizations, denials, and appeals
- Track utilization metrics and identify trends to improve efficiency and reimbursement
- Participate in audits and quality assurance initiatives
- Perform other duties as assigned
Required Experience/Abilities:
- Bachelor's degree in behavioral health, nursing, social work, or a related field required.
- Knowledge of ASAM Criteria required
- Minimum of 1 year of experience in utilization review, case management, or clinical services within behavioral health or SUD treatment
- Experience working with commercial insurance, Medicaid, and/or Medicare preferred
- Familiarity with electronic health record (EHR) systems
- Must pass BCI check, all Corporate Compliance checks, and employment drug screen
Desired Experience/Abilities:
- Master's degree or clinical licensure (e.g., LSW, LPC, LCSW, RN) preferred.3 years in a supervisory or management role within a behavioral health setting
- Working knowledge of CPT and ICD-10 coding systems, with relevant certification (e.g., CPC, CCS-P) or equivalent experience
- Understanding of medical necessity criteria, including experience with InterQual and/or Milliman (MCG) guidelines
Location: Columbus, OH
About Lighthouse Behavioral Health Solutions
Sourced by ZipRecruiter
Industry
Offices of mental health practitioners
Company size
201 - 500 Employees
Headquarters location
Columbus, OH, US
Year founded
2018