Utilization Review Coordinator
Fuller Hospital
Utilization Review Coordinator Opportunity - Fuller Hospital is a 109-bed licensed, private psychiatric facility located in South Attleboro, Massachusetts providing inpatient and outpatient behavioral health services to residents of Massachusetts and Rhode Island. Inpatient units are designed to treat adults with general psychiatric or intellectual disabilities, as well as adolescents with general psychiatric issues. Patients with co-occurring psychiatric and substance abuse disorders can be treated on most units. Fuller Hospital also provides a less intensive Partial Hospitalization Program (PHP) to patients with psychiatric and co-occurring psychiatric and substance abuse disorders. The Utilization Review Coordinator is responsible for monitoring the effective and efficient use of health care resources by review of patient admission and continued stay appropriateness in all programs of the hospital. They interact with outside agencies, third party payers, and managed care companies in accordance with contractual agreements, acting as a patient advocate and a representative of the hospital. This is a full time, 40 hour per week position. Responsibilities Thoroughly reviews the patient’s medical record, assesses the medical necessity for all admissions based on DSM-IV and hospital criteria Reviews the patient’s treatment through the course of hospitalization to ensure appropriateness of care Documents criteria and reviews findings according to established policy, procedure, and protocols Performs other duties as assigned/required by this position Benefit Highlights Student Loan Repayment - $200 per month Tuition Reimbursement - $5,000 per year Challenging and rewarding work environment Competitive Compensation & Generous Paid Time Off (26 days per year + roll over) Excellent Medical, Dental, Vision and Prescription Drug Plans 401(K) with company match and discounted stock plan SoFi Student Loan Refinancing Program Career development opportunities within UHS and its 300+ Subsidiaries! Supervision for Licensure More information is available on our Benefits Guest Website: benefits.uhsguest.com About Universal Health Services Headquartered in King of Prussia, PA, Universal Health Services, Inc. (NYSE: UHS) is one of the nation’s largest and most respected providers of hospital and healthcare services. Since our founding in 1979, UHS has grown steadily into a premier Fortune 500® corporation perennially recognized by multiple esteemed national rating entities. Through its subsidiaries, UHS operates inpatient acute care facilities, inpatient behavioral health facilities, outpatient and other facilities, nationwide virtual behavioral health services, an insurance offering, a physician network and various related services with physical locations in the U.S., Puerto Rico, Ireland and United Kingdom. From Fortune, ©2025, 2026 Fortune Media IP Limited. All rights reserved. Used under license. Qualifications Requirements Licensure: Current Massachusetts licensure as a RN, LCSW, LICSW, or LMHC Experience: One (1) or more years of experience in utilization management, insurance, and/or HMO organization Knowledge: Must be able to demonstrate knowledge and skills necessary to provide interventions appropriate to the age of the patients with whom they interact; Demonstrate knowledge of the principles of growth and development over the lifespan, possess the ability to assess data reflective of the patient’s status, and interpret the appropriate information needed to identify each patient’s requirements relative to their age specific needs. EEO Statement All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. #J-18808-Ljbffr Fuller Hospital
$55k - $75k
...a sanctuary for women to focus on healing and help prepare them for fulfilling, post-treatment lives. We are seeking a Utilization Review Coordinator to add to our dynamic team. The Utilization Review Coordinator plays a critical role in ensuring that healthcare services...SuggestedFull timePart timeWork at officeRemote work$18 - $20 per hour
PRIMARY PURPOSE To assign utilization review requests; to verify and enter data in appropriate system(s); and to provide general support to clinical staff in a team environment. ARE YOU AN IDEAL CANDIDATE? We are looking for enthusiastic candidates who thrive in a collaborative...SuggestedWork at officeLocal areaFlexible hours- Beyond Blue Job Posting Title: Supervisor, Utilization Review Requisition Number: R-000003688 Department Name: Director, Utilization Review... ...develops staff to achieve performance and quality goals. Coordinates with physicians, payers and interdisciplinary teams to support...SuggestedFull timePart timeWork experience placementReliefInternshipShift work
- ...University of South Alabama Health System seeks an experienced Registered Nurse for Utilization Review to perform quality reviews, prior authorizations, and discharge planning. The role collaborates with physicians and care teams to ensure compliant, timely patient care...Suggested
$110k
...patient needs are met and care delivery is coordinated across the continuum. Identifies and... ...time frame and with the most efficient utilization of resources. Carries out activities... ...appropriate documentation for justification. Reviews the patient’s plan of care in...SuggestedDaily paidFull timePart timeFlexible hoursShift work- ...a continuum of specialty programs throughout our inpatient, partial and outpatient services. The Utilization Management Coordinator performs timely, daily clinical reviews with all payer types, to secure authorization for initial and continued treatment based on payer’...Full timeLocal areaShift workDay shift
- ...Mesa Springs in Fort Worth, TX is seeking a dedicated Utilization Review Specialist to ensure appropriate inpatient and outpatient authorizations... ...and care teams. You will apply clinical criteria, coordinate with managed care organizations, complete pre- and post-certifications...
- ...coast. We are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. As a Utilization Review Specialist joining our team, you're embracing a vital mission dedicated to making communities healthier. Join us on this...Temporary workPart timeRelief
- ...Utilization Review Specialist – North Little Rock, AR (72113) Are you an experienced healthcare professional looking for an opportunity to make a difference in patient care management? We’re seeking a Utilization Review Specialist to join our team in North Little Rock...Work at office
$21.7 - $27 per hour
Job Description A bit about this role: The Utilization Management Coordinator plays a vital role in supporting Clinical Operations by managing the intake... ...-related inquiries across multiple case types Review member inpatient status and clinical documentation to support...Full timeContract workInternshipWork at officeRemote workMonday to FridayShift workWeekend work- Lakeside Behavioral Health System in Memphis, TN seeks an UM Coordinator who can assess psychiatric diagnoses, determine appropriate level of care, and advocate for patient length of stay and benefits. You’ll work with hospital teams and insurers to optimize reimbursement...
- ...RN - Utilization ReviewDuties:1 year of non-acute utilization review experience - required RN experience - preferred This is the pay range that RightSourcing (a part of Magnit) reasonably expects to pay someone for this position, however, as a supplier your expected pay...
$55 - $65 per hour
...Registered Nurse With Utilization Review Experience A healthcare organization is seeking a Registered Nurse with utilization review experience to support non-acute clinical review activities. This contract opportunity is based in the Queens, NY area and requires an...Hourly payContract work- ...an "as-needed" basis. POSITION SUMMARY: Performs clinically orientated medical chart reviews and other administrative tasks to meet the requirements of the medical center's utilization review plan, state and federal regulations, insurance company requirements for reimbursement...Hourly payDaily paidWork experience placement
$25 - $30 per hour
...better experience for physicians and their patients. As a UM Coordinator, you will work closely with our Ambulatory and Concurrent Care... ...requesting information or assistance related to authorizations. Review authorization requests per established level of review...Work at officeLocal areaFlexible hours- ...Care Center of Augusta is seeking a dedicated, compassionate Utilization Review Nurse, RN to add to our growing team. Lighthouse Care... ...authorization is achieved Utilization Review/Business Office Coordinator will ensure input of pre-certifications and continued stay...Work at officeLocal area
- ...Moffitt Cancer Center in Tampa, FL seeks an Utilization Review Nurse to perform initial, concurrent, and retrospective reviews ensuring medical necessity and appropriate care levels. You will collaborate with case management, physician advisers, providers, and payers...
- ...: Sentara Health Plans Community Care is looking to hire a Utilization Review Nurse. The Utilization Review Nurse is responsible for utilization... ...requiring authorization. Conducts pre-certification, care coordination for appropriateness of treatment, set reviews to ensure...Temporary workRemote workShift work
- RN - Utilization Review Shift: 5 Day Shifts X 8 Hrs Start Date: 09/21/2026 End Date: 11/14/2026 Duration: 8 Week(s) City: East Elmhurst State: NY TALENTShift workDay shift
- ...every day. Job Description: Position Summary and Purpose The Utilization Review RN performs activities which support the Utilization... ...patients are cared for in the most appropriate level of care; coordinates care in conjunction with other members of the interdisciplinary...Work at officeShift work
- ...responsible to facilitate effective resource coordination to help patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patient’s... ...and submits admission and concurrent reviews to payers, securing authorizations and identifying...Local areaRelocation packageFlexible hours
- ...Position Summary: The RN Integrated Care Coordinator (UM) provides comprehensive care coordination services and is responsible for... ...member care. Rotating weekend hours are required to address utilization review cases. Roles and Responsibilities Prepares clinical reviews...Live inRemote workFlexible hoursWeekday work
- ...The Utilization Review Nurse gathers demographic and clinical information on prospective, concurrent and retrospective in-patient admissions and out-patient treatment, certifies the medical necessity and assigns an appropriate length of stay while supporting the goals...Minimum wageWork at officeLocal areaRemote workFlexible hours
$77.08k - $119.47k
## Utilization Review NurseApplylocations: 43 New Scotland Avenue Albany, NY 12208time type: Full timeposted on: Posted Todayjob requisition id: 71163Department/Unit:Care Management/Social WorkWork Shift:Day (United States of America)Salary Range:$77,075.00 - $119,466....Shift work- ## Utilization Review NurseApplyremote type: Hybridlocations: 1301 6th Ave W - BRADENTON, FLposted on: Posted Todayjob requisition id: JR114100## # About AcrisureA global fintech leader, Acrisure empowers millions of ambitious businesses and individuals with the right...Work at officeImmediate startRemote workFlexible hours2 days per week
$88.85k
...-income communities and residents and to support the safety net required to achieve that purpose. Job Summary The Utilization Management (UM) Claims Review Nurse RN II is responsible for conducting clinical review of medical claims to ensure services were medically necessary...Full time- MarinHealth is seeking a Utilization Review Nurse II to perform admission, concurrent and retrospective reviews for designated health plans... ...Health Records. In this role you will assess clinical stability, coordinate transfers for continued care, and collaborate with a...
- Permit & Utility Clerk TYPE: Full Time HOURS: Typically M-F 8:00 to 5:00 BENEFITS: Full REPORTS TO: City Administrator & Public Works... ..., spreadsheets, correspondence, messages, emails, faxes Coordinate all facets of required state and local compliance reports (TCEQ...Full timeWork at officeLocal area
$55.27k - $62.8k
STV has immediate needs for Utility Coordinators in the Asheville, NC area to oversee utility coordination and relocations for NCDOT and Municipal projects. The work comprises of managing various resources to determine utility conflicts and subsequent utility relocations...Contract workFor contractorsWork experience placementInternshipWork at officeLocal areaImmediate startRelocationFlexible hoursNight shift- ...Comagine Health seeks Clinical Utilization Review Nurses (RN) to assess medical necessity and quality of care through prospective, concurrent, and retrospective reviews. This full-time, remote position requires Alabama licensure and focuses on compliant, cost-effective...Full timeContract workRemote work
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