Utilization Management Reviewer/UKHC

Job Title
Utilization Management Reviewer/UKHC

Requisition Number
RE51849

Working Title
Utilization Management Reviewer

Department Name
H4025:Revenue Integrity

Work Location:
Lexington, KY

Grade Level
11

Salary Range
$54,080-95,056/year

Type Of Position
Staff

Position Time Status
Full-Time

Required Education
ADN

Click here for more information about equivalencies::

Required Related Experience
5 yrs

Required License/Registration/Certification
Registered Nurse (RN)

Physical Requirements
The physical conditions of this position include; regularly sitting at a computer workstation for extended periods of time with repetitive motions (such as typing); occasionally lifting, pushing, and/or pulling objects up to 10lbs

Shift
Night shift weekdays, weekends and holidays.

Job Summary
This position works as a member of the multidisciplinary team with social workers, patient care facilitators, financial counselors, and ancillary staff to actively manage and coordinate those functions associated with third party payer certification, appropriate utilization of health services, and some aspects of discharge planning.

This is a hybrid position.

There is an internal candidate being

Skills / Knowledge / Abilities
The ideal candidate will possess strong interpersonal, leadership, organizational, and written/verbal communication skills. General knowledge of criteria for accessing appropriate utilization of resources in the hospital is necessary. Exceptional planning and organizational skill. Effective written and verbal communication skills. General knowledge of criteria utilized by third party payers for admission and continued stay authorizations is necessary. General knowledge of Medicare, Medicaid, and third party payer reimbursement issues is necessary.

Does this position have supervisory responsibilities? :
No

Preferred Education/Experience
ADN with 5 years direct patient care experience.

Deadline To Apply
01/15/2026

Our University Community
We value the well-being of each of our employees and are dedicated to creating a healthy place for everyone to work, learn and live. In the interest of maintaining a safe and healthy environment for our students, employees, patients and visitors, the University of Kentucky is a Tobacco & Drug Free campus.

The University follows both the federal and state Constitutions as well as all applicable federal and state laws on nondiscrimination. The University provides equal opportunities for qualified persons in all aspects of institutional operations and does not discriminate on the basis of race, color, national origin, ethnic origin, religion, creed, age, physical or mental disability, veteran status, uniformed service, political belief, sex, sexual orientation, gender identity, gender expression, pregnancy, marital status, genetic information or social or economic status.

Any candidate offered a position may be required to pass pre-employment screenings as mandated by University of Kentucky Human Resources. These screenings may include a national background check and/or drug screen.