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Quality Utilization Reviewer I

Children's of Alabama
Location 📍 Birmingham, United States
Posted 📅 June 19, 2026
Work Type ⏰ Full time

Position Overview

  • Job Summary The UR Reviewer 1 is responsible for performing inpatient admission, concurrent, and observation reviews based on pre-established criteria exclusively for Medicaid and commercial payers other than BCBS AL. Upon successful completion of training by UR Reviewer 2 and with approval of UM Manager & Department Director, UR Reviewer 1 with RN licensure may advance to Nurse Reviewer 2 (If position becomes available).
  • Education Graduate of an accredited School of Nursing or Social Work.
  • Experience 2 years experience in hospital setting or related field (i.e. 3rd party payer) Utilization review experience preferred.
  • Licensures, Certifications, and/or Registries Current AL licensure as LPN, RN or LCSW

  • Additional Information

    Main Campus Children's of Alabama

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    Job Details

    Employment Type
    Full time
    📊
    Category
    Engineers
    🏠
    Work Arrangement
    On-site
    📍
    Location
    Birmingham, United States