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Anthem Utilization Review Jobs (NOW HIRING)

Red Rocks

Wound and Skin Health Team Lead, RN

Gallup, NM · On-site

$43.50 - $49.50/hr

Lead the team review of all new patient admissions and readmissions for skin integrity needs ... Collaborate to ensure appropriate product utilization and support the nursing process for ...

Rohrer

2nd Shift Pre-Stage Technician

Huntley, IL · On-site

$20 - $22/hr

Review and maintain any required logs, check sheets, inspection sheets, and work orders. * Strong ... Demonstrated ability for maintaining maximum utilization/up time on machinery in assigned areas.

BRMS

Client Manager I

Sacramento, CA · On-site

Respond to Anthem Blue Cross Utilization Management update requests * Appropriately escalate issues ... Review daily and monthly reports, transactions, and trends, and provide feedback to team members ...

BRMS

Client Manager I

Folsom, CA · On-site

$25 - $27/hr

Respond to Anthem Blue Cross Utilization Management update requests * Appropriately escalate issues ... Review daily and monthly reports, transactions, and trends, and provide feedback to team members ...

BRMS Online

Client Manager I

Folsom, CA · On-site

$25 - $27/hr

Respond to Anthem Blue Cross Utilization Management update requests * Appropriately escalate issues ... Review daily and monthly reports, transactions, and trends, and provide feedback to team members ...

BRMS Online

Client Manager I

Folsom, CA · On-site

Respond to Anthem Blue Cross Utilization Management update requests * Appropriately escalate issues ... Review daily and monthly reports, transactions, and trends, and provide feedback to team members ...

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Anthem Utilization Review information

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How much do anthem utilization review jobs pay per hour?

As of Jul 2, 2026, the average hourly pay for anthem 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 is an Anthem Utilization Review job?

An Anthem Utilization Review job involves assessing medical services and treatments to ensure they are necessary, cost-effective, and aligned with insurance policies. Professionals in this role review patient records, apply clinical guidelines, and collaborate with healthcare providers to determine coverage eligibility. They help prevent unnecessary procedures while supporting quality patient care. This position typically requires a healthcare background, such as nursing or case management, along with knowledge of insurance regulations and medical necessity criteria.

What does a typical day look like for someone in an Anthem Utilization Review role?

A typical day in an Anthem Utilization Review position involves evaluating medical records and authorization requests to determine if healthcare services meet established criteria for coverage. You’ll collaborate frequently with healthcare providers, case managers, and internal teams to clarify clinical information and help guide appropriate care pathways. The job is largely desk-based and requires strong organizational skills to manage multiple concurrent cases and meet tight deadlines. Most professionals in this role work within a team structure, sharing best practices and supporting each other in making objective, evidence-based decisions. This dynamic environment offers exposure to a variety of healthcare scenarios and opportunities for ongoing learning in utilization management.

What are the key skills and qualifications needed to thrive in the Anthem Utilization Review position, and why are they important?

To thrive as an Anthem Utilization Review professional, you need a background in nursing or healthcare, strong analytical abilities, and familiarity with medical terminology and insurance guidelines. Experience with clinical documentation systems, review software, and URAC or NCQA certifications are commonly required. Excellent communication, critical thinking, and attention to detail are crucial soft skills in this position. These capabilities ensure accurate review of medical necessity, effective collaboration with providers, and regulatory compliance, which are vital for quality patient outcomes and cost management.

More about Anthem Utilization Review jobs
What cities are hiring for Anthem Utilization Review jobs? Cities with the most Anthem Utilization Review job openings:
What are the most commonly searched types of Anthem Utilization Review jobs? The most popular types of Anthem Utilization Review jobs are:
What states have the most Anthem Utilization Review jobs? States with the most job openings for Anthem Utilization Review jobs include:
What job categories do people searching Anthem Utilization Review jobs look for? The top searched job categories for Anthem Utilization Review jobs are:
Anthem Utilization Review jobs near you
Infographic showing various Anthem Utilization Review job openings in the United States as of June 2026, with employment types broken down into 100% Full Time. Highlights an 94% In-person, and 6% Hybrid job distribution, with an average salary of $87,946 per year, or $42.3 per hour.
Physician Internal Medicine - Competitive Salary

Physician Internal Medicine - Competitive Salary

RecruitWell

Sacramento, CA • On-site

$230K - $300K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 6 days ago

Job description

Associate Medical Director – Primary Care Physician – Sacramento, CaliforniaFQHC Setting

Clinical Role:

  • Do you know someone that might be a good fit for this position? Please ask about our generous referral fees!
  • Permanent, full-time opportunity
  • Associate Medical Director role within a mission-driven, multi-site FQHC
  • Outpatient-only practice setting
  • Open to Family Medicine or Internal Medicine trained physicians
  • Maintain advanced clinical expertise aligned with current Family Practice standards and guidelines
  • Collaborate with the Chief Medical Officer on clinician performance, peer review, and strategic initiatives
  • Assist with annual evaluations and quality improvement efforts for clinicians and clinic sites
  • Help develop and improve clinical workflows, policies, procedures, and EHR templates
  • Monitor referral utilization and help standardize specialty referral processes
  • Provide comprehensive outpatient primary care including acute, chronic, and preventive services
  • Deliver patient-centered, culturally sensitive care and patient education
  • Collaborate closely with clinic staff to support care coordination and patient engagement
  • Maintain productivity, quality, and fiscal performance goals
  • Timely completion of patient messaging, clinical documentation, and billing responsibilities required
  • Participate in meetings, continuing education, and leadership initiatives
  • Allow RecruitWell to set up a phone call with you and the client to discuss more!

Compensation & Benefits:

  • Compensation range approximately $230,880 – $300,144 annually depending on experience and qualifications
  • Medical, dental, and vision insurance available through Anthem Blue Cross PPO plans
  • 403(b) retirement plan with up to 4% employer match and immediate vesting
  • Up to 4 weeks PTO during the first year plus paid holidays and floating holiday
  • CME reimbursement plus paid CME time included
  • Tuition reimbursement available after one year of service
  • Employer-paid malpractice and tail coverage
  • Flexible Spending Accounts and additional voluntary benefits available
  • Strong work-life balance and supportive practice environment

Organization Information:

  • Mission-driven multi-site FQHC serving the Sacramento community
  • Collaborative and supportive leadership team
  • Focus on improving access to high-quality community healthcare
  • Emphasis on teamwork, accountability, and culturally sensitive patient care
  • Stable and growing outpatient healthcare organization

Area Information:Sacramento offers a unique combination of metropolitan amenities, outdoor recreation, and a lower cost of living compared to many California cities. The region is known for its diverse population, excellent restaurants, local farmers markets, and proximity to Napa Valley, Lake Tahoe, and San Francisco. Residents enjoy year-round outdoor activities including hiking, biking, boating, skiing, and wine country excursions. Sacramento has a growing healthcare and academic community along with vibrant arts, entertainment, and professional sports offerings. The city’s warm climate, family-friendly neighborhoods, and central Northern California location continue to attract healthcare professionals from across the country.

RecruitWell’s Core Values:

  • Open communication
  • Sense of urgency
  • Teamwork
  • Accountability
  • Driven to win
  • Higher consciousness
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About RecruitWell

Sourced by ZipRecruiter

RecruitWell is a prestigious entity operating in the recruitment and staffing industry, based out of Boynton Beach, FL, US. Its main focus is on global recruitment, providing both temporary and permanent staffing solutions. The company's primary mission is to provide the right talent to healthcare facilities while ensuring the satisfaction of healthcare professionals. Established with a vision to change the recruitment landscape for healthcare professionals, RecruitWell has been successful in establishing itself as a trusted name in the industry.

Industry

Recruiting and staffing services

Company size

11 - 50 Employees

Headquarters location

Boynton Beach, FL, US

Year founded

2019

Social media

Facebook

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