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Anthem Utilization Review Jobs (NOW HIRING)

WestBridge Inc

IOP & PHP Therapist

Manchester, NH · On-site

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Collaborates as necessary with external billing company to support timely utilization reviews to ... Anthem Blue Cross Blue Shield health insurance * Ameritas dental insurance. * Delta vision ...

Westbridge, Inc.

IOP & PHP Therapist

Manchester, NH · On-site

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Collaborates as necessary with external billing company to support timely utilization reviews to ... Anthem Blue Cross Blue Shield health insurance * Ameritas dental insurance. * Delta vision ...

WestBridge Inc

IOP & PHP Therapist

Manchester, NH · On-site

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Collaborates as necessary with external billing company to support timely utilization reviews to ... Anthem Blue Cross Blue Shield health insurance * Ameritas dental insurance. * Delta vision ...

Keystone Advisors LLC

Prior Authorization Specialist

Matteson, IL · On-site

$17.75 - $23.75/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Reviews accounts, and initiate pre-authorizations, and other requirements related to managed care ... Assists in monitoring utilization services to assure cost effective use of medical resources ...

New

Keystone Advisors LLC

Prior Authorization Specialist

Matteson, IL · On-site

$17.75 - $23.75/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Reviews accounts, and initiate pre-authorizations, and other requirements related to managed care ... Assists in monitoring utilization services to assure cost effective use of medical resources ...

Elm Wood Center

Clinical Reimbursement Coordinator

Claremont, NH · On-site

$45 - $47/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Perform concurrent MDS review to insure appropriate RUGs category is achieved through the capture ... Experience with Medicare/Medicaid reimbursement, MDS completion, clinical resource utilization and ...

Red Rocks

Wound and Skin Health Team Lead, RN

Gallup, NM · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

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 ...

Red Rocks

Wound and Skin Health Team Lead, RN

Gallup, NM · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

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 ...

Red Rocks

Wound and Skin Health Team Lead, RN

Gallup, NM · On-site

$43.50 - $49.50/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

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 ...

Red Rocks

Wound and Skin Health Team Lead, RN

Gallup, NM · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

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 ...

Red Rocks

Wound and Skin Health Team Lead, RN

Gallup, NM

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

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 ...

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All JobsAnthem Utilization Review Jobs

Anthem Utilization Review information

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$42

$68

How much do anthem utilization review jobs pay per hour?

As of Aug 15, 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?

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 an Anthem Utilization Review do?

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 an Anthem Utilization Review?

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.

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Anthem Utilization Review jobs near you
Infographic showing various Anthem Utilization Review job openings in the United States as of August 2026, with employment types broken down into 87% Full Time, and 13% Part Time. Highlights an 91% In-person, and 9% Hybrid job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

Sr. Staff Performance Tuning Engineer - CPU PMU & Virtualization

NIO USA, INC

San Jose, CA

$192K - $249K/yr

Full-time

Re-posted 28 days ago

Job description

About NIO

NIO Inc. is a pioneer and a leading company in the global smart electric vehicle market. Founded in November 2014, NIO aspires to shape a sustainable and brighter future with the mission of “Blue Sky Coming”. NIO envisions itself as a user enterprise where innovative technology meets experience excellence.

NIO designs, develops, manufactures and sells smart electric vehicles, driving innovations in next-generation core technologies. NIO distinguishes itself through continuous technological breakthroughs and innovations, exceptional products and services, and a community for shared growth.

NIO provides premium smart electric vehicles under the NIO brand, premium smart electric vehicles for families through the ONVO brand, and small smart high-end electric cars with the FIREFLY brand.

Responsibilities

Performance Analysis and Optimization

  • Identify and analyze performance bottlenecks across CPU, memory hierarchy, cache, interconnect, and interrupt subsystems.
  • Leverage hardware PMU counters to measure and interpret cycles, instructions, cache misses, branch mispredictions, TLB misses, and stall cycles.
  • Compute and analyze performance metrics such as IPC, CPI, MPKI, memory bandwidth utilization, and stall breakdowns.
  • Optimize system software, applications, and drivers for throughput, latency, and performance determinism.

Virtualization Performance Tuning

  • Profile and reduce hypervisor overhead, including VM exits, interrupt injection, and stage-2 MMU translation costs.
  • Optimize vCPU placement strategies, huge page usage, and IRQ affinity for performance-sensitive workloads.
  • Analyze and tune virtio and IOMMU performance paths.
  • Investigate cross-core and cross-cluster latency issues, including IPI overhead and interrupt routing on ARM-based systems.

CPU PMU and Microarchitectural Analysis

  • Configure and interpret ARM PMUv3 and related vendor-specific performance monitoring extensions.
  • Apply Top-Down Microarchitecture Analysis (TMA) to identify frontend/backend bottlenecks.
  • Correlate PMU-derived metrics with kernel traces, source code paths, and system behavior.
  • Design and implement custom event sets tailored to workload-specific performance characterization.
Qualifications

Required Qualifications

  • Bachelor’s, Master’s, or Ph.D. in Computer Science, Electrical Engineering, or a related field.
  • 8+ years of experience in system performance engineering or related roles.
  • Strong understanding of computer architecture, including:
  • CPU pipelines, execution engines, and memory hierarchy
  • Interrupt architectures (e.g., GICv3/GICv4, APIC concepts)
  • MMU, virtual memory, and page table structures
  • Deep expertise with Linux performance tooling:
  • perf
  • eBPF / BCC / bpftrace
  • ftrace / trace-cmd
  • Proficiency in C/C++, Python, and shell scripting for performance tooling and automation.

Preferred Qualifications

  • Hands-on experience with ARM PMUv3 on Cortex-A55/A76/A78 or Neoverse platforms.
  • Experience with one or more virtualization stacks:
  • KVM/QEMU
  • Xen
  • seL4 or other RTOS/hypervisor environments
Benefits

Along with competitive pay, as a full-time NIO employee, you are eligible for the following benefits on the first day you join NIO:

  • Anthem Blue Cross, HSA, and Kaiser HMO medical plans with $0 for Employee Only Coverage.
  • Dental (including orthodontic coverage) and vision plan. Both provide options with a $0 paycheck contribution covering you and your eligible dependents.
  • Company Paid HSA (Health Savings Account) Contribution when enrolled in the High Deductible Anthem Blue Cross medical plan
  • Healthcare and Dependent Care Flexible Spending Accounts (FSA)
  • 401(k) with Brokerage Link option
  • Company paid Basic Life, AD&D, short-term and long-term disability insurance
  • Employee Assistance Program
  • Sick and Vacation time
  • 13 Paid Holidays a year
  • Paid Parental Leave for first 8 weeks at full pay (eligible after 90 days of employment with NIO)
  • Paid Disability Leave for first 6 weeks at full pay (eligible after 90 days of employment with NIO)
  • Voluntary benefits including: Voluntary Life and AD&D options for you, your spouse/domestic partner and dependent child(ren), pet insurance
  • Commuter benefits
  • Mobile Cell Phone Credit
  • Free lunch and snacks
  • Onsite gym
  • Employee discounts and perks program
Compensation
The US base salary range for this full-time position is $192,100.00 - $249,600.00.

  • Within the range, individual pay is determined by work location and additional factors, including job-related skills, experience, and relevant education or training.

  • Please note that the compensation details listed in US role postings reflect the base salary only. It does not include discretionary bonus, equity, or benefits.

We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.