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Contract Utilization Review Jobs (NOW HIRING)

Genesis HealthCare

The Utilization Review (UR) Analyst is responsible for assuring insurance notification ... This includes preparing/distributing reports, contract maintenance, depart goals/report card ...

Bracane Co

Utilization Review Nurse

Plano, TX · Remote

Determines benefit levels in accordance to contract guidelines. * Provides information regarding ... Utilization management experience LOCATION: REMOTE in Texas ( Richardson area ? Dallas/Collin ...

tmn

Utilization Review Specialist

Akron, OH

$40.17K/mo

SUMMARY The Utilization Review Specialist is responsible for proactive planning measures, accurate ... Maintains knowledge of updated funding Rules and Contracts * Notifies internal stakeholders for any ...

VIVA USA INC

Utilization Review Nurse

Nashville, TN · On-site +1

$37.22 - $42.22/hr

Conduct reviews in compliance with medical policy, member eligibility, benefits, and contracts ... Responsible for the effective and sufficient support of all Utilization Management activities to ...

TEKsystems

Utilization Review Nurse

Bakersfield, CA

$51/hr

Position Overview The Utilization Review Nurse is responsible for coordinating care and ensuring ... Bilingual (English/Spanish) preferred Job Type & Location This is a Contract to Hire position based ...

New

tmn

Utilization Review Specialist

Akron, OH

$40.17K/mo

SUMMARY The Utilization Review Specialist is responsible for proactive planning measures, accurate ... Maintains knowledge of updated funding Rules and Contracts * Notifies internal stakeholders for any ...

Sevita

Utilization Review Specialist

Akron, OH · On-site

$40.17K/yr

SUMMARY The Utilization Review Specialist is responsible for proactive planning measures, accurate ... Maintains knowledge of updated funding Rules and Contracts * Notifies internal stakeholders for any ...

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How much do contract utilization review jobs pay per hour?

As of May 31, 2026, the average hourly pay for contract 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 a Contract Utilization Review job?

A Contract Utilization Review job involves analyzing and evaluating the usage of contracts to ensure compliance, cost-effectiveness, and efficiency. Professionals in this role review contract terms, monitor vendor performance, and assess utilization data to optimize contract value. They may work in industries such as healthcare, government, or procurement, ensuring that agreements are being properly executed. The goal is to identify areas for improvement, reduce waste, and enhance operational efficiency.

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

To thrive in Contract Utilization Review, you need a solid understanding of medical terminology, insurance policies, and contract compliance, often supported by a healthcare-related degree or certification in utilization management. Familiarity with utilization review software, electronic medical records (EMR), and knowledge of regulatory standards such as CMS guidelines is essential. Strong analytical thinking, attention to detail, and effective communication skills are crucial for collaborating with care teams and insurers. These abilities ensure reviews are accurate, contracts are properly administered, and patient care meets organizational and payer requirements.

What does a typical day look like for someone working in Contract Utilization Review?

A typical day in Contract Utilization Review involves reviewing patient medical records, ensuring adherence to payer contracts and regulatory standards, and communicating with healthcare providers to validate medical necessity of services. Professionals in this role often collaborate with clinical staff, case managers, and insurance representatives to resolve discrepancies or authorization issues. The work is detail-oriented and deadline-driven, making organizational skills vital. This dynamic position offers significant opportunities to learn more about healthcare regulations and may serve as a stepping stone toward more advanced roles in healthcare administration or compliance.
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What are the most commonly searched types of Utilization Review jobs? The most popular types of Utilization Review jobs are:
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Contract Utilization Review jobs near you
Infographic showing various Contract Utilization Review job openings in the United States as of May 2026, with employment types broken down into 78% Full Time, and 22% Part Time. Highlights an 100% In-person job distribution, with an average salary of $87,946 per year, or $42.3 per hour.
Utilization Review Nurse

Utilization Review Nurse

Healthcare Support Staffing

Troy, MI

Contractor

Posted yesterday

Job description

Company Description

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!

Job Description

Company: Molina Healthcare

Location: 880 Long Lake Rd Suite 600 Troy, Michigan 48098

Shift: Daytime hours

Employment: Contract: 1-2 months (possibility of going longer depending on business needs)


Company Job Description/Day to Day Duties:


Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Molina Healthcare members with the right care at the right place at the right time. Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review. Assesses services for Molina Members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines


Provider appeals and Utilization reviews and assist with Denial Letters 


Provides concurrent review and prior authorizations (as needed) according to Molina policy for Molina members as part of the Utilization Management team.

Identifies appropriate benefits, eligibility, and expected length of stay for members requesting treatments and/or procedures.

Participates in interdepartmental integration and collaboration to enhance the continuity of care for Molina members including Behavioral Health and Long Term Care. 

Qualifications

Minimum Education/Qualifications/Licensures:


Must be an RN 

Utilization Review background in either Managed Care of Provider environment (at least one year) 

Interqual experience 

Other basic computer skills necessary: Microsoft Office, Data Entry, etc. 

Minimum 2-4 years of clinical practice. Preferably hospital nursing, utilization management, and/or case management.

Also has a background in patient, skilled nurses facilities, rehab, and home healthcare.  

Additional Information

Apply now for immediate consideration. After applying, a recruiting consultant will contact you for pre-screening. Please provide your best phone number to contact.

Thanks and look forward to hearing from you!

Healthcare Support logo

About Healthcare Support

Sourced by ZipRecruiter

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!Healthcare Support Staffing, Inc. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.

Industry

Recruiting and staffing services

Company size

201 - 500 Employees

Headquarters location

Maitland, FL, US

Year founded

2003

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