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How much do contract utilization review jobs pay per hour?

As of Aug 25, 2026, the average hourly pay for contract utilization review in California is $41.73, according to ZipRecruiter salary data. Most workers in this role earn between $32.98 and $47.93 per hour, depending on experience, location, and employer.

What is a contract utilization review?

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 does a contract utilization review do?

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.

What are the key skills and qualifications needed to thrive in contract utilization review?

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 are the most commonly searched types of Utilization Review jobs in California?

The most popular types of Utilization Review jobs in California are:

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For Contract Utilization Review jobs in California, the most frequently searched job titles are:

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The top searched job categories for Contract Utilization Review jobs in California are:

What cities in California are hiring for Contract Utilization Review jobs?

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Contract Utilization Review jobs near you
Infographic showing various Contract Utilization Review job openings in California as of August 2026, with employment types broken down into 1% As Needed, 86% Full Time, 10% Part Time, 2% Contract, and 1% Nights. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $86,795 per year, or $41.7 per hour.

UTILIZATION MANAGEMENT COORDINATOR II MSO

NORTH EAST MEDICAL SERVICES

Burlingame, CA • On-site

$39.69 - $45.10/hr

Full-time

Medical, Dental, Vision, Retirement

Re-posted 21 days ago

Job description

The Utilization Management Coordinator II functions under the direct supervision of a physician or Registered Nurse performing utilization management (UM) and care coordination duties for the NEMS MSO. The UM Coordinator II will also provide basic training to the junior UM Coordinators.

ESSENTIAL JOB FUNCTIONS:

  • Responsible to review Referral Requests and Treatment Authorization Requests received daily; process and approve authorization requests according to the NEMS MSO Authorization Grid and established clinical guidelines.
  • Provide guidance to junior UM Coordinators during research of additional clinical guidelines from different sources for complex cases.
  • Responsible to lead the junior UM Coordinators to prepare and present complex cases to Medical Director for review and ensure follow up activities.
  • Responsible for reviewing the confirmed MD approval/modification/denial decision and notes for record tracking purposes.
  • Responsible to prepare UM Notice of Action (NOA) to provider and member for UM denial decision per AB1455 turn-around-time requirement.
  • Responsible for preparing UM statistical reports and submit to health plans per contract requirement.
  • Perform Care Coordination activities with members, families, specialists, and ancillary providers for authorized services.
  • Perform case investigation for member and/or provider complaints and appeals related to UM denials, and report findings to Health Plan.
  • Provide transition of care services to members who are discharged from the hospital.
  • Perform customer services for UM inquires to PCP, specialist, and members.
  • Stay current with DHCS regulations, Health Plan agreements, and Industry Standard guidelines applicable to healthcare programs.
  • Communicate with Health Plan for clarification about clinical guidelines for covered/uncovered benefits.
  • Communicate UM related information and updates to all members of the health care team, patients, and their families.
  • Follows the appropriate turnaround timeframe for decisions and notification of members and providers.
  • Performs other job duties as required by manager/supervisor.
     
  • BS/BA Degree in Health Science or General Education highly preferred.
  • Minimum of one year of experience in utilization management required.
  • Recent experience in a clinic or outpatient setting desirable; able to perform efficiently and appropriately in a busy environment.
  • Current Medical Assistant Certification or California Pharmacy Technician License or equivalent experience in a health care field is a plus.
  • Knowledge of medical terminology is a must
  • Strong communication, analytical, and problem-solving skills.
  • Knowledge of community resources and cultural needs.
  • Good organization and prioritization skills, outstanding in time management.

LANGUAGE:

  • Must be able to fluently speak, read and write English.
  • Fluent in Chinese (Cantonese and/or Mandarin) preferred.
  • Fluent in other languages is an asset.

STATUS:

  • This is an FLSA Non-exempt position.
  • This is not an OSHA high-risk position.
  • This is a full-time position. 

NEMS is proud to be an Equal Opportunity Employer welcoming diversity in our workforce. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

NEMS BENEFITS: Competitive benefits, including free medical, dental and vision insurance for employee, spouse and/or children; and company contribution to 401(k).
 

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