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Contract Utilization Review Jobs in Rochester, MN

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General Manager- Mayo Civic Center

Rochester, MN · On-site

... services contract. * Aggressively promotes the use of the facility to maximize its utilization ... review and analysis. * Performs Live Entertainment risk/profit analyses to secure local, regional ...

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Contract Utilization Review information

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How much do contract utilization review jobs pay per hour?

As of Sep 4, 2026, the average hourly pay for contract utilization review in Rochester, MN is $42.98, according to ZipRecruiter salary data. Most workers in this role earn between $33.94 and $49.38 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 Rochester, MN?

The most popular types of Utilization Review jobs in Rochester, MN are:

What cities near Rochester, MN are hiring for Contract Utilization Review jobs?

Cities near Rochester, MN with the most Contract Utilization Review job openings:

Contract Utilization Review jobs near you
Infographic showing various Contract Utilization Review job openings in Rochester, MN as of August 2026, with employment types broken down into 1% As Needed, 77% Full Time, 19% Part Time, 2% Contract, and 1% Nights. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution, with an average salary of $89,397 per year, or $43 per hour.

Clinical Appeals Specialist II-Hybrid

Mayo Clinic

Rochester, MN • Hybrid

Full-time

Medical, Dental, Vision, Retirement

Re-posted 6 days ago

Mayo Clinic rating

7.8

Company rating: 7.8 out of 10

Based on 705 frontline employees who took The Breakroom Quiz

135th of 898 rated healthcare providers

Job description

This is a hybrid position and must be located within 100 miles of any of the Mayo Clinic campuses for on-site expectations based on business needs. 

Primary duties may include, but are not limited to, responsibility for reviewing assigned clinically related denials, payer audits, and payer correspondence as well as preparation of relevant appeal submission or audit responses. Utilizes clinical expertise and critical thinking in the evaluation of medical records against appropriate criteria and contract requirements and utilizes appropriate communication style to appeal or defend medically denied claims. Is a liaison and resource to revenue cycle, case management and practice stakeholders in defending clinically denied claims and providing relevant feedback to key stakeholders on denial prevention opportunities.

Why Mayo Clinic

Mayo Clinic is top-ranked in more specialties than any other care provider according to U.S. News & World Report. As we work together to put the needs of the patient first, we are also dedicated to our employees, investing in competitive compensation and comprehensive benefit plans - to take care of you and your family, now and in the future. And with continuing education and advancement opportunities at every turn, you can build a long, successful career with Mayo Clinic.

Benefits Highlights
  • Medical: Multiple plan options.
  • Dental: Delta Dental or reimbursement account for flexible coverage.
  • Vision: Affordable plan with national network.
  • Pre-Tax Savings: HSA and FSAs for eligible expenses.
  • Retirement: Competitive retirement package to secure your future.
Just as our reputation has spread beyond our Minnesota roots, so have our locations. Today, our employees are located at our three major campuses in Phoenix/Scottsdale, Arizona, Jacksonville, Florida, Rochester, Minnesota, and at Mayo Clinic Health System campuses throughout Midwestern communities, and at our international locations. Each Mayo Clinic location is a special place where our employees thrive in both their work and personal lives. Learn more about what each unique Mayo Clinic campus has to offer, and where your best fit is. 

Equal Opportunity

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, protected veteran status or disability status. Learn more about the "EOE is the Law".  Mayo Clinic participates in E-Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization.

Minimum Education: Associates Degree

Minimum Experience:  3 years of relevant nursing experience

Current active unrestricted RN license.

The preferred applicant will have the following experience: Advanced knowledge of ICD-10-CM/PCS coding conventions, DRG reimbursement methodology, and clinical validation principles, with demonstrated ability to interpret Coding Clinic guidance and Medicare IPPS regulations to support accurate DRG assignment and defend coding-related denials.

Healthcare Financial Management Association (HFMA) Certification Preferred.

CCDS or CDIP Certification Preferred. 

Experience in utilization review, case management, denials and appeals, revenue cycle, or prior authorization preferred. Knowledge and use of discharge planning, case management, utilization review, and levels of care criteria. Familiarity with Medicaid and Medicare claims denials and appeals processing and regulatory requirements. Knowledge and use of payer medical policy and Medicare LCD/NCD criteria. Knowledge of billing and coding requirements. Experience utilizing Milliman Care Guidelines and InterQual Criteria. Knowledge of current NCQA/URAC standards. Knowledge and experience applying 2-Midnight Rule Criteria. Knowledge and experience in Epic. Must have the ability to effectively utilize Microsoft Office Suite and possess basic data entry skills. Must possess excellent verbal, written and interpersonal communication skills, and able to balance multiple demands and respond to time constraints. Must have high-level skills in organization as well as problem solving and analytical skills. 


**This vacancy is not eligible for sponsorship / we will not sponsor or transfer visas for this position.

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About Mayo Clinic

Sourced by ZipRecruiter

Mayo Clinic is the largest integrated, not-for-profit medical group practice in the world. We're building the future, one where the best possible care is available to everyone — and more people can heal at home. Our relentless research turns into earlier diagnoses and new cures. That's how we inspire hope in those who need it most. At Mayo Clinic, experts work together to solve the most challenging unmet needs of patients. Our history of innovation dates back almost 150 years, when brothers Will and Charlie Mayo pioneered an integrated, team-based approach to medicine. Today, that trailblazing spirit drives innovations like Mayo Clinic Platform — which powers new technologies to change how care is delivered to all.

Industry

Hospitals

Company size

10,000+ Employees

Headquarters location

Rochester, MN, US

Year founded

1919

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