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Contract Utilization Review Jobs in Spring Valley, NY

Acacia Network

Medical Director

Bronx, NY · On-site

$220K - $240K/yr

Oversee laboratory contract services and monitor contracts for medical supplies, services, and ... Experience in the development and management of quality, risk and utilization review processes.

Integrated Resources INC

Coding Auditor (ICD-10)

Newark, NJ

$28.50 - $32.50/hr

Performs and finalizes multiple per diem, bill verification, DRG Validation (utilization review ... contract stipulations. Compiles statistics and other audit information to present to accounts ...

Susquehanna University

Program Director

Manhattan, NY · On-site +1

$80K - $85K/yr

The Program Director is responsible for ensuring that contracts with clients reflect goals of ... to Utilization Review Committee. * Responsible for maintaining contact with other service agencies ...

Susquehanna University

Program Director

Manhattan, NY · On-site +1

$70K - $80K/yr

The Program Director is responsible for ensuring that contracts with clients reflect goals of ... to Utilization Review Committee. * Responsible for maintaining contact with other service agencies ...

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Showing results 21-40

All JobsContract Utilization Review JobsContract Utilization Review Jobs in Spring Valley, NY

Contract Utilization Review information

See Spring Valley, NY salary details

$21

$42

$69

How much do contract utilization review jobs pay per hour?

As of Sep 5, 2026, the average hourly pay for contract utilization review in Spring Valley, NY is $42.85, according to ZipRecruiter salary data. Most workers in this role earn between $33.85 and $49.18 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 cities near Spring Valley, NY are hiring for Contract Utilization Review jobs?

Cities near Spring Valley, NY with the most Contract Utilization Review job openings:

Contract Utilization Review jobs near you
Infographic showing various Contract Utilization Review job openings in Spring Valley, NY as of June 2026, with employment types broken down into 2% As Needed, 29% Full Time, 40% Part Time, 2% Temporary, and 27% Contract. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution, with an average salary of $89,118 per year, or $42.8 per hour.

Independent Medical Exam IME Doctor- Board-Certified Ortho Surgery (M.D., D.O.)

Dane Street, LLC

New York, NY • On-site

Contractor

Re-posted 6 days ago

Job description

Dane Street is expanding our physician panel! This is a telework opportunity for supplemental income for physicians providing a caseload customized to your schedule. Our physician panel is comprised of independent contract reviewers (1099) compensated on a per-case basis.
The ideal candidates will hold a NY license and be Board Certified in Orthopedic Surgery, with experience in completing Independent Medical Exams. The ideal candidate will be New York State Workers' Comp certified. Independent Medical Exams are available to be completed across the state of New York.
Requirements
As Physician Reviewer/Advisor, you will utilize clinical expertise and reviews insurance appeals, and prospective and retrospective claims. The Physician Reviewer will provide an interpretation of the medical necessity of services provided by other healthcare professionals in compliance with client specific policies, nationally recognized evidence-based guidelines, and standards of care.
MAJOR DUTIES AND RESPONSIBILITIES:
    • Reviews all medical records and addresses each question posed by the client utilizing client specific criteria or other nationally recognized evidence-based criteria
    • Ensures that the rationale for the determination is clear, concise, and contains adequate supporting documentation to substantiate the decision
    • Identifies, critiques, and utilizes current criteria and resources such as national, state, and professional association guidelines and peer-reviewed literature that support sound and objective decision-making and rationales in reviews; refrains from using case studies, cohorts, and the like to make decisions due to their limited sample sizes
    • Provides copies of any criteria utilized in a review with the report in a timely manner
    • Returns cases on or before the due date and time
    • Makes telephone calls as mandated by the state and/or client specifics
    • Maintains proper credentialing and state licenses and any special certifications or requirements necessary to perform the job
    • Attends all required orientation and training
    • Performs other duties as assigned including identifying and responding to quality assurance issues, complaints, regulatory issues, depositions, court appearances, or audits
  • Board certification required, active practice required

PLEASE BE AWARE: In the interest of the security of all parties, Dane Street will never conduct interviews via text or request checks from candidates for any reason including the purchase of equipment.
Benefits
Robust opportunity for supplemental income
  • Schedule flexibility and predictable work hours - You choose services and case types, dictate volume, and conduct exams and reviews based on your schedule availability
  • No doctor/patient relationship is established and no treatment is provided. These are advisory-only opinions.
  • Enhanced industry expertise strengthening your medical practice with medical necessity and utilization review/management expertise
  • Expanded credentials as an expert in Independent Medical Exams and physician advisor services
  • Fully prepped cases, streamlined case flow, transcription services at no cost, and user-friendly work portal

Dane Street supports all referral processes, scheduling, preps cases extensively, prepares all medical records, provides transcription services as applicable, facilitates all client communications, and ensures the quality and timeliness of all reports and report delivery.
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