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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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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.
Registered Nurse - Utilization Review - RNUR26-06086

Registered Nurse - Utilization Review - RNUR26-06086

Navitas Healthcare LLC

Santa Rosa, CA • Remote

Other

Posted 3 days ago

Job description

Job Title: Registered Nurse - Utilization Review
Location: Santa Rosa, CA
Shift Details: Day Shift | 5x8 Hours | 08:00 AM - 04:30 PM
Contract Duration: 13 Weeks
Orientation: 40 Hours (Non-Billable)
Required Qualifications
  • Active Registered Nurse (RN) License required
  • Minimum 1-2 years acute care experience preferred
  • Experience in Utilization Review, Case Management, or similar clinical coordination role preferred
  • Strong understanding of medical necessity criteria and payer guidelines
  • Knowledge of insurance authorization and review processes
  • Strong documentation, analytical, and communication skills
  • Ability to work independently in a remote setting
  • Experience with EMR systems preferred (Epic preferred)
Job Responsibilities
  • Perform utilization review for inpatient and outpatient services
  • Evaluate medical records for appropriate level of care and medical necessity
  • Process prior authorizations and continued stay reviews
  • Collaborate with physicians, case managers, and insurance payers
  • Document review decisions accurately in EMR systems
  • Identify cases requiring escalation to clinical reviewers or medical directors
  • Support discharge planning and care coordination when needed
  • Ensure compliance with regulatory, payer, and facility guidelines
  • Maintain productivity and quality standards in a remote environment

For more details contact at sthakur@navitashealth.com
About Navitas Healthcare, LLC certified WBENC and one of the fastest-growing healthcare staffing firms in the US providing Medical, Clinical and Non-Clinical services to numerous hospitals. We offer the most competitive pay for every position we cater. We understand this is a partnership. You will not be blindsided and your salary will be discussed upfront.

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