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Insurance Utilization Review Jobs in Connecticut

Heritage at Irene Woods

MDS Coordinator

Essex, CT

$50 - $52/hr

What We Offer: Medical, dental, and vision insurance Life insurance AD&D insurance Long-term ... Lead and participate in IDT meetings, including Daily PDPM, Utilization Review, Monthly Triple ...

The Arlington of Naples

MDS Coordinator

Essex, CT · On-site

$50 - $52/hr

What We Offer: Medical, dental, and vision insurance Life insurance AD&D insurance Long-term ... Lead and participate in IDT meetings, including Daily PDPM, Utilization Review, Monthly Triple ...

Life Care Services

MDS Coordinator

Essex, CT

$50 - $52/hr

What We Offer: Medical, dental, and vision insurance Life insurance AD&D insurance Long-term ... Lead and participate in IDT meetings, including Daily PDPM, Utilization Review, Monthly Triple ...

Life Care Services

MDS Coordinator

Essex, CT · On-site

$50 - $52/hr

What We Offer: Medical, dental, and vision insurance Life insurance AD&D insurance Long-term ... Lead and participate in IDT meetings, including Daily PDPM, Utilization Review, Monthly Triple ...

Life Care

MDS Coordinator

Essex, CT · On-site

$50 - $52/hr

What We Offer: • Medical, dental, and vision insurance • Life insurance • AD&D insurance • ... Lead and participate in IDT meetings, including Daily PDPM, Utilization Review, Monthly Triple ...

Life Care Companies, LLC

MDS Coordinator

Essex, CT · On-site

$50 - $52/hr

What We Offer: • Medical, dental, and vision insurance • Life insurance • AD&D insurance • ... Lead and participate in IDT meetings, including Daily PDPM, Utilization Review, Monthly Triple ...

Asbury Village

MDS Coordinator

Essex, CT

$50 - $52/hr

What We Offer: Medical, dental, and vision insurance Life insurance AD&D insurance Long-term ... Lead and participate in IDT meetings, including Daily PDPM, Utilization Review, Monthly Triple ...

Stryker Corporation

Medical Director -Spine

Hartford, CT · On-site

$174.07 - $374.92/hr

... insurers. That experience gives us a unique opportunity to help transform health care. We believe ... Leads all aspects of utilization review/quality assurance, directing case management. Provides ...

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All JobsInsurance Utilization Review JobsInsurance Utilization Review Jobs in Connecticut

Insurance Utilization Review information

See Connecticut salary details

$20

$40

$65

How much do insurance utilization review jobs pay per hour?

As of Aug 18, 2026, the average hourly pay for insurance utilization review in Connecticut is $40.22, according to ZipRecruiter salary data. Most workers in this role earn between $31.78 and $46.20 per hour, depending on experience, location, and employer.

What is an insurance utilization review?

An Insurance Utilization Review job involves evaluating medical treatments and services to determine if they are necessary, appropriate, and covered by a patient's insurance plan. Professionals in this role review medical records, treatment plans, and insurance policies to ensure compliance with guidelines and cost-effectiveness. They work closely with healthcare providers, insurance companies, and patients to facilitate approvals or appeals. The goal is to balance quality patient care with cost containment in the healthcare system.

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

To thrive in Insurance Utilization Review, you generally need a strong background in healthcare or nursing, an understanding of medical terminology, and analytical thinking skills, often supported by an RN license or relevant clinical experience. Familiarity with utilization management software, coding systems like ICD-10, and knowledge of regulatory requirements (such as Medicare or Medicaid) are important. Strong communication, attention to detail, and problem-solving abilities help professionals excel when interacting with providers and insurers. These skills are essential to ensure appropriate care is authorized while maintaining regulatory compliance and cost-effectiveness.

What are the most common challenges faced by insurance utilization review professionals?

One common challenge in Insurance Utilization Review is balancing the need for cost-effective care with the clinical needs of patients, which often requires careful analysis and decision-making. Professionals in this role frequently navigate complex medical records, strict policy guidelines, and collaborate with healthcare providers who may advocate strongly for particular treatments. Managing challenging conversations while maintaining professionalism and ensuring timely determinations are also a regular part of the role. Developing expertise in these areas can make the job both demanding and rewarding, while building a strong foundation for career growth within healthcare administration.

How do I get into an insurance utilization review?

To become an insurance utilization review specialist, candidates typically need a background in healthcare, nursing, or a related field, along with knowledge of insurance policies and medical terminology. Certification such as the Certified Professional in Healthcare Quality (CPHQ) or similar credentials can enhance job prospects. Relevant skills include attention to detail, analytical thinking, and familiarity with medical records and insurance software systems.

Is insurance utilization review a stressful job?

Insurance utilization review can be stressful due to the need for accuracy, attention to detail, and meeting strict deadlines. Reviewers often handle complex cases and must balance policy guidelines with patient needs, which can contribute to job pressure. However, the level of stress varies depending on workload, work environment, and individual coping skills.

What are the most commonly searched types of Insurance Utilization Review jobs in Connecticut?

The most popular types of Insurance Utilization Review jobs in Connecticut are:

What are popular job titles related to Insurance Utilization Review jobs in Connecticut?

For Insurance Utilization Review jobs in Connecticut, the most frequently searched job titles are:

What job categories do people searching Insurance Utilization Review jobs in Connecticut look for?

The top searched job categories for Insurance Utilization Review jobs in Connecticut are:

What cities in Connecticut are hiring for Insurance Utilization Review jobs?

Cities in Connecticut with the most Insurance Utilization Review job openings:

Insurance Utilization Review jobs near you
Infographic showing various Insurance Utilization Review job openings in Connecticut as of August 2026, with employment types broken down into 62% Full Time, 25% Part Time, and 13% Temporary. Highlights an 87% In-person, and 13% Hybrid job distribution, with an average salary of $83,662 per year, or $40.2 per hour.

MDS Coordinator

Heritage at Irene Woods

Essex, CT

$50 - $52/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 15 days ago

Job description

Title: MDS Coordinator

Location: Essex, CT

Pay: $50-52/hr depending on experience

Schedule: Full-time with flexible scheduling options

Who We Are: 

Walk through our doors and experience the future of senior living and care. Nestled beside a stunning 1,000-acre natural preserve and just minutes from the shoreline, Essex Meadows is a leader in comprehensive senior living in Connecticut. Here, you'll be part of a vibrant, mission-driven team that values your growth and well-being as much as the residents we serve. Don't just do a job-be part of an extraordinary life!

 What We Offer:
    Medical, dental, and vision insurance
    Life insurance 
    AD&D insurance 
    Long-term disability insurance
    401(k) with company match
    Resident sponsored appreciation bonus
    Resident sponsored educational scholarships
    Generous PTO and paid holidays
    Employee assistance program
    Free electric vehicle charging stations
    Daily Pay - Work today, get paid today
    An exceptional work environment that is both engaging and fun

Essex Meadows is looking for an experienced MDS Coordinator that brings compassion, professionalism, and strong skills to work every day. The MDS Coordinator, RN is responsible for the twenty-four-hour nursing care of all residents through the performance of the nursing personnel.  This position is responsible for providing a "system of care" for residents in a manner and environment that promotes maintenance or enhancement of each resident's quality of life and provides dignity and respect in full recognition of each resident's individuality.  

The MDS Coordinator is required to maintain a professional philosophy which grows and adapts to the prevailing philosophy of the industry and imparts this philosophy to the nursing staff. This position is responsible for ensuring accurate and timely completion of the Minimum Data Set (MDS) assessments, coordinating resident care planning, optimizing PDPM reimbursement, monitoring quality measures, and maintaining regulatory compliance.

Primary Responsibilities:

  • Coordinate and lead the interdisciplinary care planning process with Nursing, Therapy, Social Services, Dietary, and Activities.
  • Lead and participate in IDT meetings, including Daily PDPM, Utilization Review, Monthly Triple Check, and Care Plan Conferences.
  • Complete and submit accurate, timely MDS assessments in accordance with CMS and regulatory requirements.
  • Select appropriate ARDs and diagnosis codes to ensure accurate PDPM classification and reimbursement.
  • Monitor PDPM components, validate supporting documentation, and maintain compliance with CMS guidelines.
  • Perform other duties as assigned.

Qualifications:

  • Must have current and valid Connecticut RN license and BLS certification. At least 6 months nursing experience in long term care setting preferred.
  • In- depth experience and knowledge working with MDS computer software. 
  • Experience with the MDS transmittal process and understanding of regulations impacting the MDS.
  • Supervisory experience preferred.

All new hires must be able to pass our preemployment screening process, which includes a fitness for duty physical, criminal background check, drug test and employment references as required by a licensed residential care facility. Some of the roles in our community also require that we ask about your vaccination status.

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