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Insurance Utilization Review Jobs in Florida (NOW HIRING)

Enlyte

Utilization Reviewer 2

Tampa, FL · On-site

$59K - $76K/yr

Prior review experience in healthcare, insurance, utilization management, quality assurance, or other applicable capacity. * Prior experience in the workers' compensations field. Benefits We're ...

Enlyte

Utilization Reviewer 2

Tampa, FL · On-site

$59K - $76K/yr

Prior review experience in healthcare, insurance, utilization management, quality assurance, or other applicable capacity. * Prior experience in the workers' compensations field. Benefits We're ...

Banyan

Utilization Review Specialist

Pompano Beach, FL · On-site

$50K - $65K/yr

Verify insurance benefits, coordinate authorizations, and communicate effectively with external case managers and managed care organizations * Establish and maintain contracts with managed care ...

Oscar Health

Utilization Review Nurse

Miami, FL · Remote

$35 - $45.94/hr

We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... insurance, and paid wellness time and reimbursements. Artificial Intelligence (AI): Our AI ...

SBT

Be Seen First

Utilization Review (UR) Specialist

Boca Raton, FL · On-site

$60K - $70K/yr

Utilization Review (UR) Specialist Location: Boca Raton, FL Job Type: Full-time, In-Person Pay: $60 ... Work collaboratively with insurance providers, care managers, clinicians, admissions teams, and ...

UHS

DIR - UTILIZATION REVIEW / MGMT

Oakland Park, FL

Must be familiar with a variety of insurances and funding streams, including commercial insurance ... Utilization Review position, such as: * Challenging and rewarding work environment * Competitive ...

UHS

DIR - UTILIZATION REVIEW / MGMT

Oakland Park, FL · On-site

The Director of Utilization Management is also responsible for ensuring that the utilization review ... Must be familiar with a variety of insurances and funding streams, including commercial insurance ...

UHS

DIR - UTILIZATION REVIEW / MGMT

Jacksonville, FL · On-site

Responsibilities The Utilization Review Director is responsible for directing and overseeing the ... insurance offering, a physician network and various related services located all over the U.S.

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Insurance Utilization Review information

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$15

$31

$51

How much do insurance utilization review jobs pay per hour?

As of Aug 4, 2026, the average hourly pay for insurance utilization review in Florida is $31.60, according to ZipRecruiter salary data. Most workers in this role earn between $24.95 and $36.30 per hour, depending on experience, location, and employer.

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.

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 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 most commonly searched types of Insurance Utilization Review jobs in Florida? The most popular types of Insurance Utilization Review jobs in Florida are:
What are popular job titles related to Insurance Utilization Review jobs in Florida? For Insurance Utilization Review jobs in Florida, the most frequently searched job titles are:
What job categories do people searching Insurance Utilization Review jobs in Florida look for? The top searched job categories for Insurance Utilization Review jobs in Florida are:
What cities in Florida are hiring for Insurance Utilization Review jobs? Cities in Florida with the most Insurance Utilization Review job openings:
Insurance Utilization Review jobs near you
Infographic showing various Insurance Utilization Review job openings in Florida as of July 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution, with an average salary of $65,722 per year, or $31.6 per hour.

UTILIZATION REV SPEC I

Aspire Health Partners

Orlando, FL

Full-time

Re-posted 17 days ago

Aspire Health Partners rating

4.8

Company rating: 4.8 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

Job description

Behavioral Health Utilization Review Specialist I

Aspire Health Partners, Inc.

Make a Difference in Behavioral Health Care

At Aspire Health Partners, we are dedicated to transforming lives through compassionate, high-quality behavioral healthcare. As Florida’s largest nonprofit behavioral health provider, we serve diverse populations across Central Florida and are committed to clinical excellence and meaningful impact.

We are currently seeking a Utilization Review Specialist to join our team and play a key role in ensuring our clients receive the care they need while supporting effective coordination with insurance providers.

Position Summary

In this role, you will coordinate and manage insurance utilization review activities for hospitalized clients. You’ll work closely with clinical teams, insurance representatives, and internal departments to ensure timely authorizations, support treatment planning, and contribute to high-quality patient outcomes.

Key Responsibilities

  • Partner daily with the Access Center and/or Crisis Response Center (CRC) to identify clients needing utilization review
  • Communicate clinical information to insurance reviewers to secure authorizations and extended lengths of stay
  • Collaborate with attending psychiatrists on clinical assessments and treatment recommendations
  • Participate in interdisciplinary treatment team meetings to support care for managed care clients
  • Provide constructive clinical feedback to enhance service delivery and patient care
  • Ensure accurate authorization details are submitted to Patient Accounts for billing
  • Review client charts for potential denial issues and support appeal processes when needed
  • Maintain strict adherence to ethical standards, confidentiality, and organizational policies

Qualifications

Required:

  • High School Diploma or equivalent
  • Level II Background clearance- All Aspire Health Partners Internships and Careers require Level 2 clearance, with Aspire covering fingerprinting costs. Click https://info.flclearinghouse.c... to learn more.
  • Valid driver’s license with an acceptable driving record per organizational guidelines

Preferred:

  • Experience in behavioral health, utilization review, or managed care environments
  • LPN or RN experience
  • Strong communication, documentation, and organizational skills

Why Join Aspire?

  • Mission-driven organization making a real impact in your community
  • Collaborative, team-focused work environment
  • Opportunities for growth and professional development
  • A role where your work directly supports quality care and patient outcomes

Equal Opportunity Employer

Aspire Health Partners is a drug-free workplace and an Equal Opportunity Employer. We value diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will be considered without regard to race, color, religion, national origin, sex, age, disability, or veteran status.


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