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Insurance Utilization Review information

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$39

$64

How much do insurance utilization review jobs pay per hour?

As of Aug 22, 2026, the average hourly pay for insurance utilization review in Idaho is $39.78, according to ZipRecruiter salary data. Most workers in this role earn between $31.44 and $45.67 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 Idaho?

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

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

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

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

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

Insurance Utilization Review jobs near you
Infographic showing various Insurance Utilization Review job openings in Idaho as of August 2026, with employment types broken down into 1% As Needed, 76% Full Time, 19% Part Time, and 4% Contract. Highlights an 89% Physical, 1% Hybrid, and 10% Remote job distribution, with an average salary of $82,748 per year, or $39.8 per hour.

UTILIZATION REVIEW COORDINATOR

MOUNTAIN VIEW HOSPITAL LLC

Idaho Falls, ID • On-site

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 25 days ago

Mountain View Hospital (Idaho Falls) rating

5.5

Company rating: 5.5 out of 10

Based on 60 frontline employees who took The Breakroom Quiz

943rd of 1,061 rated hospitals

Job description

Mountain View Hospital is looking for a Utilization Review Coordinator to join our team!
JOB SUMMARY: As a member of the Utilization Management Team, the UR
Coordinator helps establish and maintain efficient methods of ensuring the medical necessity and appropriateness of hospital admissions and extended stays. The Utilization Management Team directs the program in accordance with Mountain View Hospital's mission and strategic goals. The Utilization Management Team directs those activities within the facility which monitor adherence to the hospital's utilization review plan. The goal of Utilization Management is to continuously improve effective use of hospital services through monitoring patient admissions and stays.
About Mountain View:
Mountain View Hospital and our 29 affiliate clinics are committed to providing compassionate, cutting edge care to our patients. We serve the entire Snake River Valley - all the way from Pocatello to Rexburg. Our medical capabilities span everything from wound care to urgent care, oncology to neurology, physical therapy to speech therapy, a Level III NICU, robust robotic surgery department and a continuously expanding rural health practice.
Our work environment is mission driven, people-centric and supportive. It is what sets apart and makes people excited to come to work each day. If you are looking for a career where you can make a difference in your community, we invite you to apply.
BENEFITS:
Taking care for our community starts with taking care of our own team. Mountain View Hospital is proud to offer its employees competitive and comprehensive benefit packages. Benefits include:
  • Medical, Dental and Vision Insurance
  • Paid Time Off (vacation, holidays and sick days) and Medical Paid Time Off
  • Retirement Plans (401K with up to 6% match)
  • Earned Quarterly Bonus Program
  • Education Reimbursement Program
  • Discount for medically necessary procedures performed at Mountain View Hospital and Idaho Falls Community Hospital

Please note benefits are based on eligibility according to full-time, part-time or PRN status classification.
Education/Certification: High School Diploma or equivalent. Coding certificate completion is required within 1 year of employment
Experience: Background in medical terminology is helpful. Medical coding and/or insurance experience preferred, however coding certification will be required with in one calendar year of employment

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