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Insurance Utilization Review Jobs in Idaho (NOW HIRING)

Evolent

Field Medical Director, Vascular Surgeon

Boise, ID · On-site

$130 - $140/hr

... Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance ... insurance benefits) to qualifying employees. All compensation determinations are based on the ...

Aldridge Pite LLP

Title Reviewer

Meridian, ID · On-site

Aldridge Pite, LLP is a multi-state law firm that focuses heavily on the utilization of technology ... Company Paid Life and Disability Insurance plans * Medical, Dental and Vision Plans with ...

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Insurance Utilization Review information

See Idaho salary details

$20

$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.

REGISTERED NURSE (RN) (EVENING SHIFT) - POST SURGICAL INPATIENT

Surgery Partners

Post Falls, ID • On-site

Full-time

Medical, Dental, Vision, Retirement

Posted 3 days ago

New

Surgery Partners rating

7.7

Company rating: 7.7 out of 10

Based on 85 frontline employees who took The Breakroom Quiz

160th of 891 rated healthcare providers

Job description

Northwest Specialty Post Surgical Inpatient Unit is seeking a compassionate, patient-focused RN to join the team!

 

This evening position can be five 8-hour shifts (3 pm to 11:30 pm) or four 10-hour shifts (1 pm – 11:30 pm)!

**This position is eligible for a $2,000 sign-on bonus**

 

Our Post-Surgical Inpatient Unit primarily cares for orthopedic, orthopedic/spine, bariatric, and general surgery patients. RNs are supported by a robust, collaborative interdisciplinary team, including Physical Therapy, Respiratory Therapy, Hospitalists, Nocturnists, Case Management, and Utilization Review.

If you’re looking for a supportive team where your voice matters, we’d love to meet you! We value teamwork, nursing excellence, strong physician collaboration, and open communication, while providing the resources you need to succeed. In this role, you’ll deliver high-quality patient care, coordinate admissions and discharges, delegate assignments, and manage medications and supplies.

Our post-surgical team benefits from a robust support structure including:

  • 24/7 Hospitalist support
  • 24/7 Respiratory Therapy support
  • Case Management & Utilization Review Nurse
  • Full-Time Physical Therapy support on day shift
  • Average 5:1 ratio based on patient acuity
  • Schedule published 4 weeks in advance

Qualifications & Preferred Experience:

  • Current RN licensure in the State of Idaho
  • Previous nursing experience strongly preferred
  • BSN strongly preferred
  • Current BLS certification
  • ACLS certification required within six months of employment
  • Demonstrated skills in verbal and written English communications for safe and effective patient care and to meet documentation standards
  • Ability to relate and work effectively with others
  • Aware of professional nursing standards and performs in accordance with them

About Northwest Specialty Hospital

Northwest Specialty Hospital is widely known for being a center of excellence and is proudly owned and operated by local physicians. The physicians have invested personally, professionally and financially in the care of the patients and the staff. They have dedicated their lives to creating a hospital that allows them to practice on their own terms and do what’s best for patients. Northwest Specialty Hospital includes 12 operating rooms and 28 inpatient beds, along with a variety of clinics and services throughout Kootenai County, that span across multiple specialties.
Northwest Specialty Hospital has earned numerous awards for patient care, surgical skill, medical care, and employee satisfaction. Northwest Specialty Hospital has been recognized as one of the Best Places to Work in the Inland Northwest for eight consecutive years! Companies throughout Washington and Idaho were selected based on employee feedback about benefits, work environment, job satisfaction, and other factors. We continue to receive this distinguished honor based on our great company culture, patient focused approach, and robust benefits package!

Some of our amazing perks and benefits offered to employees are:

  • Comprehensive medical, dental, and vision insurance options
  • Generous 401K retirement plan
  • Tuition reimbursement
  • Dedicated professional development opportunities
  • Ongoing education and training
  • Leadership development courses
  • Wellness programs, including access to a dietitian and discounted gym memberships
  • Employee discounts throughout the hospital and local community
  • Company-sponsored events, including sporting events, BBQs, and holiday parties
  • Opportunities for career growth and advancement
  • A culture that promotes and supports work/life balance

**Northwest Specialty Hospital is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected Veteran status.**

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