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Insurance Utilization Review Jobs in Iowa (NOW HIRING)

Utilization Tech/Nurse M-F 1st shift, 32 biweekly hours 8-4:30 Clinical background preferred About ... review. Compensation amp; Benefits * Competitive salary * Health, dental, vision, life insurance ...

Utilization Management Nurse Medical Associates 1 Positions ID: ou7IAfwD Posted On 09/01/2026 Job ... Dental Insurance, etc. What You Will Be Doing: * Review requests from providers or members for ...

Knowledge of insurance eligibility, CMS rules, and utilization review processes across the continuum of care. * Strong clinical judgment, communication, and independent decision-making skills.

Knowledge of insurance eligibility, CMS rules, and utilization review processes across the continuum of care. * Strong clinical judgment, communication, and independent decision-making skills.

Knowledge of insurance eligibility, CMS rules, and utilization review processes across the continuum of care. * Strong clinical judgment, communication, and independent decision-making skills.

Knowledge of insurance eligibility, CMS rules, and utilization review processes across the continuum of care. * Strong clinical judgment, communication, and independent decision-making skills.

Knowledge of insurance eligibility, CMS rules, and utilization review processes across the continuum of care. * Strong clinical judgment, communication, and independent decision-making skills.

Knowledge of insurance eligibility, CMS rules, and utilization review processes across the continuum of care. * Strong clinical judgment, communication, and independent decision-making skills.

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Insurance Utilization Review information

See Iowa salary details

$20

$39

$64

How much do insurance utilization review jobs pay per hour?

As of Sep 9, 2026, the average hourly pay for insurance utilization review in Iowa is $39.71, according to ZipRecruiter salary data. Most workers in this role earn between $31.39 and $45.62 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 Iowa?

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

Infographic showing various Insurance Utilization Review job openings in Iowa as of September 2026, with employment types broken down into 85% Full Time, and 15% Part Time. Highlights an 100% In-person job distribution, with an average salary of $82,605 per year, or $39.7 per hour.

Utilization Tech

Vinton, IA โ€ข On-site

Virginia Gay Hospital
201 - 500 employees

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 25 days ago


Job description

Utilization Tech/Nurse
M-F 1st shift, 32 biweekly hours
8-4:30
Clinical background preferred

About VGH
Virginia Gay Hospital, established in Vinton in 1923, is an independent, nonprofit critical access hospital supported by a strong local community. The organization includes a 25-bed hospital and four family medical clinics located throughout Benton County, Iowa, offering high-quality, local healthcare and opportunities for professional growth and meaningful patient relationships.

Position Summary
  • ESSENTIAL DUTIES AND RESPONSIBILITIES
โ€ขThe Utilization Review Tech/Nurse is responsible for the utilization review for preadmission screenings of patients, monitoring of patient status/needs, and notification of third-party payors, precertification of outpatient procedures, medication preauthorization and auditing charts as requested. The UR Tech/Nurse is responsible for the InterQual review of charts to assist with determination of appropriate level and length of stay.
MINIMUM QUALIFICATIONS (from job description)
โ€ขCurrent Iowa nursing license, preferred. Graduated from a state approved nursing program if applicable. Maintains current BCLS if indicated. Would prefer candidate to have previous education and experience as an MA/RN/LPN, Utilization Review Nurse and/or have experience in physician office preauthorization and utilization review.

Compensation amp; Benefits
  • Competitive salary
  • Health, dental, vision, life insurance, supplemental insurance
  • Retirement plan with match
  • Paid time off
  • License and Continuing Education Reimbursement available.

Equal Opportunity Statement
Virginia Gay Hospital is an equal opportunity employer.