Assists in utilization reviews and insurance appeals. Responds to inquiries from patients, their families, and professional referral sources. Roles and Responsibilities: • Assists the admissions ...
Assists in utilization reviews and insurance appeals. Responds to inquiries from patients, their families, and professional referral sources. Roles and Responsibilities: • Assists the admissions ...
Assists in utilization reviews and insurance appeals. Responds to inquiries from patients, their families, and professional referral sources. Roles and Responsibilities: • Assists the admissions ...
Assists in utilization reviews and insurance appeals. Responds to inquiries from patients, their families, and professional referral sources. Roles and Responsibilities: • Assists the admissions ...
Utilization Management Director - Inpatient (Hybrid)
Baltimore, MD · Hybrid
Retirement
Plans, organizes, and manages inpatient utilization review programs. Directs the utilization of ... Proficient in standard medical practices and insurance benefit structures. * Proficient in ...
Utilization Management Director - Inpatient (Hybrid)
Baltimore, MD · Hybrid
Retirement
Plans, organizes, and manages inpatient utilization review programs. Directs the utilization of ... Proficient in standard medical practices and insurance benefit structures. * Proficient in ...
Travel Nurse RN - Case Manager, Utilization Review - $2,917 per week
Silver Spring, MD · On-site
$2.9K/wk
Medical
Dental
Vision
Life
Retirement
Utilization Review * Discipline: RN * Start Date: ASAP * Duration: 13 weeks * 40 hours per week ... life insurance beginning day one of your assignment, generous 401(k) match, substantial housing ...
Travel Nurse RN - Case Manager, Utilization Review - $2,917 per week
Silver Spring, MD · On-site
$2.9K/wk
Medical
Dental
Vision
Life
Retirement
Utilization Review * Discipline: RN * Start Date: ASAP * Duration: 13 weeks * 40 hours per week ... life insurance beginning day one of your assignment, generous 401(k) match, substantial housing ...
Utilization Management Nurse
$34 - $55/hr
Medical
Dental
Vision
Life
Retirement
PTO
Reviews the medical record by applying utilization review criteria, to assess clinical, financial ... Pay Range $34--$55 USD Luminis Health Benefits Overview: • Medical, Dental, and Vision Insurance ...
Utilization Management Nurse
$34 - $55/hr
Medical
Dental
Vision
Life
Retirement
PTO
Reviews the medical record by applying utilization review criteria, to assess clinical, financial ... Pay Range $34--$55 USD Luminis Health Benefits Overview: • Medical, Dental, and Vision Insurance ...
Utilization Management Nurse
$34 - $55/hr
Medical
Dental
Vision
Life
Retirement
PTO
Reviews the medical record by applying utilization review criteria, to assess clinical, financial ... Pay Range $34--$55 USD Luminis Health Benefits Overview: • Medical, Dental, and Vision Insurance ...
Utilization Management Nurse
$34 - $55/hr
Medical
Dental
Vision
Life
Retirement
PTO
Reviews the medical record by applying utilization review criteria, to assess clinical, financial ... Pay Range $34--$55 USD Luminis Health Benefits Overview: • Medical, Dental, and Vision Insurance ...
Utilization Management CoordinatorNE
Glen Burnie, MD · On-site
$40.61 - $60.96/hr
... Review, the Utilization Management Coordinator collaborates with members of the hospital team, the insurance provider, and regulatory agencies to assure compliance with regulatory and reimbursement ...
Utilization Management CoordinatorNE
Glen Burnie, MD · On-site
$40.61 - $60.96/hr
... Review, the Utilization Management Coordinator collaborates with members of the hospital team, the insurance provider, and regulatory agencies to assure compliance with regulatory and reimbursement ...
Utilization Management CoordinatorNE
Glen Burnie, MD · On-site
$406K/yr
General Summary Using the established guidelines for Utilization Review, the Utilization Management Coordinator collaborates with members of the hospital team, the insurance provider, and regulatory ...
Utilization Management CoordinatorNE
Glen Burnie, MD · On-site
$406K/yr
General Summary Using the established guidelines for Utilization Review, the Utilization Management Coordinator collaborates with members of the hospital team, the insurance provider, and regulatory ...
Clinical Medical Director
Annapolis Junction, MD · On-site
$275K - $375K/yr
Background in health insurance, utilization review, or healthcare claims processing, including familiarity with medical necessity criteria and coverage determination standards. * Demonstrated ...
Clinical Medical Director
Annapolis Junction, MD · On-site
$275K - $375K/yr
Background in health insurance, utilization review, or healthcare claims processing, including familiarity with medical necessity criteria and coverage determination standards. * Demonstrated ...
Clinical Review Coordinator
Annapolis Junction, MD · On-site
$60K - $83K/yr
Interprets and applies coverage and payment policies, standards of care, and utilization review ... Protects the confidentiality of patient information through compliance with the Health Insurance ...
Clinical Review Coordinator
Annapolis Junction, MD · On-site
$60K - $83K/yr
Interprets and applies coverage and payment policies, standards of care, and utilization review ... Protects the confidentiality of patient information through compliance with the Health Insurance ...
RN - Case Manager
Baltimore, MD · On-site
$1.7K - $1.8K/wk
Medical
Dental
Vision
Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location: Baltimore ... Benefits: * Day 1 Insurance * Cigna medical, MetLife dental and vision insurance * License ...
RN - Case Manager
Baltimore, MD · On-site
$1.7K - $1.8K/wk
Medical
Dental
Vision
Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location: Baltimore ... Benefits: * Day 1 Insurance * Cigna medical, MetLife dental and vision insurance * License ...
RN - Case Manager
Baltimore, MD · On-site
$1.5K - $1.6K/wk
Medical
Dental
Vision
RN - Case Manager Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job ... Benefits: * Day 1 Insurance * Cigna medical, MetLife dental and vision insurance * License ...
New
RN - Case Manager
Baltimore, MD · On-site
$1.5K - $1.6K/wk
Medical
Dental
Vision
RN - Case Manager Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job ... Benefits: * Day 1 Insurance * Cigna medical, MetLife dental and vision insurance * License ...
New
Physician Advisor
Towson, MD · On-site
$10.01/hr
Medical
Dental
Vision
Life
Retirement
PTO
A background in Utilization Review, Case Management, Quality Assurance, or Performance Improvement ... Life insurance and disability coverage When you come to the University of Maryland St. Joseph ...
Physician Advisor
Towson, MD · On-site
$10.01/hr
Medical
Dental
Vision
Life
Retirement
PTO
A background in Utilization Review, Case Management, Quality Assurance, or Performance Improvement ... Life insurance and disability coverage When you come to the University of Maryland St. Joseph ...
Physician Advisor
Towson, MD · On-site
$240K - $260K/yr
Medical
Dental
Vision
Life
Retirement
PTO
A background in Utilization Review, Case Management, Quality Assurance, or Performance Improvement ... Life insurance and disability coverage When you come to the University of Maryland St. Joseph ...
Physician Advisor
Towson, MD · On-site
$240K - $260K/yr
Medical
Dental
Vision
Life
Retirement
PTO
A background in Utilization Review, Case Management, Quality Assurance, or Performance Improvement ... Life insurance and disability coverage When you come to the University of Maryland St. Joseph ...
Nurse Case Manager
Towson, MD · On-site
Medical
Dental
Vision
Life
Retirement
PTO
Chesapeake Employers' Insurance Company Chesapeake Employers' Insurance Company is a purpose-driven ... Follows established precertification and utilization review policies and protocols. * Acts as ...
Nurse Case Manager
Towson, MD · On-site
Medical
Dental
Vision
Life
Retirement
PTO
Chesapeake Employers' Insurance Company Chesapeake Employers' Insurance Company is a purpose-driven ... Follows established precertification and utilization review policies and protocols. * Acts as ...
Nurse Case Manager
Towson, MD · On-site
$81K - $122K/yr
Medical
Dental
Vision
Life
Retirement
PTO
Who We Are Chesapeake Employers' Insurance Company is a purpose-driven organization dedicated to ... Follows established precertification and utilization review policies and protocols. * Acts as ...
Nurse Case Manager
Towson, MD · On-site
$81K - $122K/yr
Medical
Dental
Vision
Life
Retirement
PTO
Who We Are Chesapeake Employers' Insurance Company is a purpose-driven organization dedicated to ... Follows established precertification and utilization review policies and protocols. * Acts as ...
Physician Advisor Director
Towson, MD · On-site
... insurance providers. * Collaborates with PA peers/mentors on an inter-rater reliability (IRR ... Liaison to Utilization Review, HIM/CDI, EHR and various quality teams throughout the hospital
Physician Advisor Director
Towson, MD · On-site
... insurance providers. * Collaborates with PA peers/mentors on an inter-rater reliability (IRR ... Liaison to Utilization Review, HIM/CDI, EHR and various quality teams throughout the hospital
Physician Advisor Director
Towson, MD · On-site
... insurance providers. * Collaborates with PA peers/mentors on an inter-rater reliability (IRR ... Liaison to Utilization Review, HIM/CDI, EHR and various quality teams throughout the hospital
Physician Advisor Director
Towson, MD · On-site
... insurance providers. * Collaborates with PA peers/mentors on an inter-rater reliability (IRR ... Liaison to Utilization Review, HIM/CDI, EHR and various quality teams throughout the hospital
Physician Advisor Director
Baltimore, MD · On-site
... insurance providers. * Collaborates with PA peers/mentors on an inter-rater reliability (IRR ... Liaison to Utilization Review, HIM/CDI, EHR and various quality teams throughout the hospital
Physician Advisor Director
Baltimore, MD · On-site
... insurance providers. * Collaborates with PA peers/mentors on an inter-rater reliability (IRR ... Liaison to Utilization Review, HIM/CDI, EHR and various quality teams throughout the hospital
Physician Advisor Director
Baltimore, MD · On-site
... insurance providers. * Collaborates with PA peers/mentors on an inter-rater reliability (IRR ... Liaison to Utilization Review, HIM/CDI, EHR and various quality teams throughout the hospital
Physician Advisor Director
Baltimore, MD · On-site
... insurance providers. * Collaborates with PA peers/mentors on an inter-rater reliability (IRR ... Liaison to Utilization Review, HIM/CDI, EHR and various quality teams throughout the hospital
Insurance Utilization Review information
See Maryland salary details
$20.76 - $24.96
2% of jobs
$24.96 - $29.16
9% of jobs
$32.04 is the 25th percentile. Wages below this are outliers.
$29.16 - $33.36
21% of jobs
The median wage is $36.76 / hr.
$33.36 - $37.56
23% of jobs
$37.56 - $41.76
13% of jobs
$45.03 is the 75th percentile. Wages above this are outliers.
$41.76 - $45.96
10% of jobs
$45.96 - $50.16
8% of jobs
$50.16 - $54.36
5% of jobs
$54.36 - $58.56
5% of jobs
$58.56 - $62.76
2% of jobs
$62.76 - $66.96
2% of jobs
$20
$41
$66
How much do insurance utilization review jobs pay per hour?
As of Aug 16, 2026, the average hourly pay for insurance utilization review in Maryland is $41.04, according to ZipRecruiter salary data. Most workers in this role earn between $32.45 and $47.12 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 Maryland?
The most popular types of Insurance Utilization Review jobs in Maryland are:
What are popular job titles related to Insurance Utilization Review jobs in Maryland?
For Insurance Utilization Review jobs in Maryland, the most frequently searched job titles are:
- Utilization Review Specialist
- Therapist Utilization Review Remote
- Utilization Review Physician
- Behavioral Health Utilization Review
- Part Time Utilization Review Nurse
- Utilization Management
- Non Exempt No Experience Utilization Management Nurse
- Freelance Utilization Review Nurse
- Contract Utilization Review Nurse
- Night Utilization Review Nurse
What job categories do people searching Insurance Utilization Review jobs in Maryland look for?
The top searched job categories for Insurance Utilization Review jobs in Maryland are:
- Behavioral Utilization Review
- Utilization Review 1099
- Authorization Utilization Review
- Manager Aetna Utilization Review
- Work From Home Utilization Review
- Remote Aetna Utilization Review
- Utilization Review No Experience
- Registered Nurse Case Review
- Utilization Review Case Manager
- Remote Aetna Utilization Review Nurse
What cities in Maryland are hiring for Insurance Utilization Review jobs?
Cities in Maryland with the most Insurance Utilization Review job openings:
Job description
Utilization Assistant - Acute | Highland Hospital | Annapolis, Maryland
About the Job:
The Utilization Assistant provides support to all utilization review/management activities of the hospital to continuously improve the collection, reimbursement, coordination, and presentation of utilization review information. Works with insurance providers to obtain coverage for patients. Assists in utilization reviews and insurance appeals. Responds to inquiries from patients, their families, and professional referral sources.
Roles and Responsibilities:
• Assists the admissions department with pre-certifications of care. Performs pre and post admission benefit verification with managed care organizations.
• Reviews medical records of patients for appropriateness of level of care at admission and at intervals determined by documentation in medical record.
• Conducts interactive and timely reviews with payers to ensure certification of care.
• Maintains accurate documentation and files as it relates to utilization management.
• Coordinates information and findings with the business office to help recognize or resolve possible payment problems.
• Attends daily treatment team to discuss patient needs and ensure that all disciplines are aware of patient insurance status and needs.
• Ensure that insurance benefits are verified in a timely manner.
• Communicates any UR or Quality issues as noted in the chart to supervisor immediately to ensure timely resolution of problems.
• Responds to telephone and Internet inquires.
• Researches insurance company guidelines and uses admission and continuing stay criteria for coverage.
• High School Diploma Required, Bachelor's Degree in social work, behavioral or mental health, or other related health field preferred.
• One or more years of direct clinical experience in a psychiatric or mental health setting preferred.
Why Highland Hospital?Highland Hospital offers a comprehensive benefit plan and a competitive salary commensurate with experience and qualifications. Qualified candidates should apply by submitting a resume. Highland Hospital is an EOE.
Veterans and military spouses are highly encouraged to apply. Summit BHC is dedicated to serving Veterans with specialized programming at our treatment centers across the country. We recognize and value the unique strengths of the military community in supporting our mission to serve those who have served.
About the Job:
The Utilization Assistant provides support to all utilization review/management activities of the hospital to continuously improve the collection, reimbursement, coordination, and presentation of utilization review information. Works with insurance providers to obtain coverage for patients. Assists in utilization reviews and insurance appeals. Responds to inquiries from patients, their families, and professional referral sources.
Roles and Responsibilities:
• Assists the admissions department with pre-certifications of care. Performs pre and post admission benefit verification with managed care organizations.
• Reviews medical records of patients for appropriateness of level of care at admission and at intervals determined by documentation in medical record.
• Conducts interactive and timely reviews with payers to ensure certification of care.
• Maintains accurate documentation and files as it relates to utilization management.
• Coordinates information and findings with the business office to help recognize or resolve possible payment problems.
• Attends daily treatment team to discuss patient needs and ensure that all disciplines are aware of patient insurance status and needs.
• Ensure that insurance benefits are verified in a timely manner.
• Communicates any UR or Quality issues as noted in the chart to supervisor immediately to ensure timely resolution of problems.
• Responds to telephone and Internet inquires.
• Researches insurance company guidelines and uses admission and continuing stay criteria for coverage.
• High School Diploma Required, Bachelor's Degree in social work, behavioral or mental health, or other related health field preferred.
• One or more years of direct clinical experience in a psychiatric or mental health setting preferred.
Why Highland Hospital?Highland Hospital offers a comprehensive benefit plan and a competitive salary commensurate with experience and qualifications. Qualified candidates should apply by submitting a resume. Highland Hospital is an EOE.
Veterans and military spouses are highly encouraged to apply. Summit BHC is dedicated to serving Veterans with specialized programming at our treatment centers across the country. We recognize and value the unique strengths of the military community in supporting our mission to serve those who have served.
About Summit BHC
Sourced by ZipRecruiter
Summit BHC, based in Franklin, TN, USA, is a recognized leader in the field of addiction treatment and behavioral health care services. The company operates a nationwide network of treatment centers aimed at caring for individuals battling substance abuse and mental health disorders. Summit BHC was established with the mission to provide high-quality, addiction treatment and behavioral health services to those in need throughout the United States. With compassion, dignity, and respect as their core values, they endeavor to instill hope during the journey to recovery and beyond.
Industry
Health care and social assistance
Company size
501 - 1,000 Employees
Headquarters location
Franklin, TN, US
Year founded
2013