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Insurance Utilization Review Jobs in Massachusetts

GQR

RN - Case Manager

Everett, MA · On-site

$2.9K - $3.0K/wk

Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location: Everett ... Benefits: * Day 1 Insurance * Cigna medical, MetLife dental and vision insurance * License ...

GQR

RN - Case Manager

Milford, MA · On-site

$2.1K - $2.2K/wk

Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location: Milford ... Benefits: * Day 1 Insurance * Cigna medical, MetLife dental and vision insurance * License ...

Activate Care

Registered Nurse, MDS (FT & PT)

Boston, MA · On-site

... review and audit. * Complete required training and ongoing training to nd maintain system access ... Valid driver's license, a personal vehicle, and verifiable insurance are required. * Minimum of 1 ...

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All JobsInsurance Utilization Review JobsInsurance Utilization Review Jobs in Massachusetts

Insurance Utilization Review information

See Massachusetts salary details

$23

$46

$75

How much do insurance utilization review jobs pay per hour?

As of Aug 12, 2026, the average hourly pay for insurance utilization review in Massachusetts is $46.18, according to ZipRecruiter salary data. Most workers in this role earn between $36.49 and $53.03 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 Massachusetts? The most popular types of Insurance Utilization Review jobs in Massachusetts are:
What are popular job titles related to Insurance Utilization Review jobs in Massachusetts? For Insurance Utilization Review jobs in Massachusetts, the most frequently searched job titles are:
What job categories do people searching Insurance Utilization Review jobs in Massachusetts look for? The top searched job categories for Insurance Utilization Review jobs in Massachusetts are:
What cities in Massachusetts are hiring for Insurance Utilization Review jobs? Cities in Massachusetts with the most Insurance Utilization Review job openings:
Insurance Utilization Review jobs near you
Infographic showing various Insurance Utilization Review job openings in Massachusetts as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution, with an average salary of $96,048 per year, or $46.2 per hour.

Social Worker, Full time, Days

TaraVista Behavioral Health

Devens, MA • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 9 days ago

Job description

Join us as a Social Worker!
To support professional growth, we're offering supervision hours to eligible master's level clinicians working toward license.
Full time - 40 hours, day shift! No weekends required!
As a Social Worker for TaraVista in Devens, Massachusetts, you'll bring your experience and knowledge where your voice matters. A Social Worker is an integral part of our multidisciplinary treatment team. You will provide direct care and support not only to our patients but also their families and make decisions that impact the lives of your peers, your patients, and your community. In exchange, we will care for you as much as you care for our patients.
As a Social Worker:
  • You will be an active participant in the health care team who provides direct and indirect care to patients, families, and legal guardians.
  • Provide clinical social work services in partnership with physicians, nurse practitioners, and direct care staff.
  • Administer biopsychosocial assessments, multidisciplinary treatment planning, case management, individual and family therapy, and systems interventions directed towards comprehensive discharge strategies and aftercare planning.
  • Assist with insurance utilization review and provide liaison services to patients and their family/guardians, the hospital, and outside community agencies and programs as needed for care coordination.
  • You will work collaboratively as a member of the multidisciplinary treatment team and contribute to each patient's treatment plan by helping develop, implement, and document appropriate goals and interventions, informed by patient strengths and presenting psychiatric problems.

The Social Worker will have the following:
  • LCSW or license eligibility for LMHC required. LICSW or LMHC with prior experience working within an inpatient behavioral health or acute care settings preferred.
  • Clinical Master's Degree, required
  • Child & Adolescent Needs & Strengths (CANS) Certification, required within 30 days of hire
  • Prior experience working within an inpatient behavioral health setting, short-term treatment and/or acute care preferred.
  • Advanced level knowledge and experience in the application of clinical behavioral health treatment and family system modalities for patients with psychiatric illnesses, as well as risk and safety assessment
  • Sufficient typing and computer skills to facilitate use of Electronic Health Record required; experience with Electronic Health Record, including Medsphere/Vista preferred.
  • Possess advanced level knowledge and experience in the application of clinical behavioral health treatment and family system modalities for patients with psychiatric illnesses.
  • Possess an understanding of appropriate community support and systems available to patients after discharge. Demonstrate competency and possess the knowledge base, skill, and ability to work in an acute inpatient setting.
  • Bilingual English/Spanish preferred.

When you join the growing TaraVista team as a Social Worker, you'll receive:
  • Medical, Dental, and Vision
  • 401(k) match
  • Employer paid long term disability (LTD)
  • Employer paid life and AD&D Insurance
  • Generous Paid Time Off
  • Flexible Spending Account
  • Tuition Reimbursement

Pay Range:
Compensation will be determined based on the candidate's relevant experience and licensure.
$64,000 - $83,000
TaraVista is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

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