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Insurance Utilization Review Jobs in Minnesota (NOW HIRING)

... utilization review processes to assure continuity for the most appropriate level of care for ... Perform insurance benefit verifications and secure initial pre-authorization for treatment and ...

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Insurance Utilization Review information

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How much do insurance utilization review jobs pay per hour?

As of Jul 15, 2026, the average hourly pay for insurance utilization review in Minnesota is $41.41, according to ZipRecruiter salary data. Most workers in this role earn between $32.74 and $47.55 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 the Insurance Utilization Review position, and why are they important?

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 job?

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 Minnesota? The most popular types of Insurance Utilization Review jobs in Minnesota are:
What cities in Minnesota are hiring for Insurance Utilization Review jobs? Cities in Minnesota with the most Insurance Utilization Review job openings:
SSBV Clinical Claim Review RN

SSBV Clinical Claim Review RN

UnitedHealth Group

Plymouth, MN • Remote

$28.94 - $51.83/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 2 days ago


UnitedHealth Group rating

7.6

Company rating: 7.6 out of 10

Based on 145 frontline employees who took The Breakroom Quiz

191st of 885 rated healthcare providers


Job description

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.   

Let's face it, no industry is moving faster than health care. And no organization is better positioned to lead health care forward than UnitedHealthcare, part of the UnitedHealth Group family of businesses. As a SSBV Clinical Claims Review RN, you can put your skills and talents to work. This is a multifaceted role that is highly rewarding.

It feels great to have autonomy, though there's also a lot of responsibility that comes with it. In this role, you'll be accountable for making decisions that directly impact on our members. And at the same time, you'll be challenged by a demanding case load in a rapidly changing, production-driven environment.

You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

  • Perform administrative reviews of short stay inpatient hospital claims in accordance with Federal, State and client specific requirements
  • Responsible for documentation of all determinations
  • Maintain accurate use of screening criteria

What are the reasons to consider working for UnitedHealth Group?   Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:

  • Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
  • Medical Plan options along with participation in a Health Spending Account or a Health Saving account
  • Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
  • 401(k) Savings Plan, Employee Stock Purchase Plan
  • Education Reimbursement
  • Employee Discounts
  • Employee Assistance Program
  • Employee Referral Bonus Program
  • Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

  • Associate's degree 
  • Current and unrestricted RN license in the state of residency
  • 5 years of clinical documentation experience
  • 3 years of experience as an RN, including inpatient/acute setting
  • Intermediate level of proficiency in Microsoft Office (to include Microsoft Excel and One Note)
  • Intermediate level of proficiency in writing
  • Designated home office workspace with access to install secure high-speed internet via cable/DSL

Preferred Qualifications:

  • Undergraduate or higher degree
  • A background in utilization review for an insurance company or experience in case management
  • Familiarity with InterQual and/or MCG Care Guidelines
  • Critical thinking skills

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.94 to $51.83 per hour based on full-time employment. We comply with all minimum wage laws as applicable. 

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. 

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

     

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

#RPO #GREEN


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