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Insurance Utilization Review Jobs in Oklahoma (NOW HIRING)

Ballard Nursing Center

Therapy - PT

Ada, OK · On-site

$1.3K - $1.7K/wk

... utilization review meetings, and rehabilitation meetings. Participates in facility and company ... Medical, dental & vision insurance * Free and unlimited continuing education units (CEUs) * 24/7 ...

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All JobsInsurance Utilization Review JobsInsurance Utilization Review Jobs in Oklahoma

Insurance Utilization Review information

See Oklahoma salary details

$19

$39

$63

How much do insurance utilization review jobs pay per hour?

As of Aug 18, 2026, the average hourly pay for insurance utilization review in Oklahoma is $39.04, according to ZipRecruiter salary data. Most workers in this role earn between $30.87 and $44.86 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 Oklahoma?

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

What are popular job titles related to Insurance Utilization Review jobs in Oklahoma?

For Insurance Utilization Review jobs in Oklahoma, the most frequently searched job titles are:

What job categories do people searching Insurance Utilization Review jobs in Oklahoma look for?

The top searched job categories for Insurance Utilization Review jobs in Oklahoma are:

Insurance Utilization Review jobs near you
Infographic showing various Insurance Utilization Review job openings in Oklahoma as of August 2026, with employment types broken down into 6% As Needed, 88% Full Time, and 6% Part Time. Highlights an 100% In-person job distribution, with an average salary of $81,204 per year, or $39 per hour.

Board Certified-(M.D, D.O) Oklahoma City Cardiology Advisor-Certified for IME

Dane Street, LLC

Oklahoma City, OK • On-site

Full-time

Re-posted 5 days ago

Job description

As Physician Reviewer/Advisor you will utilize clinical expertise and reviews insurance appeals, and prospective and retrospective claims. The Physician Reviewer will provide an interpretation of the medical necessity of services provided by other healthcare professionals in compliance with client specific policies, nationally recognized evidence-based guidelines, and standards of care.

MAJOR DUTIES AND RESPONSIBILITIES:

    • Reviews all medical records and addresses each question posed by the client utilizing client specific criteria or other nationally recognized evidence-based criteria
    • Ensures that the rationale for the determination is clear, concise, and contains adequate supporting documentation to substantiate the decision
    • Identifies, critiques, and utilizes current criteria and resources such as national, state, and professional association guidelines and peer-reviewed literature that support sound and objective decision-making and rationales in reviews; refrains from using case studies, cohorts, and the like to make decisions due to their limited sample sizes
    • Provides copies of any criteria utilized in a review with the report in a timely manner
    • Returns cases on or before the due date and time
    • Makes telephone calls as mandated by the state and/or client specifics
    • Maintains proper credentialing and state licenses and any special certifications or requirements necessary to perform the job
    • Performs other duties as assigned including identifying and responding to quality assurance issues, complaints, regulatory issues, depositions, court appearances, or audits
    • Board certification required, active practice required

PLEASE BE AWARE: In the interest of the security of all parties, Dane Street will never conduct interviews via text or request checks from candidates for any reason including the purchase of equipment.

Benefits

Benefits

  • Robust opportunity for supplemental income
  • Schedule flexibility and predictable work hours - You choose services and case types, dictate volume, and conduct exams and reviews based on your schedule availability
  • No doctor/patient relationship is established and no treatment is provided. These are advisory-only opinions.
  • Enhanced industry expertise strengthening your medical practice with medical necessity and utilization review/management expertise
  • Expanded credentials as an expert in Independent Medical Exams and physician advisor services
  • Fully prepped cases, streamlined case flow, transcription services at no cost, and user-friendly work portal