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Insurance Utilization Review Jobs in Oregon (NOW HIRING)

GQR Global Markets

RN Case Manager

Prairie City, OR · On-site

$2.7K - $2.8K/wk

Case Management/Utilization Review Shift: Day Benefits: * Day 1 Insurance * Cigna medical, MetLife dental and vision insurance * License reimbursement for new licenses needed for each assignment

GQR

RN - Case Manager

Prairie City, OR · On-site

$2.7K - $2.8K/wk

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

GQR Global Markets

RN - Case Manager

Portland, OR · On-site

$2.3K - $2.4K/wk

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

Centene

Remote Medical Director, Appeals

OR · On-site +1

$236K - $449K/yr

Performs medical review activities pertaining to utilization review, quality assurance, and medical ... Course work in the areas of Health Administration, Health Financing, Insurance, and/or Personnel ...

Centene

Remote Medical Director, Inpatient Medicare

OR · On-site +1

$236K - $449K/yr

Performs medical review activities pertaining to utilization review, quality assurance, and medical ... Course work in the areas of Health Administration, Health Financing, Insurance, and/or Personnel ...

Asante

Case Management Specialist

Medford, OR · On-site

$23.28 - $32.02/hr

... utilization review, and denials management activities as defined by the RN Discharge Coordinator ... Life insurance, disability coverage, and employee assistance programs. At Asante, we are guided by ...

GQR Healthcare

Travel ED Case Manager RN

Portland, OR · On-site

$2.3K - $2.4K/wk

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

New

GQR Healthcare

Travel RN Case Manager

Prairie City, OR · On-site

$2.7K - $2.8K/wk

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

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All JobsInsurance Utilization Review JobsInsurance Utilization Review Jobs in Oregon

Insurance Utilization Review information

See Oregon salary details

$22

$44

$72

How much do insurance utilization review jobs pay per hour?

As of Sep 7, 2026, the average hourly pay for insurance utilization review in Oregon is $44.70, according to ZipRecruiter salary data. Most workers in this role earn between $35.34 and $51.35 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 popular job titles related to Insurance Utilization Review jobs in Oregon?

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

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

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

What cities in Oregon are hiring for Insurance Utilization Review jobs?

Cities in Oregon with the most Insurance Utilization Review job openings:

Insurance Utilization Review jobs near you
Infographic showing various Insurance Utilization Review job openings in Oregon as of August 2026, with employment types broken down into 1% As Needed, 70% Full Time, 23% Part Time, 5% Contract, and 1% Nights. Highlights an 91% Physical, 1% Hybrid, and 8% Remote job distribution, with an average salary of $92,985 per year, or $44.7 per hour.

Physician Advisor-Utilization Management

Samaritan Health Services

Corvallis, OR • On-site

Per diem

Posted 3 days ago

New

Samaritan Health Services rating

6.8

Company rating: 6.8 out of 10

Based on 67 frontline employees who took The Breakroom Quiz

498th of 898 rated healthcare providers

Job description

  • JOB SUMMARY/PURPOSE
    • Provides medical consultation and utilization management case review at Samaritan Health Services Hospitals. Acts as a liaison with medical staff and hospital administration regarding admission, discharge, and length of stay and service utilization decisions.
  • DEPARTMENT DESCRIPTION
    • The Utilization Management team is a centralized team of physicians, nurses and specialists that perform admission and continued stay compliance reviews for all Samaritan Hospitals. Utilization Management nurses and physicians are specially trained in Medicare and commercial insurance regulations, perform reviews on all admitted patients and provide staff and physician education. The Utilization Management team communicates information to insurance companies to assure payment of hospital services.
  • EXPERIENCE/EDUCATION/QUALIFICATIONS
    • MD or DO degree required.
    • Board Certification in the practice specialty required.
    • Unrestricted license to practice medicine in the State of Oregon required.
    • Strong broad based clinical background with five (5) years of medical experience caring for adult patients in a hospital setting required.
    • Three (3) years experience in similar areas of accountability preferred.
    • Experience with computer applications, electronic medical records, other medical programs and electronic medical literature required.
    • Experience with hospital Utilization Review, Medicare regulations and health insurance policies preferred.
    • Experience efficiently researching, analyzing and summarizing complex clinical topics preferred.
  • KNOWLEDGE/SKILLS/ABILITIES
    • Medicine - Possess the skills and knowledge needed to review clinical documentation regarding human injuries, diseases, and/or behavioral conditions. Ability to recognize symptoms, understand drug properties and interactions and evaluate the treatment planned or provided by other SHS providers.
    • Compliance - Ability to evaluate information to determine compliance with laws, regulations, or standards in the clinical and utilization management areas of responsibility. Uses clinical and regulatory knowledge to verify compliant process application.
    • Business Writing - Strong business writing skills, including the ability to professionally communicate clinical content in written/typed documentation that is easily understood by the end user. Ability to use a computer for required documentation.
    • Communication - Effective written and oral communication skills to explain complex medical and regulatory issues, exchange information between team members, and tactfully discuss and teach utilization management and compliance concepts. Ability to listen and understand complex information and ideas.
    • Conflict resolution - Influences others to build consensus and gain cooperation. Proactively resolves conflicts in a positive and constructive manner.
  • PHYSICAL DEMANDS
    • Rarely
      (1 - 10% of the time)
      Occasionally
      (11 - 33% of the time)
      Frequently
      (34 - 66% of the time)
      Continually
      (67 - 100% of the time)
      CLIMB - STAIRS
      LIFT (Floor to Waist: 0"-36") 20 - 40 Lbs
      LIFT (Floor to Waist: 0"-36") 40 - 60 Lbs
      LIFT (Floor to Waist: 0"-36") 60 or more Lbs
      LIFT (Knee to chest: 24"-54") 0 - 20 Lbs
      LIFT (Waist to Eye: up to 54") 0 - 20 Lbs
      LIFT (Overhead: 54" and above) 0 - 20 Lbs
      CARRY 1-handed, 0 - 20 pounds
      CARRY 2-handed, 0 - 20 pounds
      CARRY 2-handed, 20 - 40 pounds
      SQUAT Static (hold >30 sec)
      SQUAT Repetitive
      KNEEL (on knees)
      REACH - Upward
      PUSH (0 - 20 pounds force)
      PULL (0 - 20 pounds force)
      PUSH (20 - 40 pounds force)
      PULL (20 - 40 pounds force)
      Enter and Exit Vehicle
      STAND
      WALK - LEVEL SURFACE
      LIFT (Floor to Waist: 0"-36") 0 - 20 Lbs
      ROTATE TRUNK Sitting
      ROTATE TRUNK Standing
      BEND FORWARD at waist
      REACH - Forward
      PINCH Fingers
      GRASP Hand/Fist
      SIT
      MANUAL DEXTERITY Hands/wrists
      FINGER DEXTERITY

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