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Insurance Utilization Review Jobs in Utah (NOW HIRING)

Imh

Manager Utilization and Care Management

Murray, UT · On-site +1

$44.99 - $69.44/hr

The Clinical Manager at Select Health leads and supervises a team of Utilization Review and Care Management clinicians within an insurance and managed care environment. This role ensures delivery of ...

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Insurance Utilization Review information

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$38

$62

How much do insurance utilization review jobs pay per hour?

As of Sep 3, 2026, the average hourly pay for insurance utilization review in Utah is $38.49, according to ZipRecruiter salary data. Most workers in this role earn between $30.43 and $44.18 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 Utah?

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

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

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

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

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

Insurance Utilization Review jobs near you
Infographic showing various Insurance Utilization Review job openings in Utah as of August 2026, with employment types broken down into 1% As Needed, 69% Full Time, 24% Part Time, and 6% Contract. Highlights an 91% Physical, 1% Hybrid, and 8% Remote job distribution, with an average salary of $80,064 per year, or $38.5 per hour.

Utilization Review Therapist

Odyssey House Inc.

Millcreek, UT • On-site

Full-time, Part-time

Medical, Dental, Vision, Retirement, PTO

Posted 8 days ago

Job description

Odyssey House is looking for a Full-Time Utilization Review Specialist.
Summary: Odyssey House's Mission is "Empowering people to heal and build better lives. We are dedicated to helping individuals and families reclaim their lives through effective substance use treatment, medical care, prevention, and mental health services. Odyssey House continues to receive Best of State awards for our clinical work and has received Top Workplace Awards. Join our amazing team of healthcare professionals today!
Full-Time Benefits:
  • $9k per year tuition eligible
  • Access to 24/7 EAP program (Employee Assistance Program) for Mental Health support and more!
  • Opportunities for paid continuing education/training
  • Monthly incentives and awards
  • Flexible scheduling
  • Casual dress and atmosphere
  • Opportunities for bonuses, awards, raises, and promotions
  • Incredible health insurance (medical, dental, vision, FSA, long and short-term disability)
  • Immediate eligibility to participate in our 403(b)-retirement plan, Employer 100% match up to 5% after 1 year
  • 35 paid days off (additional PTO accrual after 1 year)
  • EXTRA time off and gift packages for PT and FT staff that stay more than 90 days!
  • Sabbatical Program - where we pay you to take a vacation after 5 years of service!
  • On-Demand Pay - Get a portion of your paycheck early for hours already worked! (conditions apply)
  • UTA free passes available for your work commute

Functions of the Job:
  • Track UCE/UR/Insurance Due Dates for all funding and ensure timely submission of all requests.
  • Review all UR submissions for medical necessity, make corrections to UR, and submit for approval.
  • Provide ongoing training to staff regarding writing to medical necessity or other issues that present during reviewing UMs.
  • Resolve funding denials through immediate UR modification and resubmission to minimize loss of days.
  • Update Best Notes and UWITS, as needed, to reflect authorized days.
  • Generate Reports with due dates, notify staff of changes, and manage staff progress.
  • Complete monthly Medicaid check (upload snapshots to Best Notes.)
  • Complete "doc-to-doc" calls, as needed, for insurance authorization.
  • Communicate with OH billing department to resolve issues.
  • Complete all responsibilities in a timely, thorough, and professional manner.
  • Demonstrate fluency in ASAM and DSM-V through successful authorization and processing of UMs.
  • Other Duties as assigned.

Requirements
Licensure / Education / Prior Experience Required:
  • Licensed Mental Health Professional, including - CSW, LCSW, CMHC, ACHMC, LMFT, MFTI.
  • Graduate degree in the mental health field.
  • Willingness and ability to pass a criminal background check
  • First Aid and CPR Certification (available at Odyssey House)
  • Must comply with annual TB tests and Flu immunization (and other immunizations as needed)
  • Must meet employment eligibility
  • Must be able to work variable shifts as needed

All employees of Odyssey House are required to adhere to: Odyssey House mission, philosophy, and scope of service; Division of Human Services Code of Conduct and all other relevant service contract requirement standards; ensuring a safe environment for all clients and staff; providing exemplary customer service to both internal and external customers; fostering a positive work environment; ensuring high-quality client care within the scope of the assigned position.
Each employee is expected to clearly understand roles and responsibilities regarding the following: Specific job positions, time management, personnel file requirements, client record system, incident reporting, mandatory training requirements, maintaining proper client boundaries, and individual rights of clients and staff.
Physical Demands of the Job: Ability to lift up to 15 lbs., drive (or adequate alternate transportation), sit for prolonged periods, and perform light to moderate physical activity at times. Able to passively restrain residents without likely injury to self due to existing medical condition.
EEOC Statement: Odyssey House is an equal-opportunity employer. All aspects of employment, including the decision to hire, promote, discipline, or discharge, will be based on merit, competence, performance, and business needs. We do not discriminate based on race, color, religion, marital status, age, national origin, ancestry, physical or mental disability, medical condition, pregnancy, genetic information, gender, sexual orientation, gender identity or expression, veteran status, or any other status protected under federal, state, or local law.

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