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Insurance Utilization Review Jobs in Milwaukee, WI

Froedtert

RN, Denials Management

Menomonee Falls, WI · On-site

$36.38 - $56.39/hr

Assists the case managers with utilization review issues, and provides recommendations for process ... Prior utilization management, insurance background, and denial management experience is preferred.

Rogers Behavioral Health

Care Advocate

Oconomowoc, WI · On-site

Communicate with utilization review (UR), admitting and clinical leadership regarding the quality ... Communicate with patients and/or family members concerning insurance benefits, authorizations, self ...

Ambient Edge

Plumbing Manager

Milwaukee, WI · On-site

$150K/yr

Nearly 100% employer-paid Medical, Dental & Vision insurance and 50% employer-paid coverage for ... utilization. * Review scheduling efficiency, job flow, and capacity planning to minimize downtime ...

Ambient Edge

Plumbing Manager

Milwaukee, WI

$150K/yr

Nearly 100% employer-paid Medical, Dental & Vision insurance and 50% employer-paid coverage for ... utilization. * Review scheduling efficiency, job flow, and capacity planning to minimize downtime ...

Ambient Edge

Plumbing Manager

Milwaukee, WI · On-site

$150K/yr

Nearly 100% employer-paid Medical, Dental & Vision insurance and 50% employer-paid coverage for ... utilization. * Review scheduling efficiency, job flow, and capacity planning to minimize downtime ...

UHS

Intake Coordinator

West Allis, WI · On-site

$17.50 - $24/hr

... utilization review staff, Granite Hill Hospital business office staff and clinical staff to insure continuity of communication. This position is also responsible for inquiry calls, insurance ...

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All JobsInsurance Utilization Review JobsInsurance Utilization Review Jobs in Milwaukee, WI

Insurance Utilization Review information

See Milwaukee, WI salary details

$21

$41

$67

How much do insurance utilization review jobs pay per hour?

As of Aug 16, 2026, the average hourly pay for insurance utilization review in Milwaukee, WI is $41.56, according to ZipRecruiter salary data. Most workers in this role earn between $32.84 and $47.74 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 popular job titles related to Insurance Utilization Review jobs in Milwaukee, WI?

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

What job categories do people searching Insurance Utilization Review jobs in Milwaukee, WI look for?

The top searched job categories for Insurance Utilization Review jobs in Milwaukee, WI are:

What cities near Milwaukee, WI are hiring for Insurance Utilization Review jobs?

Cities near Milwaukee, WI with the most Insurance Utilization Review job openings:

Insurance Utilization Review jobs near you
Infographic showing various Insurance Utilization Review job openings in Milwaukee, WI as of July 2026, with employment types broken down into 1% As Needed, 78% Full Time, 17% Part Time, and 4% Contract. Highlights an 90% Physical, 1% Hybrid, and 9% Remote job distribution, with an average salary of $86,573 per year, or $41.6 per hour.

RN DENIALS MANAGEMENT HRLY, FCH - ENTERPRISE QUALITY CDI/UR/DM

Froedtert

Milwaukee, WI • On-site

Part-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 25 days ago

Job description

Discover. Achieve. Succeed. #BeHere

Location: US:WI:MILWAUKEE at our FROEDTERT HOSPITAL facility.

This job is REMOTE.

FTE: 0.500000

Standard Hours: 20.00

Shift: Shift 1

Shift Details: 1/2 day Wednesday, Thursday and Friday Holidays: no Weekends: no

Job Summary:

Assumes responsibility for managing inpatient denials for all payers related to medical necessity and clinical validation audits, and coordinates the appeal process with physicians, coding, third party payers, and third party auditors. Assists the case managers with utilization review issues, and provides recommendations for process improvement in the areas of utilization review and denial management. Other duties as assigned.

EXPERIENCE DESCRIPTION:

A minimum of 5 years of acute care nursing experience is required. Prior utilization management, insurance background, and denial management experience is preferred.

EDUCATION DESCRIPTION:

Bachelor's degree is required. Professional knowledge of nursing theory and practice at a level normally acquired through completion of a minimum of four years education at an accredited School of Nursing in order to be eligible for licensure as a Registered Nurse is required.

TRAINING DESCRIPTION:

Previous experience with clinical validation denial review and appeal processes. Knowledge of ICD-10 Coding Guidelines.

SPECIAL SKILLS DESCRIPTION:

Interpersonal skills necessary to instruct and maintain effective contacts with a variety of hospital personnel. Analytical skills necessary to prepare statistical reports and develop solutions to problems. Technical writing ability for appeal letters and reports.

LICENSURE DESCRIPTION:

Requires current state of Wisconsin Registered Nurse License or a Multi-state Nursing License from a participating state in the NLC (Nurse Licensure Compact).

Compensation, Benefits & Perks at Froedtert Health

Froedtert Health Offers a variety of perks & benefits to staff, depending on your role you may be eligible for the following:

  • Paid time off
  • Growth opportunity- Career Pathways & Career Tuition Assistance, CEU opportunities
  • Academic Partnership with the Medical College of Wisconsin
  • Referral bonuses
  • Retirement plan - 403b
  • Medical, Dental, Vision, Life Insurance, Short & Long Term Disability, Free Workplace Clinics
  • Employee Assistance Programs, Adoption Assistance, Healthy Contributions, Care@Work, Moving Assistance, Discounts on gym memberships, travel and other work life benefits available


The Froedtert & the Medical College of Wisconsin regional health network is a partnership between Froedtert Health and the Medical College of Wisconsin supporting a shared mission of patient care, innovation, medical research and education. Our health network operates eastern Wisconsin's only academic medical center and adult Level I Trauma center engaged in thousands of clinical trials and studies. The Froedtert & MCW health network, which includes ten hospitals, nearly 2,000 physicians and more than 45 health centers and clinics draw patients from throughout the Midwest and the nation.

We are proud to be an Equal Opportunity Employer who values and maintains an environment that attracts, recruits, engages and retains a diverse workforce. We welcome protected veterans to share their priority consideration status with us at 262-439-1961. We maintain a drug-free workplace and perform pre-employment substance abuse testing. During your application and interview process, if you have a need that requires an accommodation, please contact us at 262-439-1961. We will attempt to fulfill all reasonable accommodation requests.

Employment Type: OTHER
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About Froedtert

Sourced by ZipRecruiter

Froedtert is a world-class healthcare organization based in Milwaukee, WI, United States. The company operates within the healthcare and wellness industry, providing a broad spectrum of medical services to the residents of southeastern Wisconsin and beyond. Froedtert was founded in 1980 and is an academic health network, which ripples an integrated affiliation with the Medical College of Wisconsin. The company prides itself on its cutting-edge treatments, sophisticated technology, and groundbreaking research. Froedtert’s mission is to advance health in the communities they serve, with a profound commitment towards patient care, education, research and community outreach.

Industry

Health care and social assistance

Company size

1,001 - 5,000 Employees

Headquarters location

Milwaukee, WI, US

Year founded

1980

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