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Insurance Utilization Review Jobs in Milwaukee, WI

DERSE INC

Human Resources Generalist

Milwaukee, WI

Annually evaluates the cost of Employee Benefits, including health care cost containment, utilization review, and insurance claim costs. * Leads strategy planning and presents the communication for ...

CorVel Corporation

RN Field Case Manager I

Waukesha, WI · On-site

$65 - $90/hr

A cost containment background, such as utilization review or managed care is helpful * Strong ... Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off. In addition ...

Aurora Health Care

Outpatient Therapist

Wauwatosa, WI · On-site

$60 - $80/hr

Provides case management and utilization review services for patient in his/her assigned caseload ... Serves as a liaison with these referral sources in coordination with other staff to insure ...

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Insurance Utilization Review information

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How much do insurance utilization review jobs pay per hour?

As of Sep 6, 2026, the average hourly pay for insurance utilization review in Milwaukee, WI is $41.66, according to ZipRecruiter salary data. Most workers in this role earn between $32.93 and $47.84 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 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 August 2026, with employment types broken down into 1% As Needed, 73% Full Time, 21% Part Time, and 5% Contract. Highlights an 92% Physical, 1% Hybrid, and 7% Remote job distribution, with an average salary of $86,649 per year, or $41.7 per hour.

Human Resources Generalist

DERSE INC

Milwaukee, WI

Full-time

Medical, Dental, Life, Retirement

Re-posted 29 days ago

Job description

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Description

Derse is a complete face-to-face marketing agency and exhibit builder. We bring a smarter approach to building client sales while managing their trade show, marketing environments and event programs. Our teams are made up of smart and forward-thinking people who bring experiential marketing solutions to life!

We believe in committing to a long-term investment in your career with a total rewards package including:

  • Competitive pay and comprehensive benefits package
  • A bright and energetic culture where your ideas are valued
  • 75+ years of financial stability

Derse employs nearly 600 people in marketing, program management, creative & skilled production, and corporate support. Locations include Milwaukee, Chicago, Las Vegas, Dallas, Pittsburgh, and various communities in Poland & Germany. Visit our website derse.com to learn more! 


 As the Human Resources Generalist, you'll take ownership of a variety of HR-related initiatives within total rewards/benefits, employee onboarding & orientation, payroll, and other general Human Resource inquiries and functions. The Human Resources Generalist is also a key player in leading programs such as our insurance open enrollment, while ensuring compliance, employee support across all (6) Derse divisions, and helping drive a positive and well-informed employee experience. The Human Resources Generalist must reside within our Milwaukee office, and requires a strong mix of technical and creative skills. Read through and apply if this sounds like the opportunity for you!   


Human Resources Generalist Responsibilities

  • Administer all Employee Benefit Programs, including Health, Dental, Life, Disability, 401K and Profit Sharing Plans.
  • Annually evaluates the cost of Employee Benefits, including health care cost containment, utilization review, and insurance claim costs.
  • Leads strategy planning and presents the communication for benefit programs, improving employee engagement and understandings
  • Assume ownership of the open enrollment process. This includes:
    • Working within our HRIS to build and test open enrollment site
    • Handle all communication to staff and answer any inquiry within a timely manner
    • Share results and post-enrollment metrics with management
  • Create and distribute total rewards statements to emphasize the value to all employees of their benefit packages.
  • Maintain current knowledge of and comply with provisions of COBRA, FMLA, ADA, HIPAA, ACA, ERISA and other applicable laws as necessary. Files appropriate reports with State and Federal agencies.
  • Administer COBRA, FMLA, and ADA programs on behalf of all Derse offices. Including maintaining HR tracking of FMLA and Work Comp.
  • Launch and monitor "Wellness Program" ensuring timely notification to all employees of the yearly goals/objectives.
  • Review and communicate participation levels of Wellness Program and how they affect the insurance premium sharing percentage.
  • Manages costs of the Employee Benefit Programs and Union-related fringes. and processes and approves all correlating bills / invoices.
  • Directly responsible for planning and conducting new hire orientations for assigned divisions and department.
  • Manage the new hire process within the HRIS to ensure proper maintenance of employee records.
  • Responsible for the payroll process for all salaried personnel on a bi-weekly basis, as well as oversee German payroll.
  • Maintains knowledge of governmental regulations, reporting requirements and legal requirements affecting company policies and human resource practices to include Wage and Hour and FLSA regulations to ensure compliance.
  • Assists in carrying out the Administration of Derse's 401K and Profit-Sharing plans including audits and annual notices
  • Responds to inquiries regarding policies, procedures, and programs.
  • Completes all MRA and industry-related surveys (benefits, turnover, salary etc)
  • Complete any federal, state or local annual reports (EEO1, CA Data Reporting etc)
  • Manage all work-related injuries and appropriate reporting, while also guiding employee.
  • Serve as a member of the Milwaukee/Corporate Social Events Committee
  • Lead all company charitable / fundraising activities (including United Way).
Requirements

Human Resources Generalist Requirements and Qualifications 

  • Bachelor's degree in related discipline with 5 - 7+ years experience in Human Resources required. HR related certification preferred.
  • Prior experience leading total rewards programs, employee orientations, and payroll supervision required.
  • Beneficial to having exposure to handling FMLA, ADA, and WorkComp cases.
  • Ability to work under minimal supervision in a fast-paced environment, supporting multiple locations.
  • Strong analytical skills with the ability to research, compile and interpret data in a logical format and perform in-depth analysis
  • Ability to travel to support Human Resources initiatives across Derse offices. 

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