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Insurance Utilization Review Jobs in Milwaukee, WI

Hub Group, Inc

Driver Manager

Milwaukee, WI · On-site

$55K/yr

... safety, utilization, and retention. The DM will focus on maintaining positive employee ... The DM is responsible for conducting regular performance reviews with their drivers and determining ...

Foxconn WI

Test Engineer

Mount Pleasant, WI · On-site

The Test Engineer will develop plans for process optimization and test capacity utilization for ... Review current test equipment and facilities against present and future requirements to ensure test ...

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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.

Outpatient Therapist

Advocate Aurora Health

Wauwatosa, WI • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 19 days ago

Advocate Aurora Health rating

7.7

Company rating: 7.7 out of 10

Based on 779 frontline employees who took The Breakroom Quiz

157th of 887 rated healthcare providers

Job description

Department:
02040 ABHC Wauwatosa Adult - Behavioral Health
Status:
Full time
Benefits Eligible:
Yes
Hours Per Week:
40
Schedule Details/Additional Information:
Monday-Friday
Minimum 2 days/week in person
Pay Range:
$35.50 - $53.25
Major Responsibilities:
  • Provides quality individual, couple, family and/or group therapy, which are focused on the patient's identified diagnosis and needs. Provides crisis intervention to new and current patients as needed. Is available 24 hours a day as needed for current caseload.
  • Provides clinical/therapeutic services to a diverse client population. Accepts and treats all patients as identified or assigned willingly and with professionalism. Applies brief therapeutic intervention model as appropriate.
  • Conducts comprehensive assessments, diagnoses, formulates and monitors individualized treatment plans and treatment interventions which are in accordance with the department's Provision of Care and the Hospital's policies.
  • Provides case management and utilization review services for patient in his/her assigned caseload. Provides education to patient and family as needed.
  • Makes appropriate referrals to services within the Hospital and Aurora Behavioral Health Services or outside if needed. Serves as a liaison with these referral sources in coordination with other staff to insure continuity of care in discharge planning.
  • Actively participates in clinical supervision and peer review activities. Provides consultation with other professionals, including ongoing clinical team treatment staffing.
  • Provides community education and outreach, including referral development and marketing efforts to generate new business. Willingly accepts this as a necessary part of their job above and beyond caseload requirements.
  • Accurately completes all documentation responsibilities as outlined in department/service area procedures within established timelines. Documentation responsibilities include but are not limited to: treatment plans, discharge summaries, aftercare plans, records for billing, etc.
  • Assists in treatment development, innovation and improvements. Participates in performance improvement activities and care management initiatives as directed.
  • Must be able to demonstrate knowledge and skills necessary to provide care appropriate to the age of the patients served. Must demonstrate knowledge of the principles of growth and development over the life span and possess the ability to assess data reflective of the patient's status and interpret the appropriate information needed to identify each patient's requirements relative to his/her age-specific needs, and to provide the care needed as described in the department's policies and procedures. Age-specific information is developed further in the departmental job standards.

Licensure, Registration, and/or Certification Required:
  • Professional Counselor license issued by the State of Wisconsin or State of Illinois, or
  • Marriage and Family Therapist license issued by the State of Wisconsin or State of Illinois, or
  • Social Worker, Clinical license issued by the State of Wisconsin or State of Illinois.

Education Required:
  • Master's Degree in Social Work, or
  • Master's Degree in Psychology, Clinical, or
  • Master's Degree in Psychology, Educational, or
  • Master's Degree in Psychology, Counseling or related field.

Experience Required:
  • Typically requires 1 year of experience in providing therapy in behavioral health.

Knowledge, Skills & Abilities Required:
  • Some positions may be restricted to individuals with Master's Degree in Social Work and be a Licensed Clinical Social Worker upon hire.
  • Some positions may also require one of the following Substance Abuse licenses upon hire, Substance Abuse Counselor-In-Training, Substance Abuse Counselor, Clinical Substance Abuse Counselor, or Clinical Supervisor-In-Training.
  • Skilled as a generalist and has one or more specializations. Extensive knowledge and skills in the application of theory, practice and techniques of behavioral health and/or substance abuse treatment services.
  • Good written and verbal communication skills.
  • Demonstrates the ability to function in a complex mental health delivery system.

Physical Requirements and Working Conditions:
  • Will frequently be required to lift up to 25 lbs. without assistance, and will occasionally be required to lift over 25 lbs. with assistance.
  • May be exposed to the following hazard: mechanical, electrical, chemical, blood and body fluids.
  • Must be able to sit, stand, walk, squat, bend, and reach above shoulders and twist.
  • Must be able to restrain and control patients who are outwardly psychotic or physically combative.
  • Operates all equipment necessary to perform the job.

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.
Our Commitment to You:
Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more - so you can live fully at and away from work, including:
Compensation
  • Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training
  • Premium pay such as shift, on call, and more based on a teammate's job
  • Incentive pay for select positions
  • Opportunity for annual increases based on performance

Benefits and more
  • Paid Time Off programs
  • Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
  • Flexible Spending Accounts for eligible health care and dependent care expenses
  • Family benefits such as adoption assistance and paid parental leave
  • Defined contribution retirement plans with employer match and other financial wellness programs
  • Educational Assistance Program

Note: Eligibility for programs listed above may depend on your FTE or status (e.g., full-time, part-time, per diem, temporary, etc.); please ask a Recruiter for more information during an interview.
About Advocate Health
Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation's largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.

What Advocate Aurora Health employees say

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Benefits

Hours and flexibility

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About Advocate Health

Sourced by ZipRecruiter

Advocate Healthcare, based in Oak Lawn, Illinois, United States, is a leading figure in the health care industry. Accessible via their official website, 'advocatehealth.com', this organization provides a wide variety of medical services and treatment options. Founded in 1995 through a merger of Evangelical Health Systems Corporation and Lutheran General HealthSystem, Advocate Healthcare has grown exponentially over the years. Now, it operates more than 400 sites of care, including 12 hospitals that encompass 11 acute care hospitals, the state’s largest integrated children’s network, five Level I trauma centers, and three Level II trauma centers. Upholding their values of equality, compassion, excellence, partnership and stewardship, Advocate Healthcare's mission is centered on building lifelong relationships with patients by delivering the best health outcomes and highest level of service through an integrated approach to care and wellness.

Industry

Hospitals and health care and social assistance

Company size

10,000+ Employees

Headquarters location

Charlotte, NC, US

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