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Insurance Utilization Review Jobs in Portland, OR

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Insurance Utilization Review information

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$22

$44

$73

How much do insurance utilization review jobs pay per hour?

As of Aug 16, 2026, the average hourly pay for insurance utilization review in Portland, OR is $44.84, according to ZipRecruiter salary data. Most workers in this role earn between $35.43 and $51.49 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 Portland, OR?

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

What job categories do people searching Insurance Utilization Review jobs in Portland, OR look for?

The top searched job categories for Insurance Utilization Review jobs in Portland, OR are:

Insurance Utilization Review jobs near you
Infographic showing various Insurance Utilization Review job openings in Portland, OR as of August 2026, with employment types broken down into 1% As Needed, 73% Full Time, 22% Part Time, and 4% Contract. Highlights an 91% Physical, 1% Hybrid, and 8% Remote job distribution, with an average salary of $91,646 per year, or $44.1 per hour.

Adolescent Clinical Director

Monte Nido & Affiliates, LLC

Boring, OR • On-site

$130K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 17 days ago

Job description

Adolescent Clinical Director

Located in West Linn, Oregon

Our organization operates a 14-bed residential treatment facility in West Linn, Oregon, dedicated to adolescents seeking help for Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, or Exercise Addiction.

At our facility, we empower adolescents and their families on their journey to complete recovery. We equip each young person with the tools to face life's challenges without the burden of an eating disorder. Our approach includes providing empathy, education, and support to families, recognizing them as essential partners in the recovery process. We strive to help each adolescent develop healthy skills and a profound understanding of how to embrace their unique individuality.

We are currently looking for a Clinical Director to become a vital part of our team.

The Clinical Director will oversee the overall clinical excellence of our treatment program. Responsibilities include ensuring high-quality care, fostering continuous improvement, managing staffing needs, and overseeing budgetary responsibilities. This role is crucial in enhancing the clinical programming of our facility to improve our clients’ experiences.

Salary can reach up to $130,000, depending on experience.

Total Rewards:

Join us for a fulfilling career and take advantage of a wide range of comprehensive benefits! We are dedicated to your success and well-being, offering:

  • Competitive salary
  • Medical, dental, and vision insurance
  • Retirement plan
  • Company-funded life insurance, AD&D, and short-term disability
  • Employee Assistance Program (EAP)
  • Flexible Spending Account (FSA)
  • Health Savings Account (HSA)
  • Paid time off
  • Opportunities for professional development
  • And much more!

We are committed to fostering a diverse workplace and proudly uphold our status as an equal opportunity employer. All qualified candidates will be considered for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.

Responsibilities Include:

  • Overseeing the clinical quality of programming with a focus on continuous improvement, staffing, and fiscal management.
  • Leading clinical therapists through mentoring and coaching; assisting therapists in interactions with insurance providers.
  • Modeling healthy eating behaviors by sharing meals with clients and staff during mealtimes.
  • Occasionally conducting individual, group, or family therapy sessions.
  • Engaging in discharge and aftercare planning alongside the entire treatment team.
  • Providing safe, affirming, and empathetic support to diverse populations.

Qualifications:

  • A minimum of 5 years of leadership experience in a behavioral health environment is preferred; other leadership experience may be considered.
  • Familiarity with admissions and intake processes, Utilization Review, and interactions with third-party or insurance payers.
  • Experience with Joint Commission and regulatory compliance standards is desirable.
  • Ability to manage budgets and utilize Key Performance Indicators (KPIs) is preferred.
  • Experience in an Eating Disorder program or similar residential behavioral health setting is advantageous.
  • Understanding of Diversity, Equity, and Inclusion practices.
  • Experience in employee selection and performance management is a plus.
  • A Master’s degree in a clinical discipline is required.
  • Must possess an active state license or be eligible for licensure.