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Insurance Utilization Review Jobs (NOW HIRING)

UHS

Utilization Review Coordinator

Augusta, GA · On-site

... insurance companies/authorizing entities to ensure initial precertification and continued ... utilization review. CERTIFICATIONS, LICENSES, REGISTRATION LMHC, LAPC, LPC, LMSW, LCSW, LPN or RN ...

UHS

Utilization Review Coordinator

Mountain City, TN · On-site

Complete insurance eligibility verifications twice monthly. * Coordinate daily and weekly admission and discharge utilization processes. * Maintain utilization management databases and spreadsheets.

ARcare

Utilization Review Associate

Augusta, AR · On-site

Utilization Review Associate Job Type: Full-time, 40 hours per week required (hourly POSITION ... That mission drives everything we do, from accepting every patient, regardless of insurance status ...

ARcare

Utilization Review Associate

Augusta, AR

Utilization Review Associate Job Type: Full-time, 40 hours per week required (hourly POSITION ... That mission drives everything we do, from accepting every patient, regardless of insurance status ...

PARKSIDE INC

Utilization Review Specialist

Tulsa, OK · On-site

The Utilization Review Specialist asses, plans, implements and evaluates the internal processes to ... Company Paid Life Insurance and Disability and more! We are an Equal Opportunity Employer!

UHS

Utilization Review Coordinator

Augusta, GA · On-site

... insurance companies/authorizing entities to ensure initial precertification and continued ... utilization review. CERTIFICATIONS, LICENSES, REGISTRATION LMHC, LAPC, LPC, LMSW, LCSW, LPN or RN ...

Oscar Health

Utilization Review Nurse

Tempe, AZ · Remote

$35 - $45.94/hr

We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... insurance, and paid wellness time and reimbursements. Artificial Intelligence (AI): Our AI ...

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How much do insurance utilization review jobs pay per hour?

As of Jul 21, 2026, the average hourly pay for insurance utilization review in the United States is $42.28, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 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 the Insurance Utilization Review position, and why are they important?

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 job?

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.

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What cities are hiring for Insurance Utilization Review jobs? Cities with the most Insurance Utilization Review job openings:
What are the most commonly searched types of Insurance Utilization Review jobs? The most popular types of Insurance Utilization Review jobs are:
What states have the most Insurance Utilization Review jobs? States with the most job openings for Insurance Utilization Review jobs include:
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Insurance Utilization Review jobs near you
Infographic showing various Insurance Utilization Review job openings in the United States as of July 2026, with employment types broken down into 1% As Needed, 70% Full Time, 23% Part Time, and 6% Contract. Highlights an 96% Physical, 1% Hybrid, and 3% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.
Utilization Review Coordinator

Utilization Review Coordinator

Catholic Charities, Diocese of Paterson

Parsippany, NJ

$32.80/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 7 days ago

Job description

Are you passionate about making a difference in the lives of others?

Since 1938 we have grown to over 70 programs, providing assistance to individuals and families throughout the Diocese of Paterson and beyond - we provide help and create hope for thousands of people each day. Our ability to deliver support, education, sustenance and so much more to those in need is extensive. Through Catholic Family and Community Services, the Department for Persons with Disabilities and Straight and Narrow we offer life-changing resources in multiple facets for the families and individuals we serve. We truly have a rich history of providing essential services to our communities.

TITLE: Utilization Review (UR) Coordinator

Location: Parsippany NJ

Hours: Full Time (Monday through Friday: 8:30am – 4:30pm)

This is an hourly non-exempt position.

Salary: Up to $32.80 (with experience)

Job Summary

The Utilization Review Coordinator is responsible for securing and maintaining payer authorizations for behavioral health services, ensuring medical necessity, appropriate level of care placement, and reimbursement optimization. This role serves as the liaison between clinical teams, admissions, and insurance payers to support continuity of care and financial sustainability.

Qualifications

  • Bachelor’s degree required, master’s preferred
  • 2–5+ years in behavioral health, substance use treatment, or utilization review
  • Experience with insurance authorization processes and medical/clinical necessity criteria
  • Familiarity with ASAM criteria strongly preferred
  • Strong clinical documentation review skills
  • Knowledge of payer systems (State Contracts, FFS Initiatives, Medicaid, MCO, Third Party)
  • Excellent communication and negotiation skills
  • Detail-oriented with strong organizational abilities
  • Ability to manage multiple cases and deadlines

Benefits: For full time positions, (30+ per week) we offer:

  • We provide PAID training
  • Medical/vision and dental
  • Life insurance (agency-paid), supplemental life insurance (employee-paid)
  • Flexible spending accounts
  • Accidental/Critical Illness Insurance
  • 403B (with company-matching)
  • Generous paid time off

All offers of employment are contingent on the successful completion/passing of our criminal background/references/DMV check, fingerprinting, pre-employment physical and drug test, etc.

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