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Online Utilization Review Jobs (NOW HIRING)

Discovery Institute NJ

Utilization Review

Marlboro, NJ · On-site

Position Summary The Utilization Review (UR) Specialist is responsible for obtaining and maintaining insurance authorizations for clients receiving substance use disorder treatment services. This ...

Discovery Institute NJ

Utilization Review

Marlboro, NJ · On-site

Position Summary The Utilization Review (UR) Specialist is responsible for obtaining and maintaining insurance authorizations for clients receiving substance use disorder treatment services. This ...

Discovery Institute

Utilization Review

Marlboro, NJ · On-site

Position Summary The Utilization Review (UR) Specialist is responsible for obtaining and maintaining insurance authorizations for clients receiving substance use disorder treatment services. This ...

Prime Time Healthcare

Utilization Review

Cleveland, OH · On-site

Now Hiring: RN Utilization Review - Middleburg Heights, OH Are you a passionate RN professional looking for a new adventure? Prime Time Healthcare is seeking dynamic individuals like you to join our ...

Prime Time Healthcare

Utilization Review

Baltimore, MD · On-site

Now Hiring: RN Utilization Review - Baltimore, MD Are you a passionate RN professional looking for a new adventure? Prime Time Healthcare is seeking dynamic individuals like you to join our team in ...

MiraVista

Utilization Review Clinician

Holyoke, MA

Join us as a Utilization Review Clinician! Schedule: Monday - Friday, 40 hours, onsite 5 days a week. As a Utilization Review Clinician for MiraVista in Holyoke, Massachusetts, you'll bring your ...

Acrisure

Utilization Review Nurse

Bradenton, FL · On-site

Acrisure is seeking a Utilization Review Nurse, LPN to evaluate treatment requests and help ensure injured workers receive appropriate, timely care in accordance with applicable clinical guidelines ...

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Online Utilization Review information

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How much do online utilization review jobs pay per hour?

As of Aug 25, 2026, the average hourly pay for online 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 is an online utilization review?

An Online Utilization Review is a process in which healthcare professionals evaluate the necessity, efficiency, and appropriateness of medical services, procedures, or hospital admissions using digital platforms. This review is typically conducted remotely, using electronic health records and online communication tools to assess patient care. The goal is to ensure that patients receive the most effective care while avoiding unnecessary treatments and controlling healthcare costs. Online Utilization Review professionals may work for hospitals, insurance companies, or third-party administrators to maintain quality standards and compliance with regulations.

What are the key skills and qualifications needed to thrive as an online utilization review specialist?

To thrive as an Online Utilization Review Specialist, you need a solid background in nursing or healthcare, with credentials such as an RN or LPN license and experience in clinical review processes. Familiarity with utilization management software, electronic health records (EHRs), and knowledge of insurance guidelines and medical necessity criteria are typically required. Strong analytical thinking, attention to detail, and clear written communication help you effectively assess cases and interact with healthcare providers. These skills ensure accurate case reviews, compliance with regulations, and optimal patient care while controlling healthcare costs.

What are some common challenges faced by professionals in online utilization review, and how can they be addressed?

One common challenge in Online Utilization Review is staying up-to-date with changing regulations and payer requirements, which can impact approval criteria and documentation standards. Another challenge is effectively managing a high volume of cases while maintaining accuracy and meeting turnaround times. Building strong communication skills for collaborating with providers and interdisciplinary teams is also crucial. To address these challenges, professionals often participate in ongoing training, utilize clinical decision support tools, and foster open communication with team members and stakeholders.

What is the difference between Online Utilization Review vs Utilization Review Coordinator?

AspectOnline Utilization ReviewUtilization Review Coordinator
CredentialsTypically requires healthcare or insurance certifications, such as RN, CPC, or CCMOften requires similar certifications, with additional administrative or coordination training
Work EnvironmentRemote or office-based, reviewing patient records and insurance claims onlineOffice setting, coordinating reviews and communicating with providers and patients
Employer & IndustryHospitals, insurance companies, healthcare organizationsInsurance companies, healthcare facilities, third-party review agencies

Online Utilization Review involves assessing medical necessity and coverage remotely using digital records, while Utilization Review Coordinator manages the review process, coordinating between providers and insurers. Both roles require similar credentials and are integral to healthcare and insurance industries, but Online Utilization Review is more focused on remote case assessments, whereas the Coordinator handles administrative oversight.

How do I get into an online utilization review?

To become an online utilization review specialist, you typically need a healthcare-related degree such as nursing, health administration, or a related field, along with knowledge of insurance policies and medical terminology. Certification in utilization review or case management, like the Certified Professional in Healthcare Quality (CPHQ), can improve job prospects. Relevant skills include strong analytical abilities, attention to detail, and familiarity with electronic health records and review software.
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Online Utilization Review jobs near you
Infographic showing various Online Utilization Review job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 14% Part Time, 3% Contract, and 1% Nights. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

Utilization Review

Providence Health and Services

Eureka, CA • On-site

$1.9K/wk

Other

Posted 14 days ago

Providence Health & Services rating

7.7

Company rating: 7.7 out of 10

Based on 845 frontline employees who took The Breakroom Quiz

160th of 893 rated healthcare providers

Job description

Details
Client Name
Providence Health and Services
Job Type
Travel
Offering
Nursing
Profession
Registered Nurse
Specialty
Utilization Review
Job ID
18635671
Job Title
Utilization Review
Weekly Pay
$1948.75
Shift Details
Shift
8 Hour Days
Scheduled Hours
40
Job Order Details
Start Date
08/16/2026
End Date
11/15/2026
Duration
13 Week(s)
Client Details
City
Eureka
State
CA
Zip Code
95501

What Providence Health & Services employees say

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