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How much do optum utilization review jobs pay per hour?

As of Jul 21, 2026, the average hourly pay for optum 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 key skills and qualifications needed to thrive in the Optum Utilization Review position, and why are they important?

To succeed in an Optum Utilization Review role, candidates typically need a clinical background such as a registered nurse (RN) or social worker (LCSW), along with experience in case management and knowledge of utilization management principles. Familiarity with medical review software, electronic health records (EHRs), and utilization management platforms like InterQual or Milliman is often expected, as well as active state licensure or relevant certifications (e.g., CCM). Strong analytical thinking, attention to detail, and effective communication are critical soft skills for collaborating with healthcare providers and internal teams. These competencies are vital to ensure appropriate use of healthcare resources, compliance with regulations, and optimal patient outcomes.

What is an Optum Utilization Review job?

An Optum Utilization Review job involves assessing medical treatments and services to ensure they are medically necessary, cost-effective, and compliant with healthcare guidelines. Professionals in this role review patient cases, collaborate with healthcare providers, and apply clinical criteria to determine coverage approvals. They help optimize patient care while managing healthcare costs. Typically, these positions require a background in nursing or healthcare and knowledge of utilization management policies.

What does a typical day look like for someone in an Optum Utilization Review position?

In an Optum Utilization Review position, you can expect a mix of reviewing patient medical records, communicating with healthcare providers to gather additional information, and making decisions on the medical necessity and appropriateness of services. The role often involves using clinical guidelines and established protocols to ensure coverage aligns with insurance policies, as well as accurate documentation of findings and recommendations. You'll collaborate with physicians, other case managers, and sometimes directly with members, in a structured yet dynamic environment. While much of the work may be independent and computer-based, teamwork and communication are essential to coordinate care and resolve complex cases.

More about Optum Utilization Review jobs
What cities are hiring for Optum Utilization Review jobs? Cities with the most Optum Utilization Review job openings:
What are the most commonly searched types of Optum Utilization Review jobs? The most popular types of Optum Utilization Review jobs are:
What states have the most Optum Utilization Review jobs? States with the most job openings for Optum Utilization Review jobs include:
What job categories do people searching Optum Utilization Review jobs look for? The top searched job categories for Optum Utilization Review jobs are:
Optum Utilization Review jobs near you
Infographic showing various Optum Utilization Review job openings in the United States as of July 2026, with employment types broken down into 1% As Needed, 85% Full Time, 12% Part Time, and 2% Summer. Highlights an 92% Physical, and 8% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.
Utilization Review Assistant

Utilization Review Assistant

Odyssey House

Manhattan, NY • On-site

Other

Medical, Dental, Vision, Life, Retirement, PTO

This job post has expired today. Applications are no longer accepted.

Job description

Utilization Review Assistant

Under the direction of the Coordinator of Utilization Review, the Utilization Review Assistant will provide support with filing, tracking, scheduling, and internal/external communications to the Utilization Review team. Utilization Review Assistant documents all updates on authorizations in the electronic medical record, including communications with insurance companies, requests for clinical updates, denials received, and others as needed. Utilization Review Assistant manages discharges across all 820 programs. Participates in collaborative calls with MCOs to confirm client's engagement in treatment. Assists in managing all work queues assigned to Utilization Review to ensure timely follow up on accounts.

Specific duties and responsibilities include:

  1. Manages discharges across all 820 programs; confirm discharge documentation was received and processed accordingly by managed care organizations.
  2. Participates in collaborative calls with MCOs to confirm client's engagement in treatment.
  3. Uploads admissions LOCADTR, concurrent review LOCADTRs and pertinent UR documentation such as legal mandates, MCO correspondence, and discharge documentation to be filed in the department SharePoint and the electronic health record.
  4. Receive, track, and distribute information from MCO case management staff for client's receiving enhanced benefits plans such as HARP.
  5. Track and maintain MCO correspondence on SharePoint for intradepartmental use.
  6. Retrieves voicemails and faxes for the department and transcribes the information into the team calendar and team SharePoint.
  7. Schedule live reviews & peer to peer sessions for Coordinator of UR and relevant parties.
  8. Produce UR meeting minutes and distribution to relevant parties.
  9. Prepare, file, and submit monthly updates on the progress of identified projects, rosters, retention and reports as needed.
  10. Attend regularly scheduled staff meetings and case conferences.
  11. Communicate in a positive, professional manner at all times
  12. Attend all required in-service training seminars.
  13. Other relevant duties as required.

Requirements include:

  1. High School Diploma or GED, with 3 years' experience in an administrative support role in a healthcare setting; Or associate degree in healthcare/Business Administration or Related (Required).
  2. Highly organized and ability to manage multiple projects and priorities to meet deadlines and revenue goals.
  3. Communicate effectively, both orally and in writing.
  4. Ability to work within the context of a multi-disciplinary team, build relationships and foster partnerships.
  5. Proficiency with computer operation (Microsoft Word, Excel, Electronic Health Records, and Outlook programs).

In addition, Odyssey House offers our Utilization Review Assistant:

  • A 35-hour work week (as opposed to a 40-hour work week)
  • Vacation Plan and Holiday Schedule
  • Life Insurance
  • Medical Insurance (Two Plans)
  • Dental and Vision Insurance
  • Additional Insurance Coverages (hospitalization, accidental, critical illness coverage)
  • Long-Term & Short-Term Disability
  • Flexible Spending Account/Health Reimbursement Account
  • 403(b) Plan
  • Corporate Counseling Associates (CCA) EAP benefit
  • Ability Assist Counseling Services (through The Hartford)
  • Commuter Benefits
  • Educational Assistance Programs
  • Special shopping discounts through ADP Marketplace and PlumBenefits
  • RUFit?! Fitness Program
  • Pet Insurance
  • Legal Assistance
  • Optum Financial Service through ConnectYourCare
  • Benefit Advocacy Center through Gallagher

Odyssey House is an equal opportunity employer maintaining a non-discriminatory policy on hiring of its personnel. Odyssey House, and its operational divisions, will not discriminate against any employee or applicant because of race, creed, color, national origin, sex, disability, marital status, sexual orientation or citizen status in all employment decisions including but not limited to recruitment, hiring, upgrading, demotion, downgrading, transfer, training, rate of pay or other forms of compensation, layoff, termination and all other terms and conditions of employment.

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