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Utilization Jobs (NOW HIRING)

Socket.dev

Utilization Manager

Manhattan, NY · On-site

$100 - $125/hr

Utilization Manager SUMMARY: The Utilization Manager is responsible for overseeing and coordinating all utilization management activities within the OASAS 820 program. This role ensures that services ...

New

Samaritan Daytop Village

Utilization Manager

Ellenville, NY · On-site

$35.71 - $40.43/hr

Utilization Manager Healthcare staff can work anywhere....The BEST work with US! Monday-Friday 9am-5pm $35.71 - $40.43 per hour A nationally recognized comprehensive Health and Human Services Agency ...

Clarvida - Georgia

Utilization Manager

Savannah, GA · On-site

Utilization Manager LCSW, LPC, LMSW, LAPC As our Utilization Manager, you will coordinate Utilization Management functions for the agency. * Trains staff on proper documentation, including ...

Duke Health

Utilization Manager

Durham, NC · On-site

Complies with current rules and regulatory requirements pertaining to utilization management. Initiates actions to obtain appropriate determinations. Collaborates with members of the healthcare team ...

Clarvida - Georgia

Utilization Manager

Savannah, GA · On-site

Description Position at Clarvida - Georgia Utilization Manager LCSW, LPC, LMSW, LAPC As our Utilization Manager, you will coordinate Utilization Management functions for the agency. * Trains staff on ...

Duke University

Utilization Manager

Durham, NC · On-site

Complies with current rules and regulatory requirements pertaining to utilization management. Initiates actions to obtain appropriate determinations. Collaborates with members of the healthcare team ...

Clarvida - Georgia

Utilization Manager

Savannah, GA · On-site

Utilization Manager LCSW, LPC, LMSW, LAPC As our Utilization Manager, you will coordinate Utilization Management functions for the agency. * Trains staff on proper documentation, including ...

Southwest General

UTILIZATION SPECIALIST

Hudson, OH · On-site

The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for ...

Clarvida

Utilization Manager

Savannah, GA · On-site

Description Utilization Manager LCSW, LPC, LMSW, LAPC As our Utilization Manager, you will coordinate Utilization Management functions for the agency. * Trains staff on proper documentation ...

Duke University

Utilization Manager

Durham, NC · On-site

Complies with current rules and regulatory requirements pertaining to utilization management. Initiates actions to obtain appropriate determinations. Collaborates with members of the healthcare team ...

Southwest General

UTILIZATION SPECIALIST

Hudson, OH · On-site

The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for ...

Southwest General

UTILIZATION SPECIALIST

Hudson, OH · On-site

The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for ...

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Utilization information

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$21

$42

$68

How much do utilization jobs pay per hour?

As of Sep 7, 2026, the average hourly pay for utilization 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 a utilization specialist?

Utilization specialists are professionals who review and evaluate the necessity, appropriateness, and efficiency of the use of healthcare services, procedures, and facilities. They work closely with healthcare providers, insurance companies, and patients to ensure that care is delivered according to established guidelines and that resources are used effectively. Their goal is to help manage costs while ensuring patients receive the appropriate level of care.

What are some of the common challenges faced by utilization review specialists when assessing medical necessity of services?

Utilization Review Specialists often encounter the challenge of balancing patient advocacy with cost-effective care. They must stay updated on evolving insurance policies and clinical guidelines, which can be complex and change frequently. Additionally, coordinating with physicians and healthcare staff to obtain necessary documentation and clarifying treatment plans can be time-consuming. Strong communication skills and attention to detail are essential to ensure timely and accurate reviews, while also maintaining positive working relationships with clinical teams.

What are the key skills and qualifications needed to thrive as a utilization review specialist, and why are they important?

To thrive as a Utilization Review Specialist, you need a background in healthcare (often as an RN or LPN/LVN), strong analytical skills, and knowledge of insurance and medical necessity criteria. Familiarity with utilization management software, ICD-10/CPT coding, and regulatory guidelines like Medicare and Medicaid is typically required. Excellent attention to detail, critical thinking, and effective communication skills set top performers apart in this role. These abilities are crucial to accurately evaluating patient care needs, ensuring regulatory compliance, and optimizing resource use within healthcare organizations.

What is the difference between Utilization vs Resource Coordinator?

AspectUtilizationResource Coordinator
Primary FocusMeasuring and optimizing how staff time is usedManaging and assigning resources for projects
Required CredentialsOften no specific credentials, but industry experience helpsTypically requires organizational or project management skills
Work EnvironmentCorporate, healthcare, or consulting firmsProject teams, staffing agencies, or departments
Common UsageTracking staff utilization ratesAllocating resources to projects or tasks

Utilization focuses on measuring how effectively staff time is used, often to improve productivity. Resource Coordinator involves actively managing and assigning resources to ensure project needs are met. While related, utilization is more about analysis, and resource coordination is about execution and management.

How to become a utilization reviewer?

To become a utilization reviewer, candidates typically need a background in healthcare, nursing, or a related field, along with knowledge of medical coding and insurance policies. Relevant certifications such as Certified Professional Coder (CPC) or Certified Medical Reimbursement Specialist (CMRS) can enhance job prospects. Strong analytical skills and attention to detail are essential for reviewing medical records and determining appropriate service utilization.
More about Utilization jobs

What cities are hiring for Utilization jobs?

Cities with the most Utilization job openings:

What are the most commonly searched types of Utilization jobs?

The most popular types of Utilization jobs are:

What states have the most Utilization jobs?

States with the most job openings for Utilization jobs include:

Utilization jobs near you
Infographic showing various Utilization job openings in the United States as of August 2026, with employment types broken down into 2% As Needed, 87% Full Time, 9% Part Time, and 2% Contract. Highlights an 90% Physical, 3% Hybrid, and 7% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

Utilization Management Coordinator PRN

844107 - Utilization Management

Dallas, TX • On-site

Per diem

Medical, Retirement, PTO

Re-posted 13 days ago

Key responsibilities

  • Assist in faxing initial, concurrent, or discharge reviews to insurance companies.

  • Communicate with insurance companies to obtain pending authorizations and respond to clinical review requests within designated time frames.

  • Manage phone and fax lines, process incoming faxes, scan documents, and perform clerical duties to support Utilization Management functions.

Job description

Utilization Management Coordinator
PRN - Must have weekday availability between 7am - 7pm
WHY UT SOUTHWESTERN?
With over 75 years of excellence in Dallas-Fort Worth, Texas, UT Southwestern is committed to excellence, innovation, teamwork, and compassion. As a world-renowned medical and research center, we strive to provide the best possible care, resources, and benefits for our valued employees. Ranked as the number 1 hospital in Dallas-Fort Worth according to U.S. News & World Report , we invest in you with opportunities for career growth and development to align with your future goals. Our highly competitive benefits package offers healthcare, PTO and paid holidays, on-site childcare, wage, merit increases and so much more. We invite you to be a part of the UT Southwestern team where you'll discover a culture of teamwork, professionalism, and a rewarding career!
BENEFITS
UT Southwestern is proud to offer a competitive and comprehensive benefits package to eligible employees. Our benefits are designed to support your overall wellbeing, and include:
  • PPO medical plan, available day one at no cost for full-time employee-only coverage
  • 100% coverage for preventive healthcare-no copay
  • Paid Time Off, available day one
  • Retirement Programs through the Teacher Retirement System of Texas (TRS)
  • Paid Parental Leave Benefit
  • Wellness programs
  • Tuition Reimbursement
  • Public Service Loan Forgiveness (PSLF) Qualified Employer
  • Learn more about these and other UTSW employee benefits!
EXPERIENCE AND EDUCATION
Required
  • Education
    High School Diploma
  • Experience
    5 years of hospital and/or insurance industry experience.
Preferred
  • Education
    Some college preferred.
JOB DUTIES
  • Assists in faxing initial, concurrent or discharge reviews to insurance companies.
  • Documents information submitted/received by phone or fax from insurance companies into Epic.
  • Manages phone and fax lines. Processes incoming faxes, scans documents and other clerical duties as deemed necessary to assist with the facilitation of Utilization Management functions.
  • Communicates with insurance company to obtain pending authorizations.
  • Responds to insurance requests for clinical reviews within time frames designated by contractual obligations.
  • Generates and submits EPIC reports specific to third party payers.
  • Maintains departmental productivity, quality metrics and completes assigned tasks in compliance with regulatory and departmental requirements.
  • Assists in faxing initial, concurrent or discharge reviews to insurance companies.
  • Calls payors to notify them of patient's admission, updates Payor Communication in EPIC, monitors work queue to ensure timely notification of admission.
  • Performs other duties as assigned.
SECURITY AND EEO STATEMENT
Security
This position is security-sensitive and subject to Texas Education Code 51.215, which authorizes UT Southwestern to obtain criminal history record information.
EEO
UT Southwestern Medical Center is committed to an educational and working environment that provides equal opportunity to all members of the University community. As an equal opportunity employer, UT Southwestern prohibits unlawful discrimination, including discrimination on the basis of race, color, religion, national origin, sex, sexual orientation, gender identity, gender expression, age, disability, genetic information, citizenship status, or veteran status.

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