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Utilization Jobs (NOW HIRING)

Samaritan Daytop Village

Utilization Manager

Rhinebeck, NY · On-site

$35.71 - $43.31/hr

Overview Utilization Manager Healthcare staff can work anywhere....The BEST work with US! $35.71-$43.31 per hour A nationally recognized comprehensive Health and Human Services Agency, with over 60 ...

Samaritan Daytop Village

Utilization Manager

Queens, NY

$34.61 - $38.46/hr

Overview Utilization Manager Healthcare staff can work anywhere....The BEST work with US! $34.61-38.46 per hour A nationally recognized comprehensive Health and Human Services Agency, with over 60 ...

Samaritan Daytop Village

Utilization Manager

Rhinebeck, NY · On-site

$32.96 - $37.48/hr

Overview Utilization Manager Healthcare staff can work anywhere....The BEST work with US! Monday - Friday 9a-5p $32.96 - $37.48 per hour A nationally recognized comprehensive Health and Human ...

Samaritan Daytop Village

Utilization Manager

Queens, NY · On-site

$34.61 - $38.46/hr

Overview Utilization Manager Healthcare staff can work anywhere....The BEST work with US! $34.61-38.46 per hour A nationally recognized comprehensive Health and Human Services Agency, with over 60 ...

Samaritan Daytop Village

Utilization Manager

Queens, NY

$34.61 - $38.46/hr

Utilization Manager Healthcare staff can work anywhere....The BEST work with US! $34.61-38.46 per hour A nationally recognized comprehensive Health and Human Services Agency, with over 60 programs ...

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How much do utilization jobs pay per hour?

As of May 31, 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 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 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 utilization specialists?

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 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.

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 May 2026, with employment types broken down into 1% As Needed, 86% Full Time, 11% Part Time, and 2% Contract. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

PRN Utilization Review RN - M-F Days

844107 - Utilization Management

Dallas, TX • On-site

Per diem

Medical, Retirement, PTO

Posted 11 days ago

Job description

PRN Utilization Review RN - M-F Days
Must be available to work daytime hours (between 8am-6:30pm) Monday - Friday
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!
JOB SUMMARY
Conduct medical certification review for medical necessity for acute care facility and services. Use nationally recognized, evidence-based guidelines approved by medical staff to recommend level of care to the physician and serve as a resource to the medical staff on issues related to admission qualifications, resource utilization, national and local coverage determinations and documentation requirements.
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
    Graduate of accredited nursing program and holds an active unrestricted RN license in the State of Texas
  • Experience
    5 years experience to include 2 years of clinical experience and minimum of 3 years of recent utilization review experience. and
    Prior experience with Epic CCM.
  • Licenses and Certifications
    (RN) REGISTERED NURSE Holds an active unrestricted license in the State of Texas. and
Preferred
  • Experience
    Acute care experience preferred
JOB DUTIES
  • Collaborates with the Central Scheduling Department (CSD) team to provide accurate and complete clinical information in order to obtain authorization.
  • Conducts admission reviews for Medicare and Medicaid beneficiaries as well as private insurance members and self-pay patients utilizing evidence-based guidelines.
  • New admission reviews are done concurrently at the point of entry when the admission order is placed and necessary clinical information is available in the medical record.
  • Communicate with admitting physicians and physician advisors when documentation does not appear to support hospital level of care.
  • Use hospital approved medical necessity tool to determine level of care for inpatient or observation/outpatient services based on physician documentation, H&P, treatment plan, potential risks, and basis for expectation of a two-midnight stay.
  • Keeps current on all Federal, State and local regulatory changes that affect delivery or reimbursement of acute care services within the scope of Utilization Management. Uses knowledge of national and local coverage determinations to appropriately advise physicians.
  • Proactively collaborates with admitting physician to provide accurate level of care determination at the time of review.
  • Escalates identified progression-of-care/patient flow barriers to appropriate departments.
  • Actively participates in daily huddles, departmental meetingsand education offerings.
  • Identifies and records episodes of preventable delays or avoidable days due to failure of progression-of-care processes.
  • Educates members of the patient's care team on the appropriate access to and use of various levels of care.
  • Promotes use of evidence-based protocols and/or order sets to influence high-quality and cost-effective care.
  • Serves as a resource person to physicians, care coordinators, physician offices and billing office for coverage and compliance issues.
  • Completes all reviews within department established policies and best practice standards. Meets department quality standards as established for the department, ie: Inter-rater Reliability audits, completing all initial reviews within established time frames, completes concurrent and discharge reviews to meet department and industry standards.
  • 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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