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Utilization Analyst Jobs (NOW HIRING)

Concentra

Outcomes Analyst III

Addison, TX · On-site

Complete utilization analyses to support clinicians: evaluate practice patterns, trends, outliers and opportunities lending insight to practice patterns or variation in outcomes statistics * Generate ...

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Utilization Analyst information

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$31K

$73.3K

$130K

How much do utilization analyst jobs pay per year?

As of Aug 10, 2026, the average yearly pay for utilization analyst in the United States is $73,261.00, according to ZipRecruiter salary data. Most workers in this role earn between $52,500.00 and $87,000.00 per year, depending on experience, location, and employer.

What is the difference between Utilization Analyst vs Data Analyst?

AspectUtilization AnalystData Analyst
Required CredentialsBachelor's in healthcare, business, or related field; certifications like CPC or HCISPPBachelor's in statistics, computer science, or related field; certifications like CAP or Microsoft Certified Data Analyst
Work EnvironmentHealthcare facilities, insurance companies, or healthcare consulting firmsVarious industries including finance, marketing, healthcare, and technology
Employer & Industry UsageUsed primarily in healthcare and insurance sectors to optimize resource utilizationUsed across multiple industries to analyze data trends and support decision-making

While both roles involve analyzing data, a Utilization Analyst focuses on healthcare resource management and efficiency, whereas a Data Analyst has a broader scope across industries, analyzing diverse data sets to inform strategic decisions.

What does a utilization analyst do?

A utilization analyst monitors and analyzes the use of resources, such as staff or equipment, to ensure efficiency and cost-effectiveness. They often work with data management tools and generate reports to identify areas for improvement in resource allocation and productivity.
More about Utilization Analyst jobs
What cities are hiring for Utilization Analyst jobs? Cities with the most Utilization Analyst job openings:
What states have the most Utilization Analyst jobs? States with the most job openings for Utilization Analyst jobs include:
What job categories do people searching Utilization Analyst jobs look for? The top searched job categories for Utilization Analyst jobs are:
Utilization Analyst jobs near you
Infographic showing various Utilization Analyst job openings in the United States as of August 2026, with employment types broken down into 1% Internship, 86% Full Time, 6% Part Time, and 7% Contract. Highlights an 81% Physical, 9% Hybrid, and 10% Remote job distribution, with an average salary of $73,261 per year, or $35.2 per hour.

Utilization Reviewer

University of Maryland Medical System

Largo, MD • On-site

$40.61 - $60.96/hr

Full-time

Posted 16 days ago

Job description

Job Requirements

Located in Largo in the heart of Prince George's County, our state-of-the-art regional medical center (University of Maryland Capital Region Medical Center) will provide improved access to primary and ambulatory care services and serve as a tertiary care center for critically ill patients. In addition, our new space will allow us to expand our offerings as a community partner to help improve the health status of Prince George's County residents.


Position Summary:

Under general supervision, provides utilization review and denials management for an assigned patient case load. This role utilizes nationally recognized care guidelines/criteria to assess the patient's need for outpatient or inpatient care as well as the appropriate level of care. The role requires interfacing with the case managers, medical team, other hospital staff, physician advisors and payers.


Primary Responsibilities:

Performs timely and accurate utilization review for all patient populations, using nationally recognized care guidelines/criteria relevant to the payer.

Communicates with clinical care coordinators, physician advisor, medical team and payors as needed regarding reviews and pended/denied days and interventions.

Supports concurrent appeals process through proactive identification of pended/denied days.

Implements the concurrent appeals process with appropriate referrals and documentation.

Ensures appropriate Level of Care and patient status for each patient (Observation, Extended Recovery, Administrative, Inpatient, Critical Care, Intermediate Care, and Med-Surg).

Reviews tests, procedures and consultations for appropriate utilization of resources in a timely manner.

Conducts HINN discussions/Observation Education.

Collaborates with Clinical Care Coordinators concerning Avoidable Days Collection.

Ensures Regulatory Compliance related to Utilization Management conditions of participation.

Assures appropriate reimbursement and stewardship of organizational and patient resources.

Pursues and reports opportunities to improve reimbursement.

Collaborates with admitting specialists regarding authorization policies and procedures of third-party payers. Remains current on clinical practice and protocols impacting clinical reimbursement. 


Work Experience

Education Bachelors in Nursing required.


Licensure as a Registered Nurse in the state of Maryland, or eligible to practice due to Compact state agreements outlined through the MD Board of Nursing, is required


One year of experience in case management or utilization management with knowledge of payer mechanisms and utilization management is preferred.

Two years' experience in acute care and four years clinical healthcare experience preferred.

Certified Professional Utilization Reviewer (CPUR) preferred.

Additional experience in home health, ambulatory care, and/or occupational health is preferred.


Knowledge, Skills and Abilities


1. Highly effective verbal and written skills are required.

2. Strong communication skills, self-confidence and experience in working with physicians are required.

3. Excellent analytical and team building skills, as well as the ability to prioritize and work independently are required.

4. The ability to work collaboratively with other disciplines is required.

5. Ability to work with Hospital/ Utilization Management and related software programs is required.

6. Knowledge of utilization management is preferred.  


Benefits

Benefits

All your information will be kept confidential according to EEO guidelines.

Compensation:

Pay Range: $40.61-$60.96

Other Compensation (if applicable): 


Review the 2024-2025 UMMS Benefits Guide


Employment Type: FULL_TIME

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