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Utilization Management Assistant Jobs in Massachusetts

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Utilization Management Assistant information

See Massachusetts salary details

$31.7K

$52.9K

$75.9K

How much do utilization management assistant jobs pay per year?

As of Aug 1, 2026, the average yearly pay for utilization management assistant in Massachusetts is $52,855.00, according to ZipRecruiter salary data. Most workers in this role earn between $45,900.00 and $53,000.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Utilization Management Assistant, and why are they important?

To thrive as a Utilization Management Assistant, you need a solid understanding of healthcare processes, medical terminology, and administrative procedures, often supported by a high school diploma or associate's degree. Familiarity with electronic health records (EHR) systems, insurance verification tools, and Microsoft Office Suite is typically required. Strong organizational skills, attention to detail, and effective communication are crucial soft skills for managing documentation and collaborating with clinical teams. These skills ensure accurate data handling, efficient workflow, and compliance with healthcare regulations, all of which are vital for successful utilization management operations.

What are some common challenges Utilization Management Assistants face when working with insurance pre-authorizations?

Utilization Management Assistants often encounter challenges such as navigating complex insurance requirements, meeting tight deadlines for pre-authorization requests, and communicating effectively with both healthcare providers and insurance representatives. Staying organized and detail-oriented is essential to ensure all documentation is accurate and submitted promptly. Additionally, adapting to frequent changes in insurance policies and maintaining strong problem-solving skills are key to overcoming these obstacles.

What is a Utilization Management Assistant?

A Utilization Management Assistant is a healthcare administrative professional who supports the utilization management team by handling clerical tasks, coordinating communications, and organizing patient documentation. They often help ensure that medical services are used efficiently and that insurance requirements are met by gathering information, processing authorizations, and maintaining records. This role is essential in facilitating collaboration between healthcare providers, insurance companies, and patients, ultimately helping to optimize the quality and cost-effectiveness of patient care.
What are the most commonly searched types of Utilization Management jobs in Massachusetts? The most popular types of Utilization Management jobs in Massachusetts are:
What cities in Massachusetts are hiring for Utilization Management Assistant jobs? Cities in Massachusetts with the most Utilization Management Assistant job openings:
Utilization Management Assistant jobs near you
Infographic showing various Utilization Management Assistant job openings in Massachusetts as of June 2026, with employment types broken down into 2% As Needed, 24% Full Time, 72% Part Time, 1% Temporary, and 1% Contract. Highlights an 98% Physical, 1% Hybrid, and 1% Remote job distribution, with an average salary of $52,855 per year, or $25.4 per hour.

Concurrent Review RN

Healthcare Support Staffing

Waltham, MA

Full-time

Re-posted 21 days ago

Job description

Company Description

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!

Job Description

Day to Day Duties:


  • This person will be reviewing charts to ensure members are receiving the most appropriate/cost effective care. They will be reviewing the progress of discharge planning to make sure they take appropriate action to keep members out of the hospital. This will be 100% onsite (no travel).
  • Company Job Description:Position Purpose: Promote the quality and cost effectiveness of medical care by applying clinical acumen and the appropriate application of policies and guidelines to emergent/urgent and continued stay reviews.
  • Perform onsite review of emergent/urgent and continued stay requests for appropriate care and setting, following guidelines and policies, and approve services or forward requests to the appropriate Physician or Medical Director with recommendations for other determinations
  • Complete medical necessity and level of care reviews for requested services using clinical judgment and refer to Medical Directors for review depending on case findings
  • Collaborate with various staff within provider networks and discharge planning team electronically, telephonically, or onsite to coordinate member care
  • Conduct discharge planning
  • Educate providers on utilization and medical management processes
  • Provide clinical knowledge and act as a clinical resource to non-clinical team staff
  • Enter and maintain pertinent clinical information in various medical management systems
  • Direct care to participating network providers
  • Participate in utilization management committees and work on special projects related to utilization management as needed
  • Serve as a subject matter expert for questions or issues for other Concurrent Review Nurses and Prior Authorization Nurses
  • Audit case reviews to ensure compliance with utilization management policies and procedures
  • Assist with the development of utilization management workflows, policies, and procedures
Qualifications

Minimum Education/Licensures/Qualifications:

  • RN licensure
  • associates degree in nursing
  • 3+ years of UM experience in a managed care setting (this is a must)
  • 2+ years of clinical nursing experience

 Shift:

  • 8:00-5:00 100% office Based 


Additional Information

Interested in being considered?

If you are interested in being considered for this position, please click the apply button below.  Or call Ashley Greene 407-478-0332 ext 169

Healthcare Support logo

About Healthcare Support

Sourced by ZipRecruiter

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!Healthcare Support Staffing, Inc. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.

Industry

Recruiting and staffing services

Company size

201 - 500 Employees

Headquarters location

Maitland, FL, US

Year founded

2003

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