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Utilization Review Analyst Jobs (NOW HIRING)

Parkview Health

Utilization Review Analyst

Fort Wayne, IN · On-site

$13.05 - $19.57/hr

Summary Performs clerical, customer service and issue resolution duties within the UM/Reimbursement area. The main focus is to obtain insurance authorizations and complete data entry functions to ...

ICBD

Utilization Review Specialist

Lauderdale Lakes, FL · On-site

$55K - $70K/yr

Utilization Review Specialist - Exact Billing Solutions (EBS) Lauderdale Lakes, FL - On-site - No ... Review and analyze clinical records, including received documentation from payors, to ensure ...

ICBD

Utilization Review Specialist

Lauderdale Lakes, FL · On-site

$55K - $70K/yr

Utilization Review Specialist - Exact Billing Solutions (EBS) Lauderdale Lakes, FL - On-site - No ... Review and analyze clinical records, including received documentation from payors, to ensure ...

ICBD

Utilization Review Specialist

Lauderdale Lakes, FL

$55K - $70K/yr

Utilization Review Specialist - Exact Billing Solutions (EBS) Lauderdale Lakes, FL - On-site - No ... Review and analyze clinical records, including received documentation from payors, to ensure ...

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All JobsUtilization Review Analyst Jobs

Utilization Review Analyst information

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$31K

$73.3K

$130K

How much do utilization review analyst jobs pay per year?

As of Jun 29, 2026, the average yearly pay for utilization review 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 jobs pay 10,000 a month without a degree?

Utilization Review Analysts typically do not earn $10,000 a month without specialized experience or certifications. High-paying roles that can reach this level without a degree often include sales, real estate, or entrepreneurship, which rely on skills, performance, and networks rather than formal education. Some trades or technical roles, such as certain skilled trades or tech sales, may also offer high income with experience and training rather than a degree.

What is a utilization review analyst?

A utilization review analyst evaluates medical services to determine their necessity, appropriateness, and efficiency for insurance companies or healthcare providers. They review patient records, ensure compliance with guidelines, and often use healthcare management software; certification in healthcare or case review is common. This role helps control healthcare costs and supports quality patient care.

What are some common challenges Utilization Review Analysts face when coordinating with clinical and administrative staff?

Utilization Review Analysts often encounter challenges when balancing differing priorities between clinical providers and administrative policies. For example, clinicians may advocate for extended patient care based on medical judgment, while analysts must ensure that care aligns with insurance and regulatory guidelines. Effective communication and collaboration are essential, as analysts must diplomatically resolve discrepancies and provide clear rationale for decisions. Building strong relationships with both teams helps streamline the review process and fosters a collaborative work environment.

What jobs pay 2000 a day?

Jobs that can pay around $2,000 a day typically include specialized roles such as anesthesiologists, surgeons, corporate lawyers, or senior executives, often requiring advanced degrees, certifications, and significant experience. These positions usually involve high responsibility, long hours, and are found in healthcare, legal, or executive sectors. Freelance consulting or high-level project management in certain industries may also reach this earning level for experienced professionals.

What jobs in the US pay 300,000 a year?

Utilization Review Analysts typically do not earn $300,000 annually; such high salaries are more common in executive, specialized medical, or senior management roles. High-paying healthcare positions like medical directors or specialized surgeons often reach or exceed this level, especially with extensive experience and certifications. Salary levels depend on industry, location, experience, and advanced skills.

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

To thrive as a Utilization Review Analyst, you need a solid understanding of healthcare regulations, medical terminology, and case management, typically supported by a degree in nursing, healthcare administration, or a related field. Familiarity with electronic medical records (EMR) systems, utilization management software, and certifications like Certified Professional in Utilization Review (CPUR) are often required. Analytical thinking, attention to detail, and strong communication skills help you effectively assess medical necessity and collaborate with healthcare providers. These skills ensure accurate and compliant review processes, leading to optimal patient care and efficient resource utilization.

What is the difference between Utilization Review Analyst vs Claims Analyst?

AspectUtilization Review AnalystClaims Analyst
CredentialsTypically requires healthcare-related certifications, such as RHIA or RHITOften requires insurance or claims processing certifications, like CPC or CPC-A
Work EnvironmentHospitals, insurance companies, healthcare organizationsInsurance companies, healthcare payers, third-party administrators
Industry UsageUsed in healthcare and insurance sectors for reviewing medical necessityUsed in insurance and claims processing for evaluating claims

While both roles involve healthcare and insurance, a Utilization Review Analyst focuses on assessing the medical necessity of services, whereas a Claims Analyst handles processing and evaluating insurance claims. Both roles require understanding healthcare policies, but their daily tasks and focus areas differ.

More about Utilization Review Analyst jobs
What job categories do people searching Utilization Review Analyst jobs look for? The top searched job categories for Utilization Review Analyst jobs are:
Utilization Review Analyst jobs near you
Infographic showing various Utilization Review Analyst job openings in the United States as of June 2026, with employment types broken down into 62% Full Time, 13% Part Time, and 25% Contract. Highlights an 75% In-person, and 25% Remote job distribution, with an average salary of $73,261 per year, or $35.2 per hour.
Utilization Review Analyst

Utilization Review Analyst

EAGLEVILLE HOSPITAL

Eagleville, PA • On-site

Other

Posted 5 hours ago

Job description

Eagleville Hospital, an independent substance use and behavioral health treatment and educational organization serving the community for more than a century, provides innovative compassionate care to those seeking treatment for stigmatized illnesses including substance use and mental health.

Position Summary

Review and abstract pertinent data from medical records and communicates information to all various insurance companies and/or their contractual agencies to guarantee continued financial coverage.

This position reports to the Utilization Review Director

Objectives / Responsibilities

  • Reviews admissions to determine medical necessity and appropriateness of treatment.
  • Reviews patient records to obtain justification of treatment.
  • Secures necessary data from the clinical team for extended stay reviews.
  • Presents abstracts (via telecon) of clinical course of treatment to all various insurance companies and/or their contractual agencies, to justify continued treatment.
  • Review, abstracts and assigns initial length of stay and extensions of treatment as appropriate for all payers as assigned
  • Communicates all extensions of treatment to clinical teams and Director, Utilization Review (UR)
  • Notify clinical teams of need for current documentation.
  • Refer cases to Director, UR when appropriateness of and necessity of extended stay is questionable.
  • Attend appropriate daily treatment team meeting
  • Salary Range: $50-$57/yr

Educational Requirements

  • Bachelor’s Degree Preferred

Competencies

  • Patient-Centered Approach – Treat all individuals with dignity, empathy, and respect, recognizing that every role contributes to the patient experience.
  • Excellence & Accountability – Perform all duties with professionalism, following hospital policies to ensure safety, compliance, and efficiency.
  • Teamwork & Communication – Collaborate with colleagues across departments, maintaining a positive and solution-oriented attitude.
  • Commitment to Our Mission – Uphold the hospital’s values and contribute to a culture of trust, inclusivity, and continuous improvement.

Qualifications

  • 3+ years of UR or case management experience in Substance Use /Behavioral Health
  • Good communication
  • Ability to work independently
  • Experience with Microsoft applications
  • Knowledge of pre-certification process and ASAM. Knowledge of DSM V, private care managers and county referral sources

Physical Requirements

  • Ability to sit for long periods
  • Ability to walk around campus if needed
  • Good dexterity, must be able to type
  • Use of telephone

Work Environment

  • Office setting

Apply