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Utilization Review Assistant Jobs in Boston, MA (NOW HIRING)

AdviniaCare

Assistant Case Manager

Salem, MA · On-site

) Assistant Case Manager Job Summary: We are seeking an experienced and detail-oriented Assistant ... companies for utilization review purposes * Track and schedule all certifications and ...

Lynn Community Health Center

Team Medical Director

Lynn, MA · On-site

$120K - $250K/yr

Experience in Quality Assurance, Utilization Review, Continuous Quality Improvement preferred. * Experience with and commitment to working with Nurse Practitioners (NPs) and Physician Assistants (PAs)

Evolent

Physician Reviewer-Radiology (Part Time)

Boston, MA · On-site

$95 - $100/hr

Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD review ... May assist the Senior Medical Director in research activities/questions related to the Utilization ...

Evolent

Physician Reviewer-Radiology (Full-Time)

Boston, MA · On-site

$95 - $96/hr

Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD review ... May assist the Senior Medical Director in research activities/questions related to the Utilization ...

Care-One

Pharmacist (PRN)

Marlborough, MA · On-site

$60.50 - $72.50/hr

... to: Assist and direct support staff in the production and dispensing of medication orders to facilities and residents Practice appropriate drug utilization review and follow up Coding (Data entry ...

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Utilization Review Assistant information

See Boston, MA salary details

$11

$33

$67

How much do utilization review assistant jobs pay per hour?

As of Jul 27, 2026, the average hourly pay for utilization review assistant in Boston, MA is $33.13, according to ZipRecruiter salary data. Most workers in this role earn between $18.79 and $40.66 per hour, depending on experience, location, and employer.

What is a Utilization Review Assistant job?

A Utilization Review Assistant supports the utilization review process by reviewing medical records, verifying insurance coverage, and ensuring that healthcare services meet necessary guidelines. They assist in gathering documentation, communicating with insurance providers, and coordinating with medical staff to facilitate approvals for treatments. Their role helps ensure that healthcare services are provided efficiently while maintaining compliance with insurance policies and regulations.

What are the key skills and qualifications needed to thrive in the Utilization Review Assistant position, and why are they important?

To thrive as a Utilization Review Assistant, you need attention to detail, basic understanding of medical terminology, strong organizational skills, and typically a high school diploma or equivalent. Familiarity with healthcare management software and electronic health records (EHR) systems, along with experience in data entry, is important for this role. Strong communication, problem-solving abilities, and a customer service-oriented attitude help you excel when interacting with clinical staff and patients. These skills are essential for ensuring accurate review processes, compliance with regulations, and effective coordination within healthcare teams.

What does a typical day look like for a Utilization Review Assistant and who do they work with?

A Utilization Review Assistant typically spends their day reviewing medical records, verifying patient information, and ensuring documentation meets insurance or regulatory requirements. They often work closely with nurses, physicians, case managers, and billing staff to collect necessary data and clarify documentation. The work is usually performed in an office within a hospital, clinic, or insurance company, where prioritizing tasks and maintaining confidentiality are key. This collaborative, detail-oriented environment provides a valuable introduction to healthcare administration and can open doors to broader roles in utilization management or case management.

What are the most commonly searched types of Utilization Review jobs in Boston, MA? The most popular types of Utilization Review jobs in Boston, MA are:
What are popular job titles related to Utilization Review Assistant jobs in Boston, MA? For Utilization Review Assistant jobs in Boston, MA, the most frequently searched job titles are:
What job categories do people searching Utilization Review Assistant jobs in Boston, MA look for? The top searched job categories for Utilization Review Assistant jobs in Boston, MA are:
What cities near Boston, MA are hiring for Utilization Review Assistant jobs? Cities near Boston, MA with the most Utilization Review Assistant job openings:
Utilization Review Assistant jobs near you
Infographic showing various Utilization Review Assistant job openings in Boston, MA as of July 2026, with employment types broken down into 1% As Needed, 80% Full Time, 16% Part Time, 1% Temporary, and 2% Contract. Highlights an 98% Physical, 1% Hybrid, and 1% Remote job distribution, with an average salary of $68,904 per year, or $33.1 per hour.
Concurrent Review RN

Concurrent Review RN

Healthcare Support Staffing

Waltham, MA

Full-time

Posted 17 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

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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

Social media

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