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Utilization Review Case Manager Jobs in Boston, MA

US Tech Solutions

Utilization Review Nurse

Canton, MA · On-site

$55 - $60/hr

Minimum 3-5 years of Utilization Management (UM), Case Management, Prior Authorization, or Medical ... Experience reviewing outpatient clinical services. * Excellent clinical assessment and critical ...

New

UHS

Utilization Review Coordinator

Brookline, MA · On-site

Experience: 3 years of Utilization Management / Utilization Review experience required; 5 years of experience preferred * License: LCSW, LMHC, or LICSW preferred EEO Statement All UHS subsidiaries ...

UHS

Utilization Review Coordinator

Brookline, MA · On-site

Experience: 3 years of Utilization Management / Utilization Review experience required; 5 years of experience preferred * License: LCSW, LMHC, or LICSW preferred EEO Statement All UHS subsidiaries ...

American Traveler

Travel RN Case Manager

Boston, MA · On-site

Travel RN - Case Management/Utilization Review - Case Management About American Traveler With over 25 years of experience, American Traveler has established a reputation for outstanding customer ...

First Connect Health

RN - Case manager

Allston, MA · On-site

Experienced case manager. Responsible for initial assessment, utilization review, lead and document ITC meeting, patient/family interactions, set up skilled home care services and necessary vendors ...

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All JobsUtilization Review Case JobsUtilization Review Case Manager JobsUtilization Review Case Manager Jobs in Boston, MA

Utilization Review Case Manager information

See Boston, MA salary details

$18

$39

$65

How much do utilization review case manager jobs pay per hour?

As of Aug 10, 2026, the average hourly pay for utilization review case manager in Boston, MA is $39.64, according to ZipRecruiter salary data. Most workers in this role earn between $32.12 and $41.78 per hour, depending on experience, location, and employer.

What are some common challenges utilization review case managers face when coordinating care across multiple departments?

Utilization Review Case Managers often navigate complex communication between physicians, nursing staff, insurance providers, and patients to ensure appropriate care and resource use. Balancing timely authorizations with evolving patient needs and varying documentation standards can be challenging. Additionally, staying current with changing regulations and payer requirements requires ongoing learning and adaptability. Building strong collaborative relationships and maintaining clear, concise documentation are key strategies for overcoming these hurdles.

What is a utilization review case manager?

A Utilization Review Case Manager is a healthcare professional responsible for evaluating the necessity, appropriateness, and efficiency of medical treatments and services provided to patients. They review clinical information, coordinate with providers and insurance companies, and ensure that patient care aligns with established guidelines and policies. Their goal is to optimize patient outcomes while managing healthcare costs and ensuring compliance with regulations.

What is the difference between Utilization Review Case Manager vs Utilization Review Nurse?

AspectUtilization Review Case ManagerUtilization Review Nurse
CredentialsTypically requires a nursing license or relevant healthcare certificationRegistered Nurse (RN) license is required
Work EnvironmentOffice-based, insurance companies, healthcare organizationsHospital, clinic, insurance review departments
Primary FocusReviewing medical necessity, coordinating care, managing casesAssessing medical records, clinical review, patient care evaluation

Both roles involve healthcare review and require nursing credentials, but the Utilization Review Case Manager often focuses on coordinating care and managing cases, while the Utilization Review Nurse emphasizes clinical assessment and review of medical records. Understanding these differences helps in choosing the right career path or job search focus.

What are the key skills and qualifications needed to thrive as a utilization review case manager, and why are they important?

To thrive as a Utilization Review Case Manager, you need a clinical background such as an RN or LCSW license, strong knowledge of medical necessity criteria, and experience with case management. Familiarity with utilization management software, electronic health records (EHRs), and knowledge of regulatory guidelines like Medicare and Medicaid are essential. Excellent communication, critical thinking, and negotiation skills help facilitate collaboration between patients, providers, and payers. These skills ensure appropriate resource use, compliance with regulations, and high-quality patient care.
What are popular job titles related to Utilization Review Case Manager jobs in Boston, MA? For Utilization Review Case Manager jobs in Boston, MA, the most frequently searched job titles are:
What job categories do people searching Utilization Review Case Manager jobs in Boston, MA look for? The top searched job categories for Utilization Review Case Manager jobs in Boston, MA are:
What cities near Boston, MA are hiring for Utilization Review Case Manager jobs? Cities near Boston, MA with the most Utilization Review Case Manager job openings:
Utilization Review Case Manager jobs near you
Infographic showing various Utilization Review Case Manager job openings in Boston, MA as of August 2026, with employment types broken down into 49% Full Time, 13% Part Time, and 38% Contract. Highlights an 100% In-person job distribution, with an average salary of $82,447 per year, or $39.6 per hour.

Travel Case Management / Utilization Review RN - $2,541 per week

American Traveler

Milford, MA • On-site

$2.5K/wk

Other

Medical, Dental, Vision, Life, Retirement

This job post has expired today. Applications are no longer accepted.

Job description

American Traveler is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Milford, Massachusetts.

Job Description & Requirements
  • Specialty: Utilization Review
  • Discipline: RN
  • Start Date: 08/24/2026
  • Duration: 10 weeks
  • 40 hours per week
  • Shift: 8 hours, days
  • Employment Type: Travel
Assignment Overview
  • Shift: Days, 5x8hrs
  • Hours: 40 hrs/wk
  • Start Date: Aug 24, 2026
  • Length: 10 weeks
  • Openings: 1

American Traveler has an immediate opening for a Travel RN Case Management/Utilization Review Case Management job in Milford, Massachusetts. RN travelers who work with us receive a highly competitive pay and benefits package. You'll enjoy the personalized client service that has earned us high ratings from travelers nationwide -- and the security that comes from working with an established, Joint Commission-certified agency.

More about traveling in Massachusetts: A Massachusetts travel job gets you up close to U.S. history. Known for its superb medical facilities, Boston, MA is a great option, and you're never far from the state's coastal resorts.

Job ID: P-738529

Requirements
  • 1+ year of recent experience in this specialty and setting
  • Valid nursing license as required by this state
  • Valid Basic Life Support (BLS) certification from the American Heart Association (AHA)
  • Valid Advanced Cardiac Life Support (ACLS) certification through AHA recommended and may be required
  • Specialty-related certifications are preferred and may be required
  • Professional References
  • Additional job specific requirements will be provided by your Recruiter
Benefits
  • High Pay and Bonuses
  • Medical, Dental and Vision Insurance with Day 1 Options
  • 401(k) Plan
  • Weekly Payroll Deposit
  • Free Online CEUs
  • Generous Housing Allowance
  • Travel and Licensure Reimbursements
  • Non-taxed Per Diem and Subsidy
  • Traveler Rewards and Discounts

American Traveler Job ID #P-738529. Pay package is based on 8 hour shifts and 40 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: Travel RN - Case Management/Utilization Review - Case Management

About American Traveler

With over 25 years of experience, American Traveler has established a reputation for outstanding customer service. Our team ensures a smooth, worry-free experience for those starting on or expanding their travel nursing and allied careers.

With thousands of travel nursing and allied jobs nationwide, our attentive and approachable recruiters find positions that align perfectly with your career aspirations and personal requirements.

American Traveler offers exceptional benefits, including premium medical, dental, vision and life insurance beginning day one of your assignment, generous 401(k) match, substantial housing stipends, and more. Additionally, with 24/7 support and access to our in-house clinicians, you are assured confidence and comfort throughout your assignment.

With our team behind you, you can relax and enjoy a rewarding travel career.

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