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Utilization Review Obstetrics Jobs (NOW HIRING)

CommonSpirit Health

OBGYN Physician

Fort Morgan, CO · On-site

$406K/yr

... peer review, utilization review, and serve on medical staff committees as assigned to enhance ... Strong clinical skills and knowledge of OBGYN care principles * Excellent communication ...

Dignity Physician Careers

OBGYN Physician

Layton, UT · On-site

$415K/yr

Obstetrics & Gynecology Candidate Type: MD, DO Visas Accepted: No J-1 or H-1B Loan Repayment ... peer review, utilization review, and serve on medical staff committees as assigned to enhance ...

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Utilization Review Obstetrics information

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How much do utilization review obstetrics jobs pay per hour?

As of Sep 13, 2026, the average hourly pay for utilization review obstetrics in the United States is $42.28, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 per hour, depending on experience, location, and employer.

What is utilization review in obstetrics?

Utilization review in obstetrics is a process where healthcare professionals evaluate the necessity, appropriateness, and efficiency of medical services provided to pregnant patients. The goal is to ensure that obstetric care is evidence-based, cost-effective, and meets required guidelines. This process helps prevent unnecessary procedures, manages hospital resources, and ensures quality care for mothers and babies. Utilization review specialists often work with insurance companies, hospitals, and healthcare providers to review patient records and treatment plans.

How does a utilization review obstetrics professional typically collaborate with clinical staff and insurance providers?

A Utilization Review Obstetrics professional works closely with obstetricians, nurses, and case managers to review patient records and ensure recommended care aligns with evidence-based guidelines and insurance coverage policies. They frequently communicate with insurance providers to justify the medical necessity of specific treatments or hospital stays, ensuring that patients receive appropriate care while managing costs. Collaboration often involves participating in interdisciplinary meetings, providing documentation for appeals, and educating clinical staff about payer requirements and best practices in documentation. This role requires strong communication and negotiation skills to balance the needs of patients, providers, and payers effectively.

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

To thrive as a Utilization Review Obstetrics Nurse, you need a registered nursing license, strong clinical knowledge in obstetrics, and experience in case management or utilization review. Familiarity with electronic health records (EHRs), utilization management software, and knowledge of insurance and regulatory guidelines are vital. Exceptional analytical skills, attention to detail, and effective communication are important soft skills for collaborating with healthcare teams and payers. These competencies ensure appropriate care delivery, regulatory compliance, and efficient resource use in maternal health settings.

What is the difference between Utilization Review Obstetrics vs Utilization Review Nurse?

AspectUtilization Review ObstetricsUtilization Review Nurse
CredentialsRN, often with obstetrics certificationRN, with general utilization review training
Work EnvironmentHospitals, maternity clinics, insurance companiesHospitals, insurance companies, healthcare facilities
Job FocusObstetric care, maternity services, prenatal/postnatal reviewGeneral utilization review across various specialties

Utilization Review Obstetrics specialists focus on maternity and obstetric cases, requiring specific obstetrics credentials, while Utilization Review Nurses handle broader healthcare cases. Both roles involve reviewing medical necessity and optimizing patient care, but their focus areas differ significantly.

What are popular job titles related to Utilization Review Obstetrics jobs?

For Utilization Review Obstetrics jobs, the most frequently searched job titles are:

Infographic showing various Utilization Review Obstetrics job openings in the United States as of September 2026, with employment types broken down into 77% Full Time, 14% Part Time, and 9% Contract. Highlights an 86% In-person, and 14% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

RN Case Manager - Utilization Review

Lynwood, CA • On-site

Prime Healthcare
Hospitals • 10K+ employees
Learn more about Prime Healthcareexternal

$47.20 - $63.45/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 3 days ago

Prime Healthcare rating

6.5

Company rating: 6.5 out of 10

Based on 293 frontline employees who took The Breakroom Quiz

Job description

St. Francis Medical Center is one of the leading comprehensive healthcare institutions in Los Angeles. St. Francis provides vital healthcare services for the 700,000 adults and 300,000 children in our community who count on the hospital for high quality and compassionate medical care. St. Francis is recognized for its full range of diagnostic and treatment services in specialties including Cardiovascular, Surgical, Orthopedics, Obstetrics, Pediatrics, Behavioral Health, and Emergency and Trauma Care. In addition, the hospital offers a broad array of education and outreach programs that advance community health. St. Francis Medical Center is a Comprehensive Stroke Center, STEMI Receiving Center, ED Approved for Pediatrics, Geriatric ED, Level III Neonatal ICU, and Level II Trauma Center. Please visit www.stfrancismedicalcenter.com for more information. Join an award-winning team of dedicated professionals committed to compassion, quality, and service!


Responsible for the quality and resource management of all patients that are admitted to the facility from the point of their admission and across the continuum of the health care management.  Works on behalf of the advocate, promoting cost containment and demonstrates leadership to integrate the health care providers to achieve a perceived seamless delivery of care.  The methodology is designed to facilitate and ensure the achievement of quality, clinical and cost-effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service and severity of illness. 


EDUCATION, EXPERIENCE, TRAINING

Required Qualifications:

  1.  Minimum 5 years' work experience post-graduation of an accredited school of nursing and a current state Registered Nurse license
  2. At least one year experience in case management, discharge planning or nursing management
  3. Experience and knowledge in basic to intermediate computer skills.

Preferred Qualifications:

  1. Five years of acute care nursing experience.  preferred
  2. CCM or obtained within 1year
  3. Knowledge of Milliman Criteria and InterQual Criteria preferred.
  4. Current BCLS certificate, preferred

St. Francis Medical Center offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. Benefits may vary based on collective bargaining agreement requirements and/or the employment status, i.e. full-time or part-time. The current compensation range for this role is $47.20 to $63.45. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.


Full Time
Days

Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf


Privacy Notice for California Applicants: https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf

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