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Utilization Review Salary Jobs (NOW HIRING)

Mindful Health

Utilization Review Specialist

$25 - $30/hr

Utilization Review Specialist Mindful Health is a fast-growing company with the goal of providing ... Salary: $25.00 - $30.00 / hr Benefits: * 120 hours (15 days) of paid time off annually * 9 paid ...

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 Remote Salary: $55K - $70K Who We Are Exact Billing Solutions is a unique team of revenue cycle ...

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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 Remote Salary: $55K - $70K Who We Are Exact Billing Solutions is a unique team of revenue cycle ...

Umpqua Health

Utilization Review Specialist

Winston, OR · On-site

$41K - $47K/yr

Utilization Review Specialist HYBRID, must be able to travel to 3031 NE STEPHENS ST. ROSEBURG, OR ... SALARY Wage Band : $41,600- $47,000 BENEFITS * Salary is dependent on skills, experience, and ...

Lifepoint Health

Utilization Review Director

Englewood, CO · On-site

$110K - $148K/yr

Utilization Review Director Job Type: Onsite, Full-time Pay rate: $$110,000 -$148,000 Work Schedule ... What we offer We offer an excellent total compensation package, including a competitive salary and ...

GRO Community

Utilization Review Manager

Chicago, IL · On-site

Utilization Review Manager Location: Chicago Job Type: Full-Time Reports to: Director of Revenue ... What We Offer: * Competitive salary and benefits package. * A supportive and dynamic work ...

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How much do utilization review salary jobs pay per hour?

As of Jul 7, 2026, the average hourly pay for utilization review salary 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 are the key skills and qualifications needed to thrive as a Utilization Review Nurse, and why are they important?

To thrive as a Utilization Review Nurse, you need a valid RN license, clinical experience, and strong knowledge of medical coding and insurance guidelines. Familiarity with utilization review software, electronic health records (EHRs), and case management systems is typically required. Excellent analytical thinking, attention to detail, and effective communication skills help professionals excel in this role. These capabilities are crucial for making accurate coverage decisions, ensuring compliance, and facilitating high-quality, cost-effective patient care.

What is Chick-fil-A's highest paying job?

Chick-fil-A's highest paying positions are typically management roles such as Restaurant Director or Area Coach, which can offer salaries exceeding $70,000 annually. These roles require leadership skills, experience in restaurant operations, and often involve overseeing multiple locations or large teams.

What is the average salary for a Utilization Review Nurse?

The average salary for a Utilization Review Nurse in the United States typically ranges from $65,000 to $85,000 per year, depending on factors such as experience, education, location, and employer. Major metropolitan areas and hospitals may offer higher compensation, while remote or rural locations might pay less. In addition to base salary, some positions may offer benefits like health insurance, retirement plans, and bonuses. It's important to research the specific employer and geographic region for the most accurate salary information.

How to make $150,000 as a nurse?

To earn $150,000 as a nurse, professionals often pursue advanced roles such as nurse anesthetist, nurse practitioner, or clinical nurse specialist, which require additional certifications and education. Gaining specialized skills, working in high-demand settings, and accumulating significant experience can also help increase salary potential in nursing careers.

What are some common challenges Utilization Review professionals face in balancing patient advocacy with cost management?

Utilization Review professionals often navigate the delicate balance between ensuring patients receive appropriate care and managing healthcare costs for providers and insurers. One common challenge is interpreting complex medical records to make fair, evidence-based decisions while also adhering to strict guidelines and insurance policies. Additionally, communicating denial decisions to providers or patients requires tact and empathy. Staying current with constantly evolving regulations and medical standards is also essential to perform the role effectively.

What degree do I need for utilization review?

Utilization review professionals typically need at least a bachelor's degree in healthcare, nursing, health administration, or a related field. Many employers prefer candidates with a registered nurse (RN) license or relevant certifications, such as the Certified Professional in Healthcare Quality (CPHQ). Having strong clinical knowledge and familiarity with medical records and insurance processes is also important.

How much do utilization review nurses make in the US?

Utilization review nurses in the US typically earn an average salary ranging from $65,000 to $85,000 per year, depending on experience, location, and certifications such as CCM or ANCC. They review medical records and treatment plans to ensure appropriate care and may work in healthcare facilities or insurance companies with standard office hours.

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

AspectUtilization Review SalaryCase Manager Salary
Required CredentialsRN, LPN, or other healthcare certificationsRN, social work, or healthcare-related certifications
Work EnvironmentHospitals, insurance companies, healthcare facilitiesHospitals, community agencies, insurance companies
Employer & Industry UsageUsed mainly in insurance and healthcare review settingsUsed across healthcare, social services, and insurance sectors

Utilization Review Salary and Case Manager Salary share similar credentials and work environments, often within healthcare and insurance industries. While utilization review focuses on evaluating medical necessity and appropriateness of care, case managers coordinate patient care and support. Both roles require healthcare or social work certifications, but their primary functions differ, with utilization review emphasizing review processes and case management emphasizing patient advocacy and coordination.

More about Utilization Review Salary jobs
What cities are hiring for Utilization Review Salary jobs? Cities with the most Utilization Review Salary job openings:
What states have the most Utilization Review Salary jobs? States with the most job openings for Utilization Review Salary jobs include:
What job categories do people searching Utilization Review Salary jobs look for? The top searched job categories for Utilization Review Salary jobs are:
Utilization Review Salary jobs near you
Utilization Review Nurse

Utilization Review Nurse

Access Healthcare Staffing & Recruitment

Las Vegas, NV • On-site

Full-time

Posted 29 days ago

Be an early applicant

Job description

Salary: $40-$63

Utilization Review Nurse (RN)

Las Vegas, NV | Full-Time

Salary: $40 $63/hour


Position Summary

Reviews patient admissions for medical necessity, appropriate resource utilization, and compliance with payer guidelines. Analyzes medical records to ensure care meets established clinical and regulatory standards.


Requirements:

Education/Experience:

  • Graduate of an accredited nursing program
  • 5+ years of acute care nursing experience
  • At least 1 year in Utilization Management, Case Management, or CDI
  • Minimum 3 years of Utilization Management experience
  • 3+ years of discharge planning experience in acute care


Licensure:

  • Active Nevada RN license


Additional Requirements:

  • Experience with InterQual (must be able to pass exam)
  • Experience with Milliman criteria


Key Skills & Knowledge

  • Utilization review criteria (InterQual/Milliman), Medicare/Medicaid guidelines
  • Chart review and clinical documentation analysis
  • Regulatory compliance and hospital standards
  • Strong communication, collaboration, and analytical skills


Work Environment

  • Office-based with extended sitting and computer use
  • May require shifts and weekends