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Utilization Review Salary Jobs (NOW HIRING)

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 ...

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 ...

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 ...

Lifepoint Health

Utilization Review Director

Englewood, CO · On-site

$52 - $71/hr

What we offer We offer an excellent total compensation package, including a competitive salary and ... Previous utilization review experience in a psychiatric healthcare facility preferred. * License:

New

tmn

Utilization Review Specialist

Akron, OH · On-site

$40K/mo

Salary: $ $40,170.00 Location: Akron(Portage Lakes area) Schedule: Mon/Tue/Wed/Thur/Fri 8:30 AM - 5 ... SUMMARY The Utilization Review Specialist is responsible for proactive planning measures, accurate ...

HHC

UTILIZATION REVIEW SPECIALIST

Indianapolis, IN · On-site

Days Salary Range: Eskenazi Health serves as the public hospital division of the Health & Hospital ... FLSA Status Non-Exempt Job Role Summary The Utilization Review Specialist interacts with customers ...

Umpqua Health

Utilization Review Nurse

Roseburg, OR · On-site +1

$85K - $105K/yr

UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR ... SALARY Wage Band: $85,000- $105,340 BENEFITS * Salary is dependent on skills, experience, and ...

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Utilization Review Salary information

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How much do utilization review salary jobs pay per hour?

As of Jun 12, 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 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.

What skills do you need for utilization review?

Utilization review professionals need strong analytical skills to assess medical records and determine appropriate care. They should have good communication skills for coordinating with healthcare providers and insurers, as well as knowledge of healthcare regulations and insurance policies. Familiarity with electronic health records (EHR) systems and attention to detail are also important for accurate evaluations.

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 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.

How to make $300,000 as a nurse?

To earn $300,000 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 experience can also increase earning potential, often through overtime, travel assignments, or leadership positions.

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 background in nursing or healthcare management, and some roles may require licensure or certification such as the Certified Professional in Healthcare Quality (CPHQ).

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 Coordinator

NRT |Foundry Treatment Center

Steamboat Springs, CO • On-site

$63K - $85K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 7 days ago

Job description

Description:

Utilization Review Coordinator


Reports to: Utilization Review Manager

Job Category: Salaried | Exempt | Full-Time

Salary Range: $63,000-$85,000 per year (depending on experience and licensure)

Job Site: Remote

Schedule: Business hours, with potential for weekend rotation


Job Summary:

The Utilization Review Coordinator supports utilization review functions by obtaining and tracking authorizations, maintaining accurate documentation, and ensuring timely communication with payors and clinical staff. This role plays a key part in supporting continuity of care, regulatory compliance, and reimbursement for behavioral health services.


Education and Experience:

  • Bachelor’s degree required, Master’s degree preferred.
  • Professional clinical or nursing license strongly preferred (LPC, LCSW, LMFT, LPN, RN).
  • Experience in utilization review, care coordination, or healthcare administration preferred.
  • Behavioral health experience strongly preferred.
  • Knowledge of insurance authorization processes and medical necessity criteria a plus.

Required Skills/Abilities:

  • Strong organizational and time management skills.
  • Attention to detail and accuracy.
  • Ability to manage multiple tasks and deadlines.
  • Clear and professional communication skills.
  • Ability to work collaboratively with clinical and administrative teams.
  • Problem-solving and follow-up skills.
  • Familiarity with electronic health records and healthcare documentation standards.
  • Proficient with Google Workspace or related software.

Duties/Responsibilities:

  • Submit initial and continued stay authorization requests to insurance payors.
  • Track authorization approvals, denials, and expiration dates.
  • Maintain accurate and timely documentation in the electronic health record.
  • Communicate authorization status to clinical and administrative staff.
  • Assist with gathering clinical information for utilization reviews and audits.
  • Follow up with insurance companies to ensure timely determinations.
  • Support peer-to-peer reviews by coordinating required documentation and scheduling.
  • Identify potential authorization issues and escalate to the Utilization Review Manager as needed.
  • Ensure compliance with payor requirements, timelines, and internal policies.
  • Assist with data tracking and reporting related to utilization and denials.
  • Other duties as assigned.

Physical Requirements:

  • Prolonged periods of sitting at a desk and working on a computer.
  • Standing, sitting, bending, reaching.
  • Must be able to see, hear, talk, read, write, type.
  • Exposure to clinical and medical environments.

Benefits & Perks:

Health and Wellness

  • Medical, dental and vision insurance*
  • Supplemental accident and hospital indemnity coverage*
  • Voluntary Term Life insurance*
  • Employee Assistance Program
  • Monthly wellness reimbursement*

Financial

  • Competitive salary
  • Employee recognition and rewards programs
  • Employee referral incentive program
  • Employer-sponsored 401(k) plan

Work/Life Perks

  • Professional growth and development
  • Continuing education reimbursement
  • Unlimited paid time off (exempt employees) + sick days
  • Paid time off policy (non-exempt employees) + sick days
  • Paid holidays (exempt) or ability to earn 1.5x base hourly rate (non-exempt)

*Full-time employees


This description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required. Duties, responsibilities and activities may change or new ones may be assigned at any time with or without notice.


Requirements: