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Utilization Review Jobs in Iowa (NOW HIRING)

Telligen

Peer Review Psychiatrist

West Des Moines, IA · On-site

As a Peer Review Psychiatrist, you will conduct peer reviews and appeals to ensure the level of ... Proven background in utilization management and several years of hands-on clinical practice

New

Trinityhealth

Case Manager RN Weekends

Des Moines, IA · On-site

Perform admission, concurrent, and post-discharge utilization reviews in accordance with the Utilization Management Plan and regulatory requirements. * Apply Milliman Care Guidelines and payer ...

Fabergent

Clinical Care Reviewer

Des Moines, IA · On-site

Two years of experience in managed care quality assurance or utilization review. RN must have two years of experience in an acute care hospital. Position Summary: Responsible for conducting timely ...

Trinityhealth

Case Manager RN

Des Moines, IA

Support Utilization Management & Clinical Review * Perform admission, concurrent, and post-discharge utilization reviews. * Apply Milliman Care Guidelines and payer-specific criteria to determine ...

Trinity Health

Case Manager RN

Des Moines, IA · On-site

Support Utilization Management & Clinical Review * Perform admission, concurrent, and post-discharge utilization reviews. * Apply Milliman Care Guidelines and payer-specific criteria to determine ...

Trinity Health

Case Manager RN

Des Moines, IA · On-site

Support Utilization Management & Clinical Review * Perform admission, concurrent, and post-discharge utilization reviews. * Apply Milliman Care Guidelines and payer-specific criteria to determine ...

UHS

UR Coordinator

Clive, IA

Experience in patient assessment, treatment planning, CMS quality improvement guidelines, in particular experience working with Medicare/Medicaid and communication with external review organizations ...

UHS

UR Coordinator

Clive, IA · On-site

Experience in patient assessment, treatment planning, CMS quality improvement guidelines, in particular experience working with Medicare/Medicaid and communication with external review organizations ...

UHS

UR Coordinator

Clive, IA · On-site

Experience in patient assessment, treatment planning, CMS quality improvement guidelines, in particular experience working with Medicare/Medicaid and communication with external review organizations ...

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All JobsUtilization Review JobsUtilization Review Jobs in Iowa

Utilization Review information

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$39

$64

How much do utilization review jobs pay per hour?

As of Aug 16, 2026, the average hourly pay for utilization review in Iowa is $39.71, according to ZipRecruiter salary data. Most workers in this role earn between $31.39 and $45.62 per hour, depending on experience, location, and employer.

Is utilization review work from home?

Utilization review jobs can often be performed remotely, especially with the increased adoption of telecommuting in healthcare and insurance industries. Many employers offer work-from-home options, provided the reviewer has the necessary certifications and access to electronic health records or claims systems. However, some positions may require on-site presence for meetings or audits.

What does a utilization review do?

A typical day in Utilization Review involves reviewing patient medical records, evaluating the necessity and appropriateness of proposed treatments or services, and documenting recommendations based on clinical criteria and insurance policies. Utilization Review specialists often collaborate closely with physicians, nurses, and insurance representatives to gather additional information and clarify cases. While much of the role is desk-based and may include remote work options, it requires regular communication with both clinical and administrative teams. This position offers variety and challenge, as no two cases are exactly alike, and there are often opportunities to advance into supervisory or quality improvement roles within the department.

Is utilization review a stressful job?

Utilization review is a healthcare role that involves evaluating medical necessity and appropriateness of services, which can be stressful due to strict deadlines, high accuracy requirements, and the need to balance patient care with insurance policies. The job often requires strong attention to detail, communication skills, and the ability to handle complex cases under time pressure.

What is a utilization review?

A Utilization Review (UR) job involves assessing the medical necessity, efficiency, and appropriateness of healthcare services. UR professionals, often nurses or healthcare specialists, review patient records, insurance claims, and treatment plans to ensure they meet industry standards and payer requirements. They work with healthcare providers, insurance companies, and regulatory agencies to optimize care while controlling costs. Their goal is to balance quality patient care with cost-effective resource utilization.

What are the key skills and qualifications needed to thrive in utilization review?

To thrive in Utilization Review, professionals typically need a background in nursing or healthcare, strong clinical assessment capabilities, and a thorough understanding of medical guidelines and insurance regulations. Familiarity with electronic medical records (EMR) systems and utilization management software, and often certification such as Certified Utilization Review Specialist (CURN), are important. Excellent critical thinking, attention to detail, and strong communication skills enable effective case evaluation and collaboration with healthcare teams. These skills and qualifications ensure objective, accurate decisions that support cost-effective, quality patient care within compliance standards.

How do I get into a utilization review?

To become a utilization review specialist, typically a healthcare or related degree such as nursing, health administration, or social work is required. Certification in case management or utilization review, such as the Certified Professional in Healthcare Quality (CPHQ), can enhance job prospects. Relevant skills include knowledge of medical coding, insurance policies, and strong analytical abilities.

What are the most commonly searched types of Utilization Review jobs in Iowa?

The most popular types of Utilization Review jobs in Iowa are:

What are popular job titles related to Utilization Review jobs in Iowa?

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

What job categories do people searching Utilization Review jobs in Iowa look for?

The top searched job categories for Utilization Review jobs in Iowa are:

What cities in Iowa are hiring for Utilization Review jobs?

Cities in Iowa with the most Utilization Review job openings:

Utilization Review jobs near you
Infographic showing various Utilization Review job openings in Iowa as of August 2026, with employment types broken down into 83% Full Time, 14% Part Time, and 3% Contract. Highlights an 84% In-person, and 16% Remote job distribution, with an average salary of $82,605 per year, or $39.7 per hour.

Peer Review Psychiatrist

Telligen

West Des Moines, IA • On-site

Other

Posted 3 days ago

New

Telligen rating

7.9

Company rating: 7.9 out of 10

Based on 7 frontline employees who took The Breakroom Quiz

35th of 72 rated business consultants

Job description

As a Peer Review Psychiatrist, you will conduct peer reviews and appeals to ensure the level of care is appropriate and necessary for Concurrent Acute Inpatient Psychiatric requests.
Candidate must possess a California medical license with a psychiatry specialty.
What you'll do:

Evaluate Care Quality:

  • Perform peer reviews to ensure healthcare services meet necessity and appropriateness standards

Manage Contract Reviews:

  • Direct medical review activities across assigned contracts
  • Serve as the subject matter expert on peer review processes
  • Articulate Telligen's policies to diverse medical and non-medical audiences

Required Skills and Experience:
  • Active, unrestricted medical license in California (or willingness to obtain) and the contracted state
  • Board certification in Psychiatry or Neurology by a US board (active and unrestricted)
  • Proven background in utilization management and several years of hands-on clinical practice
  • Working knowledge of MCG or InterQual medical necessity criteria

Preferred Skills and Experience:
  • Mastery of DSM-5 and ICD-10 criteria to accurately evaluate complex mental health conditions
  • Deep understanding of psychiatric medications, side effects, and evidence-based treatment algorithms
  • Comfort with electronic health records (EHRs) and utilization review software
  • Familiarity with state and federal guidelines, HIPAA compliance, and insurance or Medicaid-specific medical necessity criteria
  • Skill in conducting conversations clearly, professionally, and respectfully with treating clinicians
  • Capacity to write clear, concise, and evidence-based rationales for decisions or quality evaluations


Who We Are:
Telligen is one of the most respected population health management organizations in the country. We offer clinical, analytical, and technical expertise to support local, Tribal, and national partners, state and federal government programs, and employers and health plans.
Over our 50-year history, health care has evolved - and so have we. What hasn't changed is our deep commitment to those we serve. Our success is built on our ability to adapt, respond to client needs and deliver innovative, mission-driven solutions.
Our business is our people and we're seeking talented individuals who share our passion and are ready to take ownership, make an impact and help shape the future of health.
Are you Ready?
We're on a mission to transform lives and economies by improving health.
Ownership: As a 100% employee-owned company, our employee-owners drive our business and share in our success.
Community: We show up - for our clients, our communities and each other. Being a responsible corporate partner is part of who we are.
Ingenuity: We value bold ideas and calculated risks. Innovation thrives when we challenge the status quo and listen to diverse perspectives.
Integrity: We foster a respectful, inclusive, and collaborative environment built on trust and excellence.
Thank you for your interest in Telligen!
Follow us on Twitter, Facebook, and LinkedIn to learn more about our mission-driven culture and stay up to speed.
While we use artificial intelligence tools to enhance our initial screening process, all applications are thoroughly reviewed by our human recruitment team to ensure a fair and comprehensive evaluation of each candidate.
Telligen and our affiliates are Equal Opportunity Employers and E-Verify Participants.
Telligen will not provide sponsorship for this position. If you will require sponsorship for work authorization now or in the future, we cannot consider your application at this time. We will not accept 3rd party solicitations from outside staffing firms.
Telligen is an equal opportunity employer. Qualified applicants will be considered without regard to race, color, religion, creed, sex, sexual orientation, gender identity, marital status, national origin, age, protected veteran status, disability or any other protected class.
Telligen is committed to ensuring that our employment process is open to all individuals, and provides reasonable accommodations to individuals who need assistance during any part of the employment process due to a disability, medical condition, or physical or mental impairment. Reasonable accommodations are considered on a case-by-base basis.
If you need assistance to navigate Telligen's careers website or to apply for a position, please send an email to careers@telligen.com

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