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Utilization Review Jobs in New York (NOW HIRING)

Travel Utilization Review

Bronx, NY ยท On-site

$1.8K - $2.7K/wk

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

Utilization Review * Discipline: Therapy * Duration: 13 weeks * 40 hours per week * Shift: 8 hours * Employment Type: Travel & Requirements RN Case Manager StartDate: ASAP Pay Rate: $1800.00 - $2700 ...

Reviews and coordinates prospective, concurrent and retrospective activities related to utilization. Monitors documentations for accuracy and clinical compliance. Organizes and coordinates activities ...

Reviews and coordinates prospective, concurrent and retrospective activities related to utilization. Monitors documentations for accuracy and clinical compliance. Organizes and coordinates activities ...

Travel Utilization Review RN

Nyack, NY ยท On-site

  • Medical

  • Dental

  • Retirement

Utilization Review * Discipline: RN * Start Date: 08/17/2026 * Duration: 13 weeks * 40 hours per week * Shift: 8 hours * Employment Type: Travel At HealthCare Support, we specialize in offering ...

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Showing results 1-20

Utilization Review information

See New York salary details

$23

$46

$75

How much do utilization review jobs pay per hour?

As of Aug 16, 2026, the average hourly pay for utilization review in New York is $46.26, according to ZipRecruiter salary data. Most workers in this role earn between $36.54 and $53.12 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 New York?

The most popular types of Utilization Review jobs in New York are:

What cities in New York are hiring for Utilization Review jobs?

Cities in New York with the most Utilization Review job openings:

Infographic showing various Utilization Review job openings in New York as of August 2026, with employment types broken down into 77% Full Time, 6% Temporary, and 17% Contract. Highlights an 72% In-person, and 28% Remote job distribution, with an average salary of $96,216 per year, or $46.3 per hour.

Utilization Review Physician

Vivo HealthStaff

Carteret, NJ โ€ข On-site

Full-time

Re-posted 20 days ago


Job description

Vivo HealthStaff is recruiting for a Utilization Review Physician based in New York for a Managed Care Insurance Plan. This position requires 4 days per month on-site.
The Utilization Review Physician is the lead clinician for the health plan. Responsible for the administration of medical services for company health plan utilizing the evidence-based medical policies and clinical guidelines of the plan, to ensure the appropriate and most cost-effective medical care is accessible and delivered to our members. Drives direction of the plan related to cost of care, clinical initiatives and population health management and outcomes.
Will function as the clinical lead, working alongside state plan president as the team interfaces with state regulators, providers and market facilities.
Requirements:
  • Board Certification in a specialty certified by either the American Board of Medical Specialties or American Osteopathic Association
  • Unrestricted Medical License in the State of New York
  • Minimum of 10 years of clinical practice post residency

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About Vivo HealthStaff

Sourced by ZipRecruiter

Vivo HealthStaff provides permanent recruitment services for both clinical and administrative positions in the healthcare sector. Over the past 2 years, our clients have seen a 98% retention rate with Vivo HealthStaff placements.

Industry

Health care and social assistance

Company size

11 - 50 Employees

Headquarters location

Dublin, CA, US

Year founded

2016

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