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Utilization Review Jobs in Oregon (NOW HIRING)

Oregon Health & Science University

Contributes to utilization case reviews. * Ensures comprehensive assessments are documented promptly. Record Keeping and Documentation * Performs timely and accurate documentation including all case ...

Oregon Health & Science University

Contributes to utilization case reviews. * Ensures comprehensive assessments are documented promptly. Record Keeping and Documentation * Performs timely and accurate documentation including all case ...

Oregon Health & Science University

Contributes to utilization case reviews. * Ensures comprehensive assessments are documented promptly. Record Keeping and Documentation * Performs timely and accurate documentation including all case ...

Performant

Medical Review Nurse II - SNF/MDS

OR · On-site +1

Experience with utilization management systems or clinical decision-making tools such as Medical ... Ability to manage multiple tasks including desk audits and claims review. * Must be able to ...

Curana Health, Inc.

Summary The primary role of the Utilization Management Nurse is to review and monitor members' utilization of health care services with the goal of maintaining high quality cost-effective care. The ...

Natera

OR · On-site

Experience with payer policies, utilization management, prior authorization, or medical necessity review. * Experience supporting AI, automation, clinical decision support systems, or technology ...

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All JobsUtilization Review JobsUtilization Review Jobs in Oregon

Utilization Review information

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$22

$44

$72

How much do utilization review jobs pay per hour?

As of Jun 15, 2026, the average hourly pay for utilization review in Oregon is $44.70, according to ZipRecruiter salary data. Most workers in this role earn between $35.34 and $51.35 per hour, depending on experience, location, and employer.

What jobs pay $10,000 a month without a degree?

Utilization Review roles typically do not pay $10,000 a month without relevant experience or certifications; most positions in this field pay lower salaries. High-paying jobs that can reach this level without a degree often include specialized sales, real estate, or entrepreneurship, but they usually require significant skills, networking, or business acumen. Achieving such income without a degree generally involves gaining expertise, certifications, or building a successful independent business.

What does a typical day look like for someone working in Utilization Review?

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.

What skills do you need for utilization review?

Utilization review professionals need strong analytical skills to assess medical necessity and appropriateness of care, attention to detail, and knowledge of healthcare regulations and insurance policies. Good communication skills are essential for coordinating with healthcare providers and explaining decisions. Familiarity with electronic health records (EHR) systems and relevant certifications, such as Certified Professional in Healthcare Quality (CPHQ), can also be beneficial.

What is a Utilization Review job?

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 the Utilization Review position, and why are they important?

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.

What is the least stressful healthcare job?

Utilization review is often considered a less stressful healthcare job because it typically involves reviewing medical cases and insurance claims in a predictable, office-based environment. It usually requires strong analytical skills and certification but involves less direct patient interaction and emergency situations compared to clinical roles.

How do I get into a utilization review?

To become a utilization review specialist, typically a healthcare professional such as a registered nurse, licensed social worker, or physician completes relevant education and obtains certification in utilization review or case management. Gaining experience in healthcare settings and understanding insurance policies and medical coding can also improve job prospects. Certification programs like the Certified Professional in Healthcare Quality (CPHQ) or Certified Case Manager (CCM) are often preferred by employers.
What are the most commonly searched types of Utilization Review jobs in Oregon? The most popular types of Utilization Review jobs in Oregon are:
What are popular job titles related to Utilization Review jobs in Oregon? For Utilization Review jobs in Oregon, the most frequently searched job titles are:
What job categories do people searching Utilization Review jobs in Oregon look for? The top searched job categories for Utilization Review jobs in Oregon are:
What cities in Oregon are hiring for Utilization Review jobs? Cities in Oregon with the most Utilization Review job openings:
Utilization Review jobs near you
Organ Utilization Specialist

Organ Utilization Specialist

Oregon Health & Science University

On-site

Full-time

Posted 11 days ago

Oregon Health & Science University rating

8.0

Company rating: 8.0 out of 10

Based on 92 frontline employees who took The Breakroom Quiz

149th of 537 rated colleges and universities

Job description

Department Overview

The Organ Utilization Specialist (OUS) utilizes healthcare knowledge, expertise, independent industry specific judgement and medical protocols to support all aspects of organ donor allocation for transplant and research in the Cascade Life Alliance (CLA) Donor Service Area (DSA) hospitals in Oregon, southern Washington, and southwest Idaho.

This position will provide coverage for all activities related to organ allocation for transplant and research, including coordination among multiple stakeholders and documentation. The OUS also acts as an integral support role to the other clinical roles at Cascade Life Alliance (CLA). The duties of this position are in support of CLA's mission and goals.

Function/Duties of Position

Donor Evaluation and Coordination

  • Assesses organ donors for abdominal organ and research allocation strategy based on predetermined criteria in collaboration with the Administrator on Call (AOC).
  • Utilizes established protocols for national organ allocation. Coordinates donor evaluations with Organ Donation Coordinator (ODC) and healthcare teams.
  • Coordinates with transplant centers to optimize organ utilization outcomes. Contributes to utilization case reviews. 
  • Ensures comprehensive assessments are documented promptly. 

Record Keeping and Documentation

  • Performs timely and accurate documentation including all case-related activities, variances, and match run completion.
  • Utilizes specialized software systems to track organ offers, acceptances, and rejections. 

Organ Procurement Logistics

  • Assists ODC with administrative aspects of organ recovery and procurement such as electronic medical record documentation, coordinating transportation logistics, and ensuring compliance with federal, state, and organizational regulations.

Other Duties as Assigned

Required Qualifications
  • Associates of Science Degree with healthcare related focus or equivalent experience.
  • 1 year recent relevant clinical experience with associate's degree.
  • Must have a valid driver's license and access to a vehicle. 

Job Related Knowledge, Skills and Abilities (Competencies):

  • Extensive clinical healthcare knowledge base, with the ability to quickly and independently exercise sound clinical judgement in an often stressful environment.
  • Excellent communication skills, flexible, highly motivated, a good team member with a positive attitude.
  • Must be able to work in an adaptive fashion with a wide range of professional and nonprofessional constituents including but not limited to governmental officials, students, healthcare staff and the public. 
Preferred Qualifications
  • Bachelor's of Science Degree with healthcare related focus or equivalent experience.
  • 3-years recent relevant clinical experience with Associates Degree.
  • Recent donation related experience.
Additional Details

The OUS works for 12-24 hour period and may on rare occasion travel onsite via commercial aircraft and

vehicle.

Why apply to OHSU?We are Oregon's only public academic health center. In addition to caring for patients, we lead groundbreaking research. We also train the next generation of health care professionals. As Portland's largest employer, we give you opportunities to learn and advance in a system of hospitals and clinics across Oregon and Southwest Washington. All are welcome. OHSU welcomes people of all ages, ethnicities, genders, national origins, religions and sexual orientations. We are striving to build an anti-racist, multicultural institution and encourage people with diverse backgrounds to apply. To request reasonable accommodation, contact askhr@ohsu.eduEmployment Type: FULL_TIME

What Oregon Health & Science University employees say

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About Oregon Health & Science University

Sourced by ZipRecruiter

Oregon Health & Science University (OHSU) is a distinguished institution under the industry of higher education and healthcare, specifically in the field of medical science. Based in Portland, Oregon, US, it maintains a reputation for promoting research, teaching, patient care, and outreach. Established in 1887, OHSU has continually sought to redefine the parameters of healthcare delivery and biomedical discovery through its expansive catalog of programs and initiatives. A galvanizing mission drives OHSU: to improve the health and quality of life for all Oregonians through excellence, innovation, and leadership in health care, education, and research.

Industry

Colleges, universities, and professional schools

Company size

10,000+ Employees

Headquarters location

Portland, OR, US

Year founded

1887

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