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Utilization Review Jobs in Burlington, VT (NOW HIRING)

Supports the Care Management/Utilization Review Roles and Functions * Case Management: Serve as a clinical resource. Contribute clinical knowledge and expertise to facilitate the attainment of the ...

Supports the Care Management/Utilization Review Roles and Functions * Case Management: Serve as a clinical resource. Contribute clinical knowledge and expertise to facilitate the attainment of the ...

Grad Pharmacist

Morrisville, VT ยท On-site

$16.50 - $20.50/hr

... drug utilization review (DUR), pharmacy professional standards such as corresponding responsibility and red flag detection. While in the pharmacy, you will assist the pharmacy team to ensure that ...

Grad Pharmacist

Morrisville, VT

$16.50 - $20.50/hr

... drug utilization review (DUR), pharmacy professional standards such as corresponding responsibility and red flag detection. While in the pharmacy, you will assist the pharmacy team to ensure that ...

Grad Pharmacist

Morrisville, VT ยท On-site

$16.50 - $20.50/hr

... drug utilization review (DUR), pharmacy professional standards such as corresponding responsibility and red flag detection. While in the pharmacy, you will assist the pharmacy team to ensure that ...

RN (Home Care)

West Lincoln, VT ยท On-site

$39.12 - $60.64/hr

... utilization reviews as required., Performs therapeutic procedures and treatments as ordered by the physician., Planning - Develops a plan that prescribes strategies to attain expected, measurable ...

... utilization reviews as required., Performs therapeutic procedures and treatments as ordered by the physician., Planning - Develops a plan that prescribes strategies to attain expected, measurable ...

Clinical Practice Coordinator

West Lincoln, VT ยท On-site

$41.10 - $63.71/hr

Maintains records of in-services presented and employee attendance to assure any related government requirements are met., Participates in regular Utilization Reviews as required. Completes weekly ...

Conduct audits and chart reviews to ensure adherence to clinical guidelines and documentation standards. * Track utilization patterns to ensure appropriate use of healthcare services. * Develop and ...

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Utilization Review information

See Burlington, VT salary details

$21

$41

$67

How much do utilization review jobs pay per hour?

As of Aug 22, 2026, the average hourly pay for utilization review in Burlington, VT is $41.67, according to ZipRecruiter salary data. Most workers in this role earn between $32.93 and $47.84 per hour, depending on experience, location, and employer.

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 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.

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, like the Certified Professional in Healthcare Quality (CPHQ), can enhance job prospects, and strong analytical and communication skills are essential for success in the role.

Is utilization review a stressful job?

Utilization review is a healthcare role that involves evaluating medical necessity and appropriateness of services, often under strict deadlines and documentation requirements. The job can be stressful due to high workload, the need for accuracy, and managing complex cases, but stress levels vary based on work environment and individual coping skills.

What are popular job titles related to Utilization Review jobs in Burlington, VT?

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

What job categories do people searching Utilization Review jobs in Burlington, VT look for?

The top searched job categories for Utilization Review jobs in Burlington, VT are:

Infographic showing various Utilization Review job openings in Burlington, VT as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 16% Part Time, 2% Contract, and 1% Nights. Highlights an 88% Physical, 3% Hybrid, and 9% Remote job distribution, with an average salary of $86,671 per year, or $41.7 per hour.

Utilization Intake Review Coordinator

Cobalt Benefits Group LLC

South Burlington, VT โ€ข On-site

$21.50 - $22/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

This job post hasย expired today.ย Applications are no longer accepted.


Job description

Description:

Join our team at Cobalt Benefits Group and start an exciting new career in employee benefits solutions. As a Utilization Intake Coordinator, you’ll play an important role in helping us offer customized, self-funded insurance options to our clients and members.


Under the supervision of the Utilization Review Process Manager and Lead Utilization Review Intake Coordinator, the Utilization Review Intake Coordinator is responsible for managing the initial intake and data entry of clinical information required for the utilization review processes. This includes verifying patient information, preparing and submitting authorization requests to the nursing staff or external UR vendor AHH. The intake coordinator plays a key role in ensuring timely reviews and preventing delays in treatment.



Responsibilities

  • Supports the daily operations of the Utilization Review department by assisting the Lead Utilization Review Intake Coordinator with various requested tasks.
  • Data entry of clinical and intake information to the appropriate platform, directed to the appropriate vendor.
  • Maintains a current knowledge base of UR processes and timelines.
  • Uses good listening skills, conducts outreach calls, collects data according to script, tools, and protocols meeting both productivity and performance expectations as identified by the lead and manager. Conducts all calls in a courteous and customer service friendly manner. Refers to appropriate staff when indicated by workflow.
  • Processes incoming and outgoing correspondence/faxes as assigned in accordance with required standards and within respective timeliness guidelines. Referring to the appropriate clinical team members for review as defined by workflow.
  • Clerical responsibilities such as processing urgent scanning, and document retrieval routed to UR.
  • Demonstrates a professional and courteous manner when communicating with others with the ability to state clearly and accurately the agreed upon resolution.
  • Adhere to, Standard Operating Procedures and maintains current knowledge of member benefits, rights and responsibilities.
  • Performs other related duties and projects as assigned within the assigned timeframes.
  • Interprets Plan language and applies to intake tasks.
  • Adheres to company policies and procedures.
Requirements:
  • High school diploma or equivalent required.
  • Minimum of 1-2 years of experience in healthcare field.
  • Fluent computer skills including MS Office (Word, Excel, and Outlook) and Internet applications.
  • Strong reading comprehension
  • Self-motivated, self-directed, operates without constant guidance.
  • Excellent communication and problem-solving abilities.

Benefits


After successfully completing a waiting period, eligible Full-time employees have access to our comprehensive benefits package, including:

  • Fantastic medical, dental, and vision insurance*
  • Twice annual employer HSA contributions, covering 50% of the HDHP plan’s annual deductible!
  • Company provided Basic Life and AD&D
  • Company paid Short-Term and Long-Term Disability**
  • Flexible Spending Accounts*
  • 401(k) Retirement Plan with up to a 6% employer-match** WOW! (100% fully vested after 3 years)
  • 10+ paid holidays
  • Generous paid vacation and sick time
  • Annual Volunteer Paid Day
  • Annual Tuition Reimbursement
  • Annual Health and Wellness Reimbursement
  • Lots of fun company events

Who We are
As a trusted third-party administrator (TPA) specializing in self-funded benefit plans, Cobalt Benefits Group (CBG) is committed to helping employers find high-quality coverage at a cost they can afford. We administer self-funded insurance benefits through our four companies: EBPA, Blue Benefit Administrators of Massachusetts, CBA Blue, and Great Bay Administrators. With over 30 years of experience and a dedicated team of nearly 300 employees, we work collaboratively to build customized self-funded health plans, manage claim payments and disputes, and administer other specialized programs such as FSAs, HSAs, COBRA, and retiree billing. Join us as we match employers across our region with the right solutions for their employee benefit needs. To learn more about working at CBG, visit https://www.cobaltbenefitsgroup.com/careers/. Benefit Waiting Period Notes:*60 day waiting period**90 day waiting period


Cobalt Benefits Group is an Equal Employment Opportunity Employer.


Cobalt Benefits Group participates in E-Verify to confirm the employment eligibility of all new hires.