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Utilization Review Jobs in Seattle, WA (NOW HIRING)

The level I UM Coordinator is responsible for administrative functions in processing Utilization ... Reviews completed denial letters for accuracy and adherence to compliance deadlines. Edits and ...

RN MDS Nurse

Everett, WA · On-site

$50 - $60/hr

Bethany of the Northwest is a non-profit icon of the healthcare industry for nearly 100 years. Bethany is seeking a passionate and motivated RN MDS Nurse to join our team at Bethany in Everett. Come ...

Denial Management Specialist

Kirkland, WA · Remote

$28.83 - $46.14/hr

Wage Range: $28.83 - $46.14 per hour 5 years of experience in denial management, utilization review or prior authorization in a hospital, provider, or healthcare system. Healthcare medical billing ...

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Utilization Review information

See Seattle, WA salary details

$24

$48

$78

How much do utilization review jobs pay per hour?

As of Jul 27, 2026, the average hourly pay for utilization review in Seattle, WA is $48.12, according to ZipRecruiter salary data. Most workers in this role earn between $38.03 and $55.24 per hour, depending on experience, location, and employer.

What jobs make $3,000 a day?

High-paying jobs that can reach $3,000 a day include specialized roles such as senior physicians, anesthesiologists, or surgeons, often requiring advanced certifications and extensive experience. Certain executive positions, like CEOs or investment bankers, may also earn this level of daily income, especially through bonuses or profit sharing. These roles typically involve high responsibility, expertise, and demanding schedules.

What jobs pay 4000 a week without a degree?

Utilization Review specialists typically do not earn $4,000 per week without a degree; most roles in this field require healthcare-related certifications or experience. High-paying jobs that can reach this level without a degree include certain sales positions, real estate brokers, or specialized trades like commercial pilots or skilled trades, which often rely on experience, licensing, or certifications rather than formal degrees. These roles may involve commission, bonuses, or overtime to achieve such weekly earnings.

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.

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 gains experience in healthcare or insurance. Certification in utilization review or case management, such as the Certified Professional in Healthcare Quality (CPHQ), can improve job prospects. Strong analytical skills and knowledge of medical coding and insurance policies are also important.
What are the most commonly searched types of Utilization Review jobs in Seattle, WA? The most popular types of Utilization Review jobs in Seattle, WA are:
What cities near Seattle, WA are hiring for Utilization Review jobs? Cities near Seattle, WA with the most Utilization Review job openings:
Infographic showing various Utilization Review job openings in Seattle, WA as of July 2026, with employment types broken down into 95% Full Time, and 5% Part Time. Highlights an 68% In-person, and 32% Remote job distribution, with an average salary of $100,085 per year, or $48.1 per hour.

RN - Care Manager Utilization Review

MLee Medical Employment

Vashon, WA • On-site

Other

Medical, Dental, Vision, Retirement

Posted 25 days ago


Job description

Join a dynamic healthcare team in the Pacific Northwest as a Registered Nurse Care Manager specializing in Utilization Review. This role involves coordinating care and managing the utilization of services for patients in acute and post-acute skilled care settings. You will collaborate closely with interdisciplinary teams both inside and outside the organization to enhance patient outcomes and ensure cost-effective care.
Job Summary
As a vital member of the care team, you will continuously assess the appropriateness and timeliness of care levels, ensuring resources are used efficiently. Your daily activities include rounding with patients, conducting assessments, and facilitating smooth transitions from hospital to home or other care facilities. You will also identify and resolve discharge barriers, provide clear documentation, and support peer-to-peer reviews for concurrent denials.
Education and Experience

  • Minimum of 2 years of Registered Nursing experience in acute care or care management/utilization review.
  • Current RN license valid in the region or multistate license.
  • BLS certification is required.
  • Bachelor's degree in Nursing and Care Manager Certification are preferred.
Skills and Abilities
  • Strong organizational and prioritization skills.
  • Excellent written and verbal communication tailored to diverse audiences.
  • Proficiency with technology and software, including intermediate to advanced Microsoft Office skills.
  • Ability to maintain confidentiality and accurate documentation.
  • Demonstrated teamwork, collaboration, and customer service skills in fast-paced environments.
  • Independent problem-solving and sound judgment to complete tasks effectively.

Work Environment and Benefits
This full-time exempt position offers a supportive work environment with opportunities for professional growth. Benefits include competitive compensation, comprehensive medical, dental, and vision coverage, retirement plans with employer contributions, tuition reimbursement, employee wellness programs, and more. The location provides access to numerous outdoor recreational activities such as hiking, kayaking, fishing, and cultural experiences in the Pacific Northwest region.