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Utilization Reviewer Jobs in Delaware (NOW HIRING)

Application Review * Your application will be forwarded to the leadership team of your highest-ranked specialty and/or units for review. Interview Scheduling * If the unit leadership is interested in ...

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Utilization Reviewer information

See Delaware salary details

$31K

$38K

$44K

How much do utilization reviewer jobs pay per year?

As of Sep 10, 2026, the average yearly pay for utilization reviewer in Delaware is $38,025.00, according to ZipRecruiter salary data. Most workers in this role earn between $34,000.00 and $42,000.00 per year, depending on experience, location, and employer.

What does a utilization reviewer do?

A Utilization Reviewer is a healthcare professional responsible for evaluating the necessity, appropriateness, and efficiency of medical services provided to patients. They review patient records, treatment plans, and insurance policies to ensure that care meets established guidelines and standards. Their role helps control healthcare costs while maintaining quality patient care and ensuring compliance with regulatory requirements. Utilization Reviewers often communicate with healthcare providers, insurance companies, and patients to gather information and make informed decisions.

What does a utilization reviewer do?

There are different types of Utilization Reviewer jobs, including Nurse Utilization Reviewers, Insurance Utilization Reviewers, Speech Therapy, Physical Therapy, and Occupational Therapy Utilization Reviewers. Regardless of the area of focus, a Utilization Reviewer is responsible for setting best practices, reviewing healthcare program requirements, ensuring the quality of care, controlling costs, and developing and implementing initiatives for review processes. Utilization Reviewers ensure compliance of programs, regularly audit patient and client records, work with staff to implement best practices and correct problem areas, monitor industry trends, and remain up-to-date and train others on industry standards and requirements.

What are the key skills and qualifications needed to thrive as a utilization reviewer?

To thrive as a Utilization Reviewer, you need a clinical background (such as RN or LCSW), in-depth knowledge of medical terminology, and an understanding of healthcare regulations and insurance guidelines. Familiarity with utilization management software, electronic health records (EHRs), and relevant certifications like CCM or URAC accreditation is typically required. Strong critical thinking, attention to detail, and effective communication skills help in evaluating patient care and collaborating with providers. These competencies are crucial for ensuring appropriate, cost-effective care while maintaining compliance with healthcare standards.

How does a utilization reviewer typically collaborate with healthcare providers to ensure appropriate patient care?

Utilization Reviewers work closely with physicians, nurses, and other healthcare professionals to assess the necessity and efficiency of medical services provided to patients. They review clinical documentation, verify that treatments meet established guidelines, and may discuss care plans directly with providers to clarify information or suggest alternatives. This collaboration ensures that patients receive appropriate care while controlling costs and complying with insurance or regulatory requirements. Effective communication and a thorough understanding of medical protocols are essential for success in this role.

What is the difference between Utilization Reviewer vs Medical Coder?

AspectUtilization ReviewerMedical Coder
Required CredentialsTypically requires healthcare-related certifications, such as RHIT, RHIA, or CPCUsually requires coding certifications like CPC, CCS, or CCS-P
Work EnvironmentHealthcare facilities, insurance companies, or utilization review organizationsHospitals, clinics, or medical billing companies
Employer & Industry UsageUsed in insurance, managed care, and healthcare administrationUsed in medical billing, coding, and health information management

While both roles work within healthcare settings, Utilization Reviewers focus on evaluating the necessity of medical services for insurance and care management, whereas Medical Coders translate medical records into standardized codes for billing and documentation. Understanding these differences helps professionals choose the right career path or job search focus.

How do I become a utilization review nurse?

To become a utilization review nurse, you typically need to hold a registered nurse (RN) license and have experience in clinical nursing. Additional certifications such as the Certified Professional Utilization Review (CPUR) or Certified Case Manager (CCM) can enhance job prospects, and strong knowledge of healthcare policies and documentation is essential.

Is utilization review a good job?

Utilization reviewers evaluate medical necessity and appropriateness of healthcare services, often working in healthcare or insurance settings. The role requires attention to detail, knowledge of healthcare policies, and sometimes certification, with typical schedules being standard business hours. It can offer stable employment and opportunities for advancement in healthcare administration.

What are popular job titles related to Utilization Reviewer jobs in Delaware?

For Utilization Reviewer jobs in Delaware, the most frequently searched job titles are:

What cities in Delaware are hiring for Utilization Reviewer jobs?

Cities in Delaware with the most Utilization Reviewer job openings:

Infographic showing various Utilization Reviewer job openings in Delaware as of September 2026, with employment types broken down into 84% Full Time, 11% Part Time, and 5% Contract. Highlights an 95% In-person, and 5% Remote job distribution, with an average salary of $38,025 per year, or $18.3 per hour.

Nurse Residency Program: Progressive Care Track Fall 2026

Christiana Care Health Services
Outpatient Health Care • 10K+ employees

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 20 days ago


ChristianaCare rating

7.7

Company rating: 7.7 out of 10

Based on 132 frontline employees who took The Breakroom Quiz


Job description

Job DetailsSenior Nursing Students, Nurse Graduates and new RN's, it is time to apply for our Nurse Residency Program: ProgressiveCare Track! This is a rolling application available for all start dates.

The ChristianaCare Nurse Residency Program is accredited with distinction as a Practice Transition Program by the American Nurses Credentialing Center's Commission on Accreditation in Practice Transition Programs.

Research demonstrates that new to practice nurses completing a structured and accredited residency program leads to:

  • Increase in competency

  • Reduction of error

  • Reduced self-reported stress

  • Increase in job satisfaction

Therefore, we are committed to supporting all registered nurses with under one year of experience through a nurse residency specialty track.

This exciting curriculum integrates:

  • Lecture and simulation education

  • Peer support

  • Up to 16 weeks (as determined by your individual transition to practice needs) of preceptor-led clinical experiences structured to foster critical thinking, evidence-based practice, interdisciplinary collaboration, effective communication, quality and safety, and professional development.

The progressive care nurse resident will complete preceptor-led training on our intermediate or transitional level step-down units at our Newark or Wilmington campuses. The nurse resident completes preceptor-led training followed by continued residency meetings during months 6, 8, 10, and 12 to further develop as professional nurses and integral member of our caregiver team.

Upon completion of this program, participants will have built a strong foundation for nursing practice in a fast-paced, challenging environment, bridging care for medically complex patients outside of the Intensive Care Unit.

Nurse residents are required to pass State Boards and be licensed as a RN in the State of Delaware (or compact state) prior to starting position. Upon hire, a commitment agreement to work at the ChristianaCare will be signed. The agreement requires completion of a two years with the requirement to remain on the unit of hire for a minimum of 15 months. Individuals unable to fill this commitment will be charged $10,000.

What we have to offer to you:
  • We are a 4xrecognized Magnet Status Hospital!

  • Growth Opportunities defined by our Clinical Ladder.

  • We offer a robust benefits package. Our healthcare benefits include medical, dental & eyecare, starting day one!Enjoy generous paid time off, paid parental leave, competitive pay with shift differentials,tuition reimbursement.Additional benefits include, dependent care assistance, pet insurance, financial coaching, fitness & wellness reimbursements and discounts on multiple services and events.

  • Advance Your Nursing Skills by providing a higher level of care.

Units available at this time (subject to change dependent upon the needs of the hospital):

Newark:

5E: Heart Failure (December Dates Only)

3C: Intermediate Medical Unit

Requirements:

  • Graduating from accredited nursing school (BSN Preferred)

  • BLS required

  • Less than 12 months of nursing experience by the start of the program

  • Eligible for Delaware license as a Graduate Nurse/Registered Nurse or RN license from a compact state

  • Must be willing and able to work all shifts (day, evening, and overnight), including weekends and holidays, during and after the residency program, based on unit staffing and operational needs.

How to apply:
  • In the section "My Experience," on the application, be sure to upload your cover letter and transcripts in the section "Resume/CV/Other Documents." PDF format works best.

  • Submit a cover letter for the Progressive Care Nurse Residency expressing your interest in this specific program/specialty
  • Please address your cover letter to Carolyn Gutzmirtl

  • Resume
  • Transcript (unofficial)
  • Two clinical recommendations will be required, but not at the time of the application. If it is determined the minimum qualifications are met, a separate email will be sent from an outside vendor for you to provide us with your clinical instructors' information.

We are conducting in- person interviews every Wednesday and Thursday so be sure to complete the required steps to be seen by a hiring manager!

To be interviewed you must have completed:

One audio on-demand interview through Hey Milo and have both clinical instructor references completed through Skill Survey.

What to Expect After Applying

  • You will be contacted by the Talent Acquisition team regarding next steps, which may include:
    • A HeyMilo video interview (required even if you have previously completed a HireVue interview).
    • Clinical reference requests through SkillSurvey. Current ChristianaCare caregivers should monitor their work email inbox for the SkillSurvey invitation.
    • Please check your junk, spam, and trash folders regularly, as these emails can occasionally be filtered there.

Assessments and Specialty Preferences

  • After completing the HeyMilo and Skill Survey assessments, you will receive a form to rank your preferred specialties and/or units.

Application Review

  • Your application will be forwarded to the leadership team of your highest-ranked specialty and/or units for review.

Interview Scheduling

  • If the unit leadership is interested in moving forward, you will receive a scheduling link to arrange an interview.

Interview Timeline

  • Interviews are held every Tuesday and Wednesday throughout the month.

In summary: Complete the required assessments, rank your preferred units, await leadership review, interview if selected, and if offered, a decision is needed within 24 hours of the offer.

Currently Hiring for Fall 2026 Start Dates:

October 26th

November 9th

November 23rd

December 7th

December 14th (not available for Internal Caregivers)

January 4th, 2027

If you have any issues with your application or any inquiries, please contact Cathleen Mengel, the Nurse Residency recruiter at cathleen.s.mengel@christianacare.org.

It is important to note that the DE license process may take 6-8 weeks to complete and the failure to do so will directly impact employees' ability to start a position if an offer is made. We strongly encourage applicants to visit the DE Board of Nursing website and begin the fingerprinting and background check process immediately after you submit your application.

This is a flat rate position, any individual hired into this position will be paid $39.38/hr plus any applicable differentials.

This is a flat rate position, any individual hired into this position will be paid $39.38/hr plus any applicable differentials.This pay rate/range represents ChristianaCare's good faith and reasonable estimate of compensation at the time of posting. The actual salary within this range offered to a successful candidate will depend on individual factors including without limitation skills, relevant experience, and qualifications as they relate to specific job requirements.

Christiana Care Health System is an equal opportunity employer, firmly committed to prohibiting discrimination, whose staff is reflective of its community, and considers qualified applicants for open positions without regard to race, color, sex, religion, national origin, sexual orientation, genetic information, gender identity or expression, age, veteran status, disability, pregnancy, citizenship status, or any other characteristic protected under applicable federal, state, or local law.

Post End Date

Nov 16, 2026

EEO Posting Statement

ChristianaCare offers a competitive suite of employee benefits to maximize the wellness of you and your family, including health insurance, paid time off, retirement, an employee assistance program. To learn more about our benefits for eligible positions visithttps://careers.christianacare.org/benefits-compensation/


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About ChristianaCare

Sourced by ZipRecruiter

ChristianaCare is one of the country's most dynamic health care organizations, centered on improving health outcomes, making high-quality care more accessible and lowering health care costs. ChristianaCare includes an extensive network of outpatient services, home health care, urgent care centers, three hospitals (1,299 beds), a free-standing emergency department, a Level I trauma center and a Level III neonatal intensive care unit, a comprehensive stroke center and regional centers of excellence in heart and vascular care, cancer care and women's health. It also includes the pioneering Gene Editing Institute and was rated by IDG Computerworld as one of the nation's Best Places to Work in IT. ChristianaCare is a nonprofit teaching health system with more than 260 residents and fellows. It is continually ranked by U.S. News & World Report as a Best Hospital. With the unique CareVio data-powered care coordination service and a focus on population health and value-based care, ChristianaCare is shaping the future of health care.

Industry

Outpatient health care

Company size

10,000+ Employees

Headquarters location

Wilmington, DE, US

Year founded

1888