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Utilization Reviewer Jobs in Minnesota (NOW HIRING)

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Utilization Reviewer information

See Minnesota salary details

$30.4K

$37.2K

$43.1K

How much do utilization reviewer jobs pay per year?

As of Jul 29, 2026, the average yearly pay for utilization reviewer in Minnesota is $37,210.00, according to ZipRecruiter salary data. Most workers in this role earn between $33,300.00 and $41,100.00 per year, depending on experience, location, and employer.

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 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 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.

How to become a utilization reviewer?

To become a utilization reviewer, candidates typically need a healthcare-related degree such as nursing, health administration, or a related field. Relevant experience in healthcare or insurance, strong analytical skills, and knowledge of medical coding and documentation are important; some employers may also require certification such as the Certified Professional Medical Auditor (CPMA).

Is utilization review a stressful job?

Utilization reviewers often work in a fast-paced environment where accuracy and attention to detail are essential, which can contribute to job stress. The role may involve managing high caseloads and strict deadlines, but stress levels vary depending on the work setting and individual coping strategies.

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, and why are they important?

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.

Is utilization review work from home?

Utilization reviewer jobs can often be performed remotely, especially in organizations that utilize electronic health records and telecommunication tools. Many employers offer work-from-home options for this role, which typically requires strong analytical skills, knowledge of healthcare policies, and certification in case management or utilization review. However, some positions may require on-site presence depending on company policies and regulatory requirements.

What jobs pay 4000 a week without a degree?

Utilization reviewers typically do not earn $4,000 a week without a degree; this role usually requires healthcare or insurance industry experience and certifications. High-paying jobs that can reach this level without a degree often include sales, real estate, or skilled trades like plumbing or electrical work, which rely on experience and skills rather than formal education.
More about Utilization Reviewer jobs
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What cities in Minnesota are hiring for Utilization Reviewer jobs? Cities in Minnesota with the most Utilization Reviewer job openings:
What are popular job titles related to Utilization Reviewer jobs in MN? For Utilization Reviewer jobs in MN, the most frequently searched job titles are:
Utilization Reviewer jobs near you
Infographic showing various Utilization Reviewer job openings in Minnesota as of July 2026, with employment types broken down into 84% Full Time, 10% Part Time, 2% Contract, and 4% Nights. Highlights an 60% Physical, 2% Hybrid, and 38% Remote job distribution, with an average salary of $37,210 per year, or $17.9 per hour.
Board-Certified Foot and Ankle Surgeon

Board-Certified Foot and Ankle Surgeon

Dane Street, LLC

Lake Elmo, MN • On-site

Other

Posted 26 days ago

Job description

Dane Street is expanding our physician panel! We are seeking a skilled and board-certified Foot and Ankle Surgeon in Lake Elmo, MN to join our team for Independent Medical Examinations (IMEs). This role offers flexible scheduling, allowing you to select or decline assignments based on your availability. Our physician panel is comprised of independent contract reviewers (1099) compensated on a per-case basis.

Dane Street is a national leader in Independent Medical Examinations (IMEs) and peer review services, trusted by insurance carriers and organizations across the country for objective, high-quality medical evaluations.

Key Responsibilities:

  • Thorough review of Medical Records
  • Perform in-person evaluations of patients with orthopedic issues
  • Respond to clinical queries to support claims management
  • Deliver detailed IME reports within an expected turnaround time of 5 days

Requirements

  • Board-certification required.
  • Previous experience in performing IMEs is preferred.
  • Strong analytical skills and excellent communication abilities are a plus

Benefits

  • Robust opportunity for supplemental income
  • Schedule flexibility and predictable work hours-conduct exams and reviews based on your schedule availability
  • No doctor/patient relationship is established, and no treatment is provided. These are advisory-only opinions.
  • Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management expertise
  • Expanded credentials as an expert in Independent Medical Exams 
  • Fully prepped cases, streamlined case flow, transcription services at no cost, and a user-friendly work portal

If you are a dedicated Foot and Ankle Surgeon looking for a flexible opportunity to apply your expertise in an IME capacity, we encourage you to apply.

Apply