ZipRecruiter

Log In

1

Utilization Reviewer Jobs in Boston, MA (NOW HIRING)

Evolent

Physician Reviewer-Radiology (Full-Time)

Boston, MA · On-site

$95 - $96/hr

As a FMD, Radiology you will be a key member of the utilization management team. We can offer you a ... Serve as the Physician match reviewer in Imaging cases, that do not initially meet the applicable ...

Evolent

Physician Reviewer-Radiology (Part Time)

Boston, MA · On-site

$95 - $100/hr

As a FMD, Radiology you will be a key member of the utilization management team. We can offer you a ... Serve as the Physician match reviewer in Imaging cases, that do not initially meet the applicable ...

previous pagenext page

Showing results 21-40

All JobsUtilization Reviewer JobsUtilization Reviewer Jobs in Boston, MA

Utilization Reviewer information

See Boston, MA salary details

$33.7K

$41.3K

$47.8K

How much do utilization reviewer jobs pay per year?

As of Aug 10, 2026, the average yearly pay for utilization reviewer in Boston, MA is $41,273.00, according to ZipRecruiter salary data. Most workers in this role earn between $36,900.00 and $45,600.00 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.

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.
More about Utilization Reviewer jobs
What are popular job titles related to Utilization Reviewer jobs in Boston, MA? For Utilization Reviewer jobs in Boston, MA, the most frequently searched job titles are:
What job categories do people searching Utilization Reviewer jobs in Boston, MA look for? The top searched job categories for Utilization Reviewer jobs in Boston, MA are:
What cities near Boston, MA are hiring for Utilization Reviewer jobs? Cities near Boston, MA with the most Utilization Reviewer job openings:
Utilization Reviewer jobs near you
Infographic showing various Utilization Reviewer job openings in Boston, MA as of August 2026, with employment types broken down into 84% Full Time, 3% Part Time, 3% Temporary, and 10% Contract. Highlights an 94% In-person, 3% Hybrid, and 3% Remote job distribution, with an average salary of $41,273 per year, or $19.8 per hour.

Travel Nurse RN - Case Manager, Utilization Review - $2,250 per week

AMN Healthcare Nursing

Allston, MA • On-site

$2.2K/wk

Other

Medical, Dental, Vision, Life, Retirement

Posted 8 days ago

Job description

AMN Healthcare Nursing is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Allston, Massachusetts.

Job Description & Requirements
  • Specialty: Utilization Review
  • Discipline: RN
  • Start Date: 08/24/2026
  • Duration: 13 weeks
  • 36 hours per week
  • Shift: 12 hours
  • Employment Type: Travel

Job Description & Requirements
RN Case Manager
StartDate: 8/24/2026 Pay Rate: $1800.00 - $2700.00

POSITION SUMMARY – RN Case Manager

POSITION DUTIES – Responsible for initial assessment, utilization review, lead and document ITC meeting, patient/family interactions, set up skilled home care services and necessary vendors for O2 and respiratory equipment, enterals and TPN, hospital beds. Participate in care plan meetings. 

MINIMUM REQUIRED QUALIFICATIONS – 

  • MA RN license
  • AHA BLS
  • 2+ years of case management experience

LENGTH OF ASSIGNMENT – 8 weeks

SHIFT / HOURS PER WEEK – 8a-4:30p

SYSTEMS – Epic

START DATE – ASAP


Job Benefits
Becoming an AMN Healthcare professional gives you the incredible opportunity to gain critical career experience, work with new people, and earn a highly competitive salary—but the perks don't stop there. There are many additional benefits to enjoy, including:
  • Medical, dental and vision benefits
  • Earned time off and paid holidays
  • Paid continuing education time
  • 401(K) retirement planning
  • Short-term disability, life insurance, paid jury duty
  • Access to the largest network of facilities and providers in the country
  • Industry experienced workforce management team
  • Licensure and certification reimbursement

About the Company
At AMN Healthcare, we strive to be recognized as the most trusted, innovative, and influential force in helping healthcare organizations provide quality patient care that continually evolves to make healthcare more human, more effective, and more achievable.

American Mobile Healthcare Job ID #3552291. Pay package is based on 12 hour shifts and 36 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: RN Case Manager

About AMN Healthcare Nursing

AMN Healthcare is a leader in Nurse staffing. Our relationships with numerous healthcare facilities - including hospitals, home health agencies, and long-term care facilities - enable us to offer the most current travel nurse, local staffing, rapid response and crisis nurse jobs nationwide. We''re committed to finding you the best nursing job to fit your career goals. AMN Healthcare is an EEO/AA/Disability/Protected Veteran Employer. We encourage minority and female applicants to apply.

Benefits
  • Company provided housing options
  • Medical benefits
  • Dental benefits
  • Continuing Education

Apply