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Utilization Reviewer Jobs in Seattle, WA (NOW HIRING)

Pacer Group

RN - UTILIZATION REVIEW

Everett, WA · On-site

$65/hr

Fully Remote Position Job Title : RN - UTILIZATION REVIEW Location: Everett, WA 98201 Start Date: 05/04/2026 Duration: 13 weeks Schedule Shift: Day 5x8-Hour (08:00 - 16:30) Shift Notes: Days (5×8 ...

Briljent

Clinical Domain Project Manager (PBM)

Seattle, WA · On-site

$110 - $140/hr

Assigned projects span drug coverage administration, Preferred Drug List (PDL) management, prior authorization, utilization management, drug utilization review, clinical criteria configuration, and ...

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All JobsUtilization Reviewer JobsUtilization Reviewer Jobs in Seattle, WA

Utilization Reviewer information

See Seattle, WA salary details

$35.3K

$43.2K

$50.1K

How much do utilization reviewer jobs pay per year?

As of Aug 24, 2026, the average yearly pay for utilization reviewer in Seattle, WA is $43,236.00, according to ZipRecruiter salary data. Most workers in this role earn between $38,700.00 and $47,800.00 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.
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The top searched job categories for Utilization Reviewer jobs in Seattle, WA are:

What cities near Seattle, WA are hiring for Utilization Reviewer jobs?

Cities near Seattle, WA with the most Utilization Reviewer job openings:

Utilization Reviewer jobs near you
Infographic showing various Utilization Reviewer job openings in Seattle, WA as of August 2026, with employment types broken down into 70% Full Time, and 30% Part Time. Highlights an 65% In-person, and 35% Remote job distribution, with an average salary of $43,236 per year, or $20.8 per hour.

RN - UTILIZATION REVIEW

Pacer Group

Everett, WA • On-site

$65/hr

Other

Re-posted 16 days ago

Job description

Fully Remote Position
Job Title : RN - UTILIZATION REVIEW
Location: Everett, WA 98201
Start Date: 05/04/2026
Duration: 13 weeks
Schedule Shift: Day 5x8-Hour (08:00 - 16:30)
Shift Notes: Days (5×8) | 08:00 - 16:30PAY DETAILS (72 HOURS / 2 WEEKS)
Pay Rate: $65/hr
Description:
Start date: ASAP
Shift:5x8 Days Monday-Friday
Years of Experience Required: 1 year
First-timers accepted: Yes
Weekends Required: No
Certs Required: BLS, WA RN License
Will this traveler need to float between like units? No
Locals accepted? No.
Pending License accepted: No
Fully Remote Position
RTO Restrictions: Please include all RTO at the time of submittal.
Guaranteed Hours: 72 hours per 2 week period
Hospital Highlights
Type of Facility: Level II Trauma Center
Total Staffed Beds: 571 total for both campuses
Scrub Color: Any (no reddish orange permitted)
Charting: EPIC
Parking Cost: Facility Paid

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