ZipRecruiter

Log In

1

Utilization Reviewer Jobs in Springfield, MA (NOW HIRING)

InterCommunity, Inc.

CLINICIAN 1 - FULL-TIME

Hartford, CT · On-site

$55K - $72K/yr

Follows the utilization review process. * Required to transport clients in personal or Agency vehicle. * Provides a safe and nurturing environment for children when client is in engaged in specific ...

InterCommunity, Inc.

CLINICIAN 1 - FULL-TIME

Hartford, CT · On-site

$70K - $75K/yr

Follows the utilization review process. * Required to transport clients in personal or Agency vehicle. * Provides a safe and nurturing environment for children when client is in engaged in specific ...

InterCommunity

CLINICIAN 1 - FULL-TIME

Hartford, CT · On-site

Follows the utilization review process. * Required to transport clients in personal or Agency vehicle. * Provides a safe and nurturing environment for children when client is in engaged in specific ...

Colorwave Inc

Nurse Case Manager (RN)

Hartford, CT · On-site

$61K - $145K/yr

Clinical pathway, Navigator, or Utilization Review. Shifts available: day shift and mid shift Job types available: full time, part time, and per diem Employer features: 401(K), 403(B), Academic ...

Behavioral Health Network, Inc.

Clinician

Springfield, MA · On-site

$75K - $81K/yr

Participate in multidisciplinary team meetings, case conferences, and utilization reviews. * Provide crisis intervention and risk assessments when necessary. * Educate individuals and families on ...

Behavioral Health Network, Inc.

Clinician

Springfield, MA · On-site

$75K - $81K/yr

Participate in multidisciplinary team meetings, case conferences, and utilization reviews. * Provide crisis intervention and risk assessments when necessary. * Educate individuals and families on ...

previous page

Showing results 41-60

All JobsUtilization Reviewer JobsUtilization Reviewer Jobs in Springfield, MA

Utilization Reviewer information

See Springfield, MA salary details

$30.9K

$37.9K

$43.8K

How much do utilization reviewer jobs pay per year?

As of Aug 10, 2026, the average yearly pay for utilization reviewer in Springfield, MA is $37,859.00, according to ZipRecruiter salary data. Most workers in this role earn between $33,900.00 and $41,900.00 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 job categories do people searching Utilization Reviewer jobs in Springfield, MA look for? The top searched job categories for Utilization Reviewer jobs in Springfield, MA are:
What cities near Springfield, MA are hiring for Utilization Reviewer jobs? Cities near Springfield, MA with the most Utilization Reviewer job openings:
Utilization Reviewer jobs near you
Infographic showing various Utilization Reviewer job openings in Springfield, MA as of August 2026, with employment types broken down into 1% As Needed, 88% Full Time, 9% Part Time, and 2% Contract. Highlights an 82% Physical, 2% Hybrid, and 16% Remote job distribution, with an average salary of $37,859 per year, or $18.2 per hour.

Clinical Supervisor - Child Outpatient Clinic

The Village For Families & Children

Hartford, CT • On-site

$70K/yr

Full-time

Re-posted 12 days ago

Job description


About us: The Village was one of the first agencies in the country to provide homes for neglected children. Today, we continue to achieve our mission "to build a community of strong, healthy families who protect and nurture children" by providing a full range of behavioral health, early childhood and youth development, substance use treatment and support services for children, adults and families in the Greater Hartford, Connecticut region.
Named a Connecticut Top Workplace for five consecutive years with national distinction for workplace culture and diversity, equity and inclusion practices, you can be sure you're joining an organization that's just as committed to your success as we are to those we serve.
Visit our career site: https://thevillage.org/careers/
Starting annual Salary: $70,000- 75,000
It is not typical for an individual to be hired at or near the top of the range for their role. Actual placement within range will be contingent upon a number of factors, including but not limited to the candidate's qualifications, education, experience, internal equity and alignment with market data.
ECC Clinical Supervisor:
The ECC Clinical Supervisor provides clinic and school-based therapy to children and families presenting with a broad range of clinical diagnoses and presenting needs. Services provided include individual and family therapy, parent skills training, risk assessments and crisis management, trauma informed treatment, case management and advocacy. Participates in the development and implementation of treatment plans modifying as appropriate during the course of service. Services provided are in collaboration with DCF, schools, PCPs, and other community-based providers as needed. Supervisors are responsible for attending their own individual supervision and group supervision, clinical rounds, and other department meetings. Participates as full member of the multidisciplinary clinical team. Provides clinical and administrative supervision to staff. Participates in Quality Assurance and Utilization Review. Assists in implementing programmatic and agency priorities. Is responsible for maintaining and overseeing clinical documentation according to licensing, accreditation, Medicaid/DCF, and best practice standards. Must maintain targets for client contact hours as determined by the department for self and for supervisees. Opportunities exist for training in evidence-based models and support is given for use of those models. Works as part of the larger management team to develop new policies, procedures, workflows, and to support new initiatives.
Our staff are energetic, enthusiastic, mission-driven and open to learning. If you'd like to grow your career in a diverse and supportive environment rich with learning opportunities, join us!
JOB SUMMARY
Renders assessment and psychotherapeutic services to young children and families. Provides clinical and administrative supervision to staff. Participates in Quality Assurance and Utilization Review. Assists in implementing programmatic and agency priorities.
KEY RESPONSIBILITIES
  1. Provides direct services to children and their families which include:
  • Assessment and engagement
  • Formulation and contracting for services or treatment plan
  • Implementation of treatment plan, modifying it as appropriate during the course of treatment
  • Discharge planning which may include linkages to community support services
  • Case management services
  • Clinical documentation required by agency and program policies, and funding sources.
  • Maintain productivity targets determined by service
  • Provides clinical and administrative supervision to staff members and interns, including orientation, evaluation, and support/monitoring of staff development.
  • Works as a team member with other clinical and administrative staff to respond to client and programmatic needs, including the implementation of agency policies, procedures, and initiatives.
  • Partners with supervisor to identify and develop plans for professional growth.
  • With supervisor's approval, partners with other program or clinical staff to identify and develop approaches to address clients' unmet needs or service gaps.
  • Contributes to program functioning by assuming responsibility for special tasks or leadership in special projects as appropriate.
  • Contributes to agency organizational life by participating in agency wide task forces, committees or problem solving teams as appropriate.
  • Contributes to agency visibility and development of community linkages by representing the Village in community groups or committees.
  • Acquiring and maintaining the needed skills in evidenced based models that the agency/program ascribes to.

Experience and Skills
EDUCATION
  • Clinical degree in social work, psychology, marriage and family therapy or other licensed counseling degree.

EXPERIENCE/REQUIREMENTS
  • CT licensure is required.
  • Three years of experience working with children and families required
  • Supervisory experience preferred.
  • Bilingual/bicultural skills preferred.
  • Cultural competency to serve a diverse population
  • Physically able to perform the essential functions of the position, with or without reasonable accommodations. These responsibilities include but are not limited to, the ability to function safely in a therapeutic situation, including provision of services in client homes or host settings

Apply