ZipRecruiter

Log In

1

Utilization Jobs in New Mexico (NOW HIRING)

Hired by Matrix

RN Utilization Review

Portales, NM · On-site

Job Title: RN Utilization Review City: Portales State: NM Job Type: Travel Discipline: RN Speciality: Utilization Review Facility Setting: Short Term Actut Care (STAC) Accepting Locals per Radius ...

next page

Showing results 1-20

All JobsUtilization JobsUtilization Jobs in New Mexico

Utilization information

See New Mexico salary details

$20

$40

$66

How much do utilization jobs pay per hour?

As of Aug 30, 2026, the average hourly pay for utilization in New Mexico is $40.97, according to ZipRecruiter salary data. Most workers in this role earn between $32.40 and $47.07 per hour, depending on experience, location, and employer.

What is a utilization specialist?

Utilization specialists are professionals who review and evaluate the necessity, appropriateness, and efficiency of the use of healthcare services, procedures, and facilities. They work closely with healthcare providers, insurance companies, and patients to ensure that care is delivered according to established guidelines and that resources are used effectively. Their goal is to help manage costs while ensuring patients receive the appropriate level of care.

What are some of the common challenges faced by utilization review specialists when assessing medical necessity of services?

Utilization Review Specialists often encounter the challenge of balancing patient advocacy with cost-effective care. They must stay updated on evolving insurance policies and clinical guidelines, which can be complex and change frequently. Additionally, coordinating with physicians and healthcare staff to obtain necessary documentation and clarifying treatment plans can be time-consuming. Strong communication skills and attention to detail are essential to ensure timely and accurate reviews, while also maintaining positive working relationships with clinical teams.

What are the key skills and qualifications needed to thrive as a utilization review specialist, and why are they important?

To thrive as a Utilization Review Specialist, you need a background in healthcare (often as an RN or LPN/LVN), strong analytical skills, and knowledge of insurance and medical necessity criteria. Familiarity with utilization management software, ICD-10/CPT coding, and regulatory guidelines like Medicare and Medicaid is typically required. Excellent attention to detail, critical thinking, and effective communication skills set top performers apart in this role. These abilities are crucial to accurately evaluating patient care needs, ensuring regulatory compliance, and optimizing resource use within healthcare organizations.

What is the difference between Utilization vs Resource Coordinator?

AspectUtilizationResource Coordinator
Primary FocusMeasuring and optimizing how staff time is usedManaging and assigning resources for projects
Required CredentialsOften no specific credentials, but industry experience helpsTypically requires organizational or project management skills
Work EnvironmentCorporate, healthcare, or consulting firmsProject teams, staffing agencies, or departments
Common UsageTracking staff utilization ratesAllocating resources to projects or tasks

Utilization focuses on measuring how effectively staff time is used, often to improve productivity. Resource Coordinator involves actively managing and assigning resources to ensure project needs are met. While related, utilization is more about analysis, and resource coordination is about execution and management.

How to become a utilization reviewer?

To become a utilization reviewer, candidates typically need a background in healthcare, nursing, or a related field, along with knowledge of medical coding and insurance policies. Relevant certifications such as Certified Professional Coder (CPC) or Certified Medical Reimbursement Specialist (CMRS) can enhance job prospects. Strong analytical skills and attention to detail are essential for reviewing medical records and determining appropriate service utilization.

What are the most commonly searched types of Utilization jobs in New Mexico?

The most popular types of Utilization jobs in New Mexico are:

Utilization jobs near you
Infographic showing various Utilization job openings in New Mexico as of August 2026, with employment types broken down into 2% As Needed, 83% Full Time, 12% Part Time, 1% Temporary, and 2% Contract. Highlights an 91% Physical, 2% Hybrid, and 7% Remote job distribution, with an average salary of $85,227 per year, or $41 per hour.

RN Utilization Review

Hired by Matrix

Portales, NM • On-site

Other

Re-posted 8 days ago

Job description

Job Title: RN Utilization Review
City: Portales
State: NM
Job Type: Travel
Discipline: RN
Speciality: Utilization Review
Facility Setting: Short Term Actut Care (STAC)
Accepting Locals per Radius Rule?: Yes
Contract Length: 13 weeks
Shifts: Days
Shift Details: Day 5x8-Hour
Weekly Schedule: 40 Hours
Certifications/License: Mandatory Experience:
  • Routine case management, discharge planning, swing bed coordinator and utilization review duties.
  • Evaluating and screening potential admissions to the facilities swing bed program
  • knowledgeable of criteria for Medicare, Medicaid, HMO, swing bed and private insurance coverage
  • Initiate ongoing communication with the resident and resident's family to assess discharge needs.
  • Actively involvement in daily rounds with bedside staff, physicians and ancillary team members
  • Communicate with physicians to ascertain their plans for a timely discharge.
  • document updates and discharge planning as an ongoing review.
  • Manage and collaborate with the healthcare team on swing bed placement and complete MDS documentation as necessary.
  • assist with obtaining referrals, prior authorization for Home Health Care, CME, SNF, acute rehab and appointments.
  • Educates physicians and staff regarding appropriate level of care/utilization and required documentation that meets admission status
  • Run Interqual for each IP and OBS patient admitted to the floor
Get in Touch:
We want to hear from you! If you think you'd be a good match, submit your resume and reach out to Shrishti at (201) 366-0647 to learn more.

Apply