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Insurance Utilization Reviewer Jobs Near Me

ABHS

Primary Therapist

Lancaster, OH · On-site

$60K - $70K/yr

Ensure all documentation supports the "Medical Necessity" of the residential level of care for insurance utilization reviews (UR). 4. Multidisciplinary Collaboration * Participate in weekly Treatment ...

syfs

UR Manager

Columbus, OH · On-site

Initiate admission and concurrent medical record review on Medicare, Medicaid and private insurance ... For billing and hospitalization utilization review purposes, the reviewer will identify and certify ...

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Insurance Utilization Reviewer information

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$31K

$38K

$44K

How much do insurance utilization reviewer jobs pay per year?

As of Jul 13, 2026, the average yearly pay for insurance utilization reviewer in the United States is $37,992.00, according to ZipRecruiter salary data. Most workers in this role earn between $34,000.00 and $42,000.00 per year, depending on experience, location, and employer.
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Insurance Utilization Reviewer jobs near you
A map of the United States highlighting the number of Insurance Utilization Reviewer job openings by state according to ZipRecruiter. The image is accompanied by a detailed chart listing the number of Insurance Utilization Reviewer job openings in each state, with California having the most at 2 and Hawaii the least at 0.
Care Review Nurse

Care Review Nurse

Integrated Resources INC

Columbus, OH

Contractor

Re-posted 2 days ago

Job description

Company Description

Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business more efficiently and effectively. Since launching in 1996, IRI has attracted, assembled and retained key employees who are experts in their fields. This has helped us expand into new sectors and steadily grow.

We've stayed true to our focus of finding qualified and experienced professionals in our specialty areas. Our partner-employers know that they can rely on us to find the right match between their needs and the abilities of our top-tier candidates. By continually exceeding their expectations, we have built successful ongoing partnerships that help us stay true to our commitments of performance and integrity.

Our team works hard to deliver a tailored approach for each and every client, critical in matching the right employers with the right candidates. We forge partnerships that are meant for the long term and align skills and cultures. At IRI, we know that our success is directly tied to our clients' success.

Job Description

Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Healthcare members with the right care at the right place at the right time. Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review. Assesses services for Members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines.

Medicaid Division

Duties: Review cases for in patients/in hospital: skilled care, acute rehab and long term acute care
Nurses working at the facilities Members are being care for, will be sending over clinical information to be reviewed by the Care Review Clinician. Therefore, this agent will not be traveling and will be reviewing information at the office.

Qualifications

Background 
Hospital Utilization Management. Insurance Utilization Manager/Review and Millemen Experience (MCG). No case managers if that is their only experience. Must have Utilization Review or Management. Utilization Review (1 year +), Past hospital experience (3-4 years of experience, less experience is ok if they have more Utilization Review experience) 
Potential for longer term dependent on enrollment 
Workers will be doing Concurrent Inpatient Review 
MUST have one of the following AT LEAST 
-Utilization Review in hospital setting 
Nurses who are used to doing both production and review work

Additional Information

All your information will be kept confidential according to EEO guidelines.

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About Integrated Resources

Sourced by ZipRecruiter

Integrated Resources Inc (IRI), based in Edison, NJ, US, is an esteemed player in the staffing solutions industry with a credible presence on their official website irionline.com. Notably, IRI provides a range of professional staffing services including contract, contract-to-hire, and direct hire solutions to a wide spectrum of industries such as healthcare, life sciences, manufacturing, financial, insurance, and others. Since its inception, IRI has been committed to delivering top-talent and optimum solutions to meet its clients' diverse needs.

Industry

Recruiting and staffing services

Company size

51 - 200 Employees

Headquarters location

Edison, NJ, US

Year founded

1996

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