Average Salary for Jobs with Utilization Review Skills

Manages cases regarding utilization review, discharge planning, and patient services coordination. Collaborates with insurers, managed care organizations, referral providers, patients, and families to assist developing case management guidelines. May require a bachelor's degree. Typically reports to a manager. Gains exposure to some of the complex tasks within the job function. Occasionally direct... View job details

Manages the medical claims review function to ensure accurate, compliant, and clinically appropriate adjudication of medical claims. Oversees a team of reviewers, examiners, or clinical staff responsible for evaluating coverage, coding, and medical necessity. Develops review procedures, quality standards, and performance metrics to ensure consistency and regulatory compliance. Reviews complex, hig... View job details