Utilization Review Nurse Jobs

RN Case Manager and Utilization Manager

Orchard Hospital  •  Full-time  •  Gridley, California, United States  •  $115,107 - $138,129 / year  •  6m ago
The professional  RN Case Manager and Utilization Manager , in collaboration with the Provider and other healthcare team members, provides overall support to daily operations of the utilization management department - d... more
6m ago
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Aetna Better Health of Oklahoma, a CVS Health company, embodies the vision to be a trusted health partner in the local Oklahoma communities we serve. We provide a full array of innovative services that enhance overall w... more
8m ago
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Utilization Management Nurse: Home Solutions

Humana  •  Full-time  •  Remote (Louisville, Kentucky, United States)  •  $69,800 - $96,200 / year  •  8m ago
Description Full-Time, Remote Telephonic opportunity As a Utilization Management RN working on the Home Solutions team, you will have the opportunity to use your clinical knowledge, communication skills, and independe... more
8m ago
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We have an outstanding reputation for providing patient- and family-centered care that exceeds all expectations. Together, we have created an award-winning, nationally-recognized system where every effort is focused on... more
3m ago
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If you are a current University Health or University Health Physicians employee and wish to be considered, you must apply via the internal career site. Please log into myWORKDAY to search for positions and apply... more
3m ago
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If you are a current University Health or University Health Physicians employee and wish to be considered, you must apply via the internal career site. Please log into myWORKDAY to search for positions and apply... more
3m ago
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Care Manager RN - Utilization

Providence Covenant Health  •  Full-time  •  Lubbock, TX, US  •  $34 - $54 / hour  •  1d ago
Description Comprehensively plans for case management services for a targeted patient population. Carries out activities related to utilization management, discharge planning, care coordination and referral to other l... more
1d ago
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Inpatient and Outpatient Setting. Under general direction: The Utilization Management RN serves as a leader resource in the Utilization Management process. They collaborate with physicians and other members of the health... more
1d ago
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Description The Case Manager RN UR/Bed Planner reflects the mission, vision, and values of NM, adheres to the organization’s Code of Ethics and Corporate Compliance Program, and complies with all relevant policie... more
2d ago
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Newport News, Virginia This is not a remote position, this position is located on site at Riverside Regional Medical Center in the Emergency Department working 12 hour shifts. Available Shifts: 7am-7pm, 11a-11pm,... more
2d ago
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Description The Case Manager RN UR/Bed Planner reflects the mission, vision, and values of NM, adheres to the organization’s Code of Ethics and Corporate Compliance Program, and complies with all relevant policie... more
2d ago
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Description The Case Manager RN UR/Bed Planner reflects the mission, vision, and values of NM, adheres to the organization’s Code of Ethics and Corporate Compliance Program, and complies with all relevant policie... more
2d ago
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Description Position Summary Collaborates and coordinates with all members of the health care team, patient and family (or significant others) to coordinate and ensure timely and efficient delivery of required work... more
2d ago
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Company Description Experience the highest level of appreciation at UM Baltimore Washington Medical Center — named Top Workplace in the Baltimore area by The Baltimore Sun two years in a row (2019 & 2020); Top Wor... more
2d ago
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Overview Chino Valley Medical Center is a 112-bed community hospital established in 1972 and centrally located in Southern California’s Chino Valley. A nine-time recipient of the Healthgrades Patient Safety Exce... more
3d ago
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Overview Do you have a passion for caring for older adults? If so you have found the right place to continue your career! Join our compassionate and dedicated team and make a difference in the lives of our members at... more
3d ago
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RN, Utilization Management - Behavioral Health

Humana  •  Full-time  •  Remote  •  $69,800 - $96,200 / year  •  3d ago
Become a part of our caring community and help us put health first   Full-Time Remote, Telephonic RN opportunity. The Utilization Management Behavioral Health Nurse utilizes behavioral health knowledge and skill... more
3d ago
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At BayCare, we are proud to be one of the largest employers in the Tampa Bay area. Our network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thous... more
3d ago
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Functions under the direction of the Utilization Documentation Manager and Director of Case Management. Demonstrates fiscal responsibility related to patient needs, resource utilization, payer requirements and organizat... more
3d ago
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All the benefits and perks you need for you and your family: Paid Days Off from Day One Student Loan Repayment Program Career Development Whole Person Wellbeing Resources Mental Health Resources and Support... more
3d ago
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Utilization Management RN

VNS Health  •  Full-time  •  New York, New York, United States  •  $85,000 - $106,300 / year  •  4d ago
Overview Assesses member needs and identifies solutions that promote high quality and cost-effective health care services. Manages providers, members, team, or care manager generated requests for medical services and r... more
4d ago
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Work Shift: Capital Health is the region's leader in providing progressive, quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advance technology. Capital H... more
4d ago
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The Utilization Management (UM) LVN performs utilization review activities, including, but not limited to, precertification, ensures appropriate level of care and status (Inpatient, Outpatient, and Observation) through... more
4d ago
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Senior Clinical Review Nurse - Concurrent Review - Remote CA

Centene  •  Full-time  •  Remote  •  $29.43 - $52.98 / hour  •  4d ago
You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive bene... more
4d ago
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Our Mission To improve the health of the communities we serve through contemporary, innovative, quality healthcare solutions. Schedule: PRN The position will be hybrid remote once fully trained. About U... more
4d ago
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We are looking for a Utilization Management, RN to join us in leading our organization forward. McLaren Integrated HMO Group (MIG), a division of McLaren Health Care Corporation, is an organization with a culture of hig... more
4d ago
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We are looking for a Utilization Management, RN - IN to join us in leading our organization forward. McLaren Integrated HMO Group (MIG), a division of McLaren Health Care Corporation, is an organization with a culture o... more
4d ago
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Overview   Performs admission and continued stay utilization reviews and discharge screening to assure the medical necessity of hospital admission, appropriate level of care, continued stay and supportive services, and... more
5d ago
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Overview   Performs admission and continued stay utilization reviews and discharge screening to assure the medical necessity of hospital admission, appropriate level of care, continued stay and supportive services, and... more
5d ago
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Job Description At UC Health, we're proud to have the best and brightest teams and clinicians collaborating toward our common purpose: to advance healing and reduce suffering. As the region's adult academic health sy... more
5d ago
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As a utilization review (UR) nurse, you help ensure that patients are receiving the appropriate level of care while being mindful of expenditures to your employer, whether you work for a hospital, managed care facility, or insurance company.

If you’re in search of utilization review nurse jobs or other non-bedside nurse jobs, you’ve come to the right place. Start looking for full-time, part-time, remote, contract, temporary, or per diem positions on IntelyCare today.

Utilization Review Nurse Education and Skills

Before you can work in utilization review, you must complete either an associate degree in nursing (ADN) or a bachelor degree in nursing (BSN), however some employers will prefer a BSN vs. an ADN. Once you pass the NCLEX and receive your RN license, you’ll want to gain clinical experience in direct patient care. You may also want to pursue experience as an RN case manager.

While likely not required for most jobs, specialty certification can increase both your knowledge and also your leverage when it comes time to look for a new utilization review nurse job. Certifications include:

  • Health Utilization Management Certification (HUMC)
  • Health Care Quality and Management (HCQM)
  • Certified Case Manager (CCM)
  • Accredited Case Manager (ACM)

Utilization Review Nurse Resume and Cover Letter

Put some effort into customizing your utilization review nurse resume to each job posting. For instance, if an employer is seeking a candidate “proficient in insurance prior authorizations and medical necessity criteria for different payers,” include that phrase in your resume. This helps demonstrate that your skills are a good fit for the job.

In your UR nurse cover letter, explain a bit about what drew you to this particular position. Remember, you don’t want just any old job — you want this job. To reinforce this sentiment, search the employer’s website for their mission statement and see where your values overlap.

Interviewing for a Utilization Review Nurse Job

A job interview has the potential to determine whether or not you’ll get a job offer. Need some pointers? Review our nursing interview tips in advance to help you formulate smart answers to common questions and boost your confidence.

Utilization Review Nurse Salary

The average annual salary for a UR RN is around $89,900. Your location, level of education and experience, and employer can impact this number. For a more accurate picture of utilization review nurse jobs’ salary estimates in your area, explore the current openings on IntelyCare.

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