Utilization Review Nurse Jobs

We've made a lot of progress since opening the doors in 1942, but one thing has never changed - our commitment to serve, heal, lead, educate, and innovate.  We believe t...
4d ago
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Number of Job Openings Available: 1 Date Posted: December 26, 2024 Department: 62206600 Allina Health Group Urgent Care Shoreview Shift: Day/Evening (United States of America) Shift Length:...
3w ago
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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...
2w ago
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Elevance Health Full-time CA-WOODLAND HILLS, 21215 BURBANK BLVD 3w ago
Anticipated End Date: 2025-01-27 Position Title: Nurse Reviewer I Job Description: A proud member of the Elevance Health family of companies, Carelon Medical Benefits Management, formerly AIM Specialty Health, is...
3w ago
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Harris Health System is the public healthcare safety-net provider established in 1966 to serve the residents of Harris County, Texas. As an essential healthcare system, Harris Health champions better health for the enti...
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Overview Baylor St. Luke’s Medical Center is an 881-bed quaternary care academic medical center that is a joint venture between Baylor College of Medicine and CHI St. Luke’s Health. Located in the Texas Medical C...
4d ago
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Job Summary: Works collaboratively with an MD to coordinate and screen for the appropriateness of admissions and Continued stays.  Makes recommendations to the physicians for alternate levels of care when the pati...
1w ago
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Pay Schedule III, Grade 18N, Regular Schedule:  35 hours per week.  A vacancy exists in the Department of Health and Human Services, Community Health Services, Adult Evaluation and Review Services (AERS).   A list of...
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SRMC Has an Exciting Opportunity for Qualified Candidates! Position: Full Time RN Case Manager/Utilization Review Department : Case Management Shift: 8:00 am – 4:30 pm P...
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Responsibilities River Vista Behavioral Health sits along the bluffs overlooking the San Joaquin River, this brand new, 128-bed facility, will provide high-quality and advanced behavioral health services to r...
2w ago
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Date:   Dec 9, 2024 Location:   Warwick, RI, US, 02886-1782 Req ID:   28274 It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put you...
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Pay Schedule XIV, Grade R06, Regular Schedule:  30 hours per week. A vacancy exists in the Department of Health and Human Services, Adult Evaluation and Review Services Program.  Non-Merit positions are not classifi...
2m ago
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Description Summary: The Utilization Review Nurse is responsible for determining the clinical appropriateness of care provided to patients and ensuring proper hospital resource utilization of services. This nurse is...
1w ago
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Denial Review Nurse Department: Health Services Employment Type: Full Time Location: 1600 Corporate Center Dr., Monterey Park, CA 91754 Reporting To: Felicia Calles Compensation: $30.00 - $45.00 / hour...
1m ago
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Utilization Management Review Nurse - Hybrid Department: Health Services Employment Type: Full Time Location: 1600 Corporate Center Dr., Monterey Park, CA 91754 Reporting To: Sandra Castellon Compensation...
1m ago
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*** MUST reside in AZ to be considered for this role** Welcome to Abrazo Health Network, where making a real difference in people's lives is at the heart of everything we do. Beyond just medical treatments, w...
5d ago
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Elevance Health Full-time ME-SOUTH PORTLAND, 2 GANNETT DR 4d ago
Anticipated End Date: 2025-01-21 Position Title: Clinical Review Nurse I (US) Job Description: Clinical Review Nurse I - Medicare Part B National Government Services is a proud member of Elevance Health's fam...
4d ago
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JOB SUMMARY CCCS uses a holistic approach to medical management. The Utilization Management Nurse and the Personal Health Nurse (PHN) works within a team to move the member through the continuum of medical manageme...
5d ago
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Elevance Health Full-time IL-CHICAGO, 8600 W BRYN MAWR AVE, STE 800 3w ago
Anticipated End Date: 2025-01-27 Position Title: Nurse Reviewer I Job Description: A proud member of the Elevance Health family of companies, Carelon Medical Benefits Management, formerly AIM Specialty Health...
3w ago
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Department Overview The NM’s decisions and actions are based on the ethical principles outlined by the American Nurses Association’s Code of Ethics for Nursing. The NM practices in adherence with the American Nurses A...
1m ago
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Division: Eskenazi Health   Sub-Division:  Hospital   Req ID:   22268  Schedule : Full Time  Shift : Days  Salary Range:   Eskenazi Health serves as the public hospital division of the Health...
1m ago
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JOB DESCRIPTION Job Summary Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the co...
1w ago
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Location:  Steward Health Care Posted Date:  6/11/2024 Job Type:  Full Time Department:  1301.40601 Centralized UR The Care Manager assumes primary responsibility for documentation of appropriate medical necessi...
7m ago
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Salary Range:   $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage...
9m ago
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Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse nee...
6m ago
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Description Summary: The Utilization Management Nurse I is responsible for determining the clinical appropriateness of care provided to patients and ensuring proper hospital resource utilization of services. This N...
4w ago
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Overview Clinical Reimbursement Review Nurse is responsible for data collection and data entry that represents the residents’ level of care requirements into the utilization software for Maryland Medicaid, in accordan...
2m ago
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Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse nee...
6m ago
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Risk Management   Full Time Day Shift  Day Shift Consistently named best hospital, Lexington Medical Center dedicates itself to providing quality health services that meet the needs of its communities. Ranked #2 i...
7m ago
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Location: Miramar, Florida 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 syste...
1m ago
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Utilization Review Nurse Jobs Overview

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. Some of the more in-demand roles include:

Utilization Review Nurse Job Locations

Wondering where you might work in this role? The federal government requires that organizations participating in Medicare and Medicaid conduct utilization reviews. This means that you’ll find a variety of workplace options.

A graphic showing the locations where healthcare professionals can find utilization review nurse jobs.

Utilization Review Nurse Education and Skills

Before you can work in utilization review, you must complete a nursing program from an approved institution. Once you pass the NCLEX and receive your license, you’ll want to gain clinical experience in direct patient care. Registered nurses 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.

Learn how to answer interview questions about your strengths as a nurse below:

Utilization Review Nurse Salary

The average annual salary for a UR nurse is around $90,900 for a registered nurse. 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.

Ready to Find Utilization Review Nurse Jobs?

Check out all the positions available right now. Want additional options? IntelyCare can match you with even more nursing jobs that interest you.