Utilization Review Nurse Jobs

Inspire health. Serve with compassion. Be the difference. Job Summary This position provides coding and utilization analysis for Homecare patients and clinical staff. This job requires analytical skills and clo... more
3w ago
VIEW JOB
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
3w ago
VIEW JOB
Overview Performs utilization review of inpatient admissions, outpatient surgeries, and ancillary services. Performs precertification, concurrent and retrospective reviews, and coordination of discharge planning.... more
2w ago
VIEW JOB
We are recruiting for a motivated RN Utilization Review Coordinator - Denver Health Medical Plan to join our team! We are here for life’s journey. Where is your life journey taking you? Being the heartbeat of... more
2w ago
VIEW JOB

Utilization Review Clinician - Behavioral Health

Centene  •  Full-time  •  Indianapolis - 550 North Meridian St (MHS IN) (10059), United States of America  •  $25.97 - $46.68 / hour  •  3w 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
3w ago
VIEW JOB
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
2w ago
VIEW JOB
Department: Jackson Memorial Hospital - Utilization Review Case Management Leadership Address: 1611 NW 12 Ave., Miami, FL 33136 Shift details: 8:00 - 4:30 PM, Monday - Friday (remote position, must live within on... more
1m ago
VIEW JOB
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
2w ago
VIEW JOB

Utilization Review RN

Providence  •  Full-time  •  Portland, OR, US  •  $45 - $71 / hour  •  2w ago
Description The RN Coordinator-Utilization Review supports the care of the patient through assessment, planning, implementation and evaluation of appropriate services and resources to maximize optimum outcomes. This p... more
2w ago
VIEW JOB
Note: If you are CURRENTLY employed at Children's and/or have an active badge or network access, STOP here.  Submit your application via Workday using the Career App (Find Jobs). Work Shift Day Work Day(s) Vari... more
2m ago
VIEW JOB
Overview M Health Fairview has an immediate opening for a Utilization Management Specialist RN. This position provides comprehensive assessment, planning, coordination, implementation, and reporting of complex clini... more
3m ago
VIEW JOB

Facility Site Review Nurse Specialist RN II

L.A. Care Health Plan  •  Full-time  •  Los Angeles, CA, US  •  $88.85 - $142.17 / year  •  7m ago
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 to l... more
7m ago
VIEW JOB
Overview Assists and collaborates with multidisciplinary team in providing specific clinical information that meets expectations of third party payors; responsible for timely provision/flow of clinical information... more
2m ago
VIEW JOB
ABOUT MARINHEALTH Are you looking for a place where you are empowered to bring innovation to reality? Join MarinHealth, an integrated, independent healthcare system with deep roots throughout the North Bay. With a w... more
3m ago
VIEW JOB
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... more
3m ago
VIEW JOB
Salary Range:   $67,186.00 (Min.) - $87,342.00 (Mid.) - $107,498.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to lo... more
6m ago
VIEW JOB
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 to l... more
6m ago
VIEW JOB
Salary Range:   $102,183.00 (Min.) - $132,838.00 (Mid.) - $163,492.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage... more
7m ago
VIEW JOB
Are you ready to bring your expert clinical skills to a world-class facility recognized as one of the top ten in the United States? Do you have a passion for the highest quality and patient happiness? Then please respon... more
13m ago
VIEW JOB
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... more
2m ago
VIEW JOB
Overview Performs utilization review of inpatient admissions, outpatient surgeries, and ancillary services. Performs precertification, concurrent and retrospective reviews, and coordination of discharge planning.... more
3w ago
VIEW JOB
Salary Range:  $45.8900 - $70.5400 /hour. Actual compensation may vary based on geographic location, work experience, skill level, and education. Case Manager – RN Do you thrive on supporting the professional... more
6m ago
VIEW JOB
Description Responsible for providing utilization review and coordination of care throughout the healthcare continuum to promote quality and cost-effective care to the members. Providence caregivers are not simply va... more
3w ago
VIEW JOB
Baptist Health South Florida is the region’s largest not-for-profit healthcare organization with 12 hospitals, more than 27,000 employees, 4,000 physicians, and 200 outpatient centers, urgent care facilities, and phys... more
1m ago
VIEW JOB
Summary Best in Class Work Environment  5x Modern Healthcare Best Places to work  America’s Greatest Workplaces 2023 – Newsweek  Greatest Workplace for Women 2023,... more
2m ago
VIEW JOB
Department: Jackson Memorial Hospital- Case Management, Utilization Review  Address: 1611 NW 12 Ave, Miami, FL 33136 Shift details: Per Diem, Day Shift, 8:00 am-4:30 pm (Local remote, available to work during the week... more
4m ago
VIEW JOB
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... more
5m ago
VIEW JOB
Salary Range:   $67,186.00 (Min.) - $87,342.00 (Mid.) - $107,498.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to lo... more
6m ago
VIEW JOB
Salary Range:  $45.8900 - $70.5400 /hour. Actual compensation may vary based on geographic location, work experience, skill level, and education. Case Manager – RN (Utilization Review)) Do you thrive on suppor... more
7m ago
VIEW JOB
Applies InterQual Level of Care and/or Milliman criteria to all admissions to determine the appropriateness of admission and the level of care (e.g., critical care, observation). Works with admitting physician, the... more
7h ago
VIEW JOB

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.