Utilization Review Nurse Jobs

Department: Quality Outcomes FTE: 1.00 Full Time Shift: Days Position Summary: The Professional Practice Excellence RN Case Reviewer supports the Professional Practice Committee (PPC) through the management of data... more
1w ago
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About Hilton Head Regional Healthcare Hilton Head Regional Healthcare provides comprehensive healthcare to the Lowcountry at four locations including Coastal Carolina Hospital, Hilton Head Hospital, the Bluffton Medic... more
1w ago
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Registered Nurse Concurrent Utilization Review - 3rd Shift Job Category Nursing Schedule Part time Shift 3 - Night Shift Demonstrates fiscal responsibility related to patient needs, resource... more
1w ago
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AdventHealth Corporate All the benefits and perks you need for you and your family: Benefits from Day One Career Development When screening criteria does not align with the physician order or a... more
1w ago
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Care Manager RN - Utilization

Providence Covenant Health  •  Full-time  •  Lubbock, TX, US  •  $34 - $54 / hour  •  2w 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
2w 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
2w 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
2w 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
2w 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
2w 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
2w 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
2w 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
2w 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
2w 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
2w ago
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Utilization Management RN

VNS Health  •  Full-time  •  New York, New York, United States  •  $85,000 - $106,300 / year  •  2w 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
2w 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
2w 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
2w ago
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Senior Clinical Review Nurse - Concurrent Review - Remote CA

Centene  •  Full-time  •  Remote  •  $29.43 - $52.98 / hour  •  2w 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
2w 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
2w 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
2w 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
2w 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
2w 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
2w 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
2w ago
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RN Utilization Review Coordinator

Valleywise Health  •  Full-time  •  Phoenix, AZ, US  •  $34 - $50 / hour  •  2w ago
Facility: Valleywise Health Medical Center Department: Care Management Schedule: Regular FT 40 Hours Per Week Shifts: Mid As a Valleywise Utilization Review RN Coordinator, you... more
2w ago
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Overview ERP International, LLC is seeking a Registered Nurse - Utilization Managment for a full-time position supporting Medical Managment in support of Tinker AFB, OK .  Be the Best!   Join our team of exce... more
3w ago
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Salary Range:  $31.0400 - $47.7300 /hour. Actual compensation may vary based on geographic location, work experience, skill level, and education. Primary Duties and Responsibilities The Quality Review Nurse is a pr... more
3w ago
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Description: RN Utilization Management Specialist (Remote) Holiday and Saturday check-ins will be required in order to maintain compliancy. Expected Starting Salary Range: 31.43 - 39.59 Utilization Management pr... more
3w ago
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A Case Manager facilities a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual’s and family’s comprehensive health need... more
3w ago
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RN - Utilization Review

Providence Health & Services  •  Full-time  •  Olympia, WA, US  •  $40 - $83 / hour  •  3w ago
Description The Utilization Review (UR) Nurse has a strong clinical background blended with well-developed knowledge and skills in Utilization Management (UM), medical necessity and patient status determination. This... more
3w 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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