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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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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Summary This position plays a pivotal role in maintaining the fiscal health of the organization by ensuring the organization is fully reimbursed. Educating and consulting with the physician and the health care team to... more
12h ago
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Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: The Registered Nurse assesses human responses and plans, implements and evaluates nursing care for individuals or families for whom th... more
1d ago
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Description Summary: The Utilization Management Nurse III is responsible for determining the clinical appropriateness of care provided to patients and ensuring proper hospital resource utilization of services. This... more
2d 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... more
2d 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
2d ago
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Per Diem Utilization Management RN

VNS Health  •  Per Diem  •  New York, New York, United States  •  $45.09 - $56.39 / hour  •  2d 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
2d ago
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Company : Allegheny Health Network Job Description :  GENERAL OVERVIEW: The Registered Nurse assesses human responses and plans, implements and evaluates nursing care for individuals or families for whom the nur... more
2d ago
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$5,000 SIGN ON BONUS Utilization management (UM ) is the evaluation of the medical necessity, appropriateness, and efficiency of the use of health care services, procedures, and facilities under the provisions of t... more
2d ago
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Overview 40 hours per week - Fully Remote Position The Utilization Review RN facilitates transitions of care and bed availability through review of patient status and medical necessity.This position requires stro... more
3d ago
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Registered Nurse Utilization Review

SelectHealth Inc  •  Full-time  •  Murray, Utah, United States  •  $38.83 - $57.46 / hour  •  3d ago
Job Description: Proactively manage inpatient and outpatient utilization to assure that medical care is appropriate, efficient, and medically necessary. Support facility discharge planning efforts, coordination of tr... more
3d 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... more
4d ago
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Overview Insurance Managed Care RN - UR/CM Precedence, Inc., Rock Island, IL Remote or Hybrid with Experience - Based Off Of Location Full-Time + Benefits PRN *Seeking candidate with insurance expereinc... more
4d ago
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JOB SUMMARY About Christian Health: We have had the privilege of caring for those in need for more than a century. Founded on the belief that everyone has the right to exceptional care, today we continue to provide q... more
5d ago
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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
5d ago
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Clinical Review Nurse - Prior Authorization - Remote IA

Centene  •  Full-time  •  Remote  •  $25 - $44.85 / hour  •  5d 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
5d 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
5d 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  •  1w 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
1w ago
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Discover. Achieve. Succeed. #BeHere Location: US:WI:MENOMONEE FALLS at our CP-NORTH HILLS HEALTH CENTER facility. This job is REMOTE. FTE: 1.000000 Shift: Shift 1 Monday - Friday: 8:00a - 4:30p. Job Sum... more
1w 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
1w 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
1w 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
1w 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
1w ago
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Registered Nurse, Utilization Coordinator-2

Denver Health  •  Full-time  •  Denver, Colorado, United States  •  $78,802 - $118,203 / year  •  1w ago
We are recruiting for a motivated Registered Nurse, Utilization Coordinator-2 to join our team! We are here for life’s journey. Where is your life journey taking you? Being the heartbeat of Denver means our h... more
1w ago
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It's more than a career, it's a calling MO-REMOTE Worker Type: Regular Job Highlights: At SSM Health, we believe in providing our employees with a fulfilling career. We strive to create an environment w... more
1w 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
1w 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
1w 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
1w 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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