Utilization Review Nurse Jobs

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...
1w ago
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Employment Type: Full time Shift: Day Shift Description: Position Purpose: As a Case Manager in Utilization Management, you will be the key to ensuring patients receive appropriate, high-quality care. You’ll...
1w ago
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Navajo Preference Employment Act In accordance with Navajo Nation and federal law, TCRHCC has implemented an Affirmative Action Plan pursuant to the Navajo Preference in Employment Act.  Pursuant to this Plan and corre...
3m ago
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Overview Since the doors opened more than 59 years ago, UF Health Leesburg Hospital has continued to build upon its reputation as a leading medical center and the most comprehensive provider of health care services i...
3d ago
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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...
3d ago
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Responsibilities The Oaks outpatient programs incorporate a range of services to adolescents, adults and seniors, including; physician oversight, medication management, group therapy practices such as Cognitive...
1w ago
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Responsibilities Join the Southwest Healthcare Team! About Us: Creating Health and Harmony, Southwest Healthcare is a comprehensive network of care with convenient hospital and ambulatory care/outpat...
2w ago
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APPLICATION DEADLINE: 04/20/2025 Job Summary: The RN Case Manager/Utilization Reviewer is responsible for hospital case management/utilization review, and discharge planning to assure that patients progress th...
1w ago
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Job Summary: We are seeking a Part-Time Utilization Review Nurse to join our dedicated healthcare team. In this role, you will play a critical part in ensuring that patients receive appropriate and effective medical...
1w ago
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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...
1w ago
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General Position Summary: Provides comprehensive review of patient care issues.  Assists with the implementation of the hospital and medical staff performance improvement program.  Collects and organizes data to sup...
2w ago
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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...
2w ago
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AHCCCS Arizona Health Care Cost Containment System Accountability, Community, Innovation, Leadership, Passion, Quality, Respect, Courage, Teamwork The Arizona Health Care Cost Containment System (AHCCCS), Arizona’...
1w ago
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St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission o...
2w ago
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“They made it easier for me to live, breathe, eat, and stay clean. Without them, I’d be waiting somewhere, waiting for someone to give me a chance to live...” - Client from Telecare  What You Will Do to Change Liv...
2m ago
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For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Grow...
1w ago
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Utilization Review RN - PRN - Monday-Friday Days Three (3) years of utilization review experience in acute care setting WHY UT SOUTHWESTERN? With over 75 years of excellence in Dallas-Fort Worth, Texas, UT South...
1w ago
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For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Grow...
1w ago
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Overview The RN - Case Management -  Utlization Review to provide clinically-based case management to support the delivery of effective and efficient patient care. The role integrates utilization management, car...
24m ago
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Overview Make a difference and work with a diverse team of professionals as a Utilization Review Clinician at the Department of Vermont Health Access (DVHA)! DVHA's Clinical Integrity Unit (CIU) is seeking a Ut...
5d ago
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Grow Healthy If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn’t just welcomed – it’s nurtured, celebrated, a...
6d ago
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Job Summary: Conducts utilization review for in-house patients and/or those members at contracted facilities. Assists in the discharge planning process. Essential Responsibilities: Conducts utilization re...
3m ago
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The County of Riverside - Riverside University Health System-Medical Center is seeking highly skilled and experienced Registered Nurses to join our team as a Health System Nurse Case Manager with the UR Case Ma...
3d ago
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Overview NaphCare is hiring experienced PRN- Utilization Management Registered Nurse  just like you at the Corporate Headquaters located in Birmingham, Alabama. NaphCare is a family owned, medical technology co...
1w ago
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Utilization Review Nurse  MAIN FUNCTION:  The Utilization Management Nurse Reviewer (RN) serves as the Subject Matter Expert for the organization for patient admission status (inpatient and observation) and works...
2w 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...
3w ago
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Job Summary: Conducts utilization review for in-house patients and/or those members at contracted facilities. Assists in the discharge planning process. Essential Responsibilities: Conducts utilization revi...
3w ago
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Full Time, Day Shift, M-F 8 am- 4:30 pm Minimum Age Requirement: 18 years of age or older JOB REQUIREMENTS Education Registered Nurse or Licensed Practical Nurse with current and unrestricte...
4w ago
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Who We Are JPS Health Network is a $950 million, tax-supported healthcare system in North Texas. Licensed for 582 beds, the network features over 25 locations across Tarrant County, with John Peter Smith Hospit...
2m ago
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*Step Pay Range of $81.940 - $111.913 pending per board approval Application materials will be reviewed in an ongoing basis until position is filled .  Please allow two (2) weeks for processing of all application...
11m 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.