Utilization Review Nurse Jobs

RN Utilization Management Referral Coordinator

Corewell Health  •  Part-time  •  SITE - Helen Devos Childrens Hospital - 100 Michigan St - Grand Rapids, United States of America  •  1w ago
This position is Hybrid which consists of the schedule of: Days Worked Thursday, Friday on site + e/o Saturday & Sunday (4 hours) remote About Helen DeVos Children’s Hospital We fight for every child. Wit... more
1w ago
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Utilization Review RN

Providence Health & Services  •  Contract  •  Everett, WA, US  •  $44 - $66 / hour  •  1w ago
Description Oversee utilization management and review of patients care delivery while in the hospital and provide clinical reviews and denial appeals where appropriate either during admission or post discharge. Provi... more
1w ago
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Utilization Review RN

Swedish Health Services  •  Full-time  •  Everett, WA, US  •  $44 - $66 / hour  •  1w ago
Description Oversee utilization management and review of patients care delivery while in the hospital and provide clinical reviews and denial appeals where appropriate either during admission or post discharge. Provi... more
1w ago
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Overview Make your move to Alaska! Experience the midnight sun in the summer, a front-row seat to the northern lights in the winter, and the opportunity to advance your experience and skills as you enjoy the Alaskan... more
1w 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 Managem... more
1w ago
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LVN, Utilization Management

AltaMed  •  Full-time  •  Montebello, California, United States  •  $30.15 - $37.69 / hour  •  1w ago
Work Boldly. Live Brilliantly. At AltaMed, we don’t just serve our communities, we are part of them. We have raised the expectations of what a community clinic can deliver because we think quality care is for everyon... more
1w ago
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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
1w ago
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Clinical Review Nurse - Concurrent Review - Remote CA

Centene  •  Full-time  •  Remote  •  $25 - $44.85 / hour  •  1w 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
1w ago
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Clinical Review Nurse - Concurrent Review

Centene  •  Full-time  •  Tucson, Arizona, United States  •  $25 - $44.85 / hour  •  1w 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
1w 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 He... more
1w ago
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SCHEDULE: Hybrid-remote. You will work mostly remote and are required to work onsite for quarterly meetings.  3, 12 hour shifts. Saturday, Sunday, Monday. JOB SUMMARY The Utilization Review... 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
2w 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
2w 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
2w 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
2w 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  •  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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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
2w 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
2w 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
2w 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
2w 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
2w 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
2w 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
2w ago
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Care Manager RN - Utilization

Providence Covenant Health  •  Full-time  •  Lubbock, TX, US  •  $34 - $54 / hour  •  3w 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
3w 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
3w 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
3w 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
3w 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
3w 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
3w 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
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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