1w
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Utilization Review Nurse
New Lenox, Illinois, United States
$35-$45/hr HybridFull Time
Current RN licensure, current CPR, knowledge of clinical norms, strong communication and critical thinking; experience in utilization review, case management or hospital nursing preferred.
2mo
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Utilization Review Nurse
Las Vegas, Nevada, United States
$40-$63/hr OnsiteFull Time
5+ YOEActive Nevada RN license, 5+ years acute care nursing, minimum 3 years utilization management experience, experience with InterQual and Milliman criteria, strong chart review and communication skills.
InterQual, Milliman
1w
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Utilization Management Nurse
Annapolis or Lanham
$34-$55/hr HybridFull Time
3+ YOECurrent Maryland RN license, BSN (or ADN with equivalent experience; BSN to be completed within 5 years), 3 years acute care nursing, chart review and utilization management experience, EPIC proficiency.
EPIC
1mo
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Utilization Review Nurse
Dallas, Texas, United States
$90k-$98k/yr RemoteFull Time
3+ YOECurrent unrestricted RN license, 3+ years clinical nursing, 1+ year UM/UR experience, proficiency with Microsoft Excel/Word/Outlook/Teams and utilization management systems; strong analytical and communication skills.
Microsoft Excel, Microsoft Word, Microsoft Outlook, Microsoft Teams, Milliman
2w
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Utilization Management Nurse
Nashville, Tennessee, United States
OnsiteFull Time
3+ YOEPerform prospective/concurrent/retrospective utilization reviews, analyze trends, collaborate with providers, and document reviews; RN license and 3+ years utilization management experience required.
1mo
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Utilization Management Nurse Registered
Woodland Park or Paterson
$49-$74/hr OnsiteFull Time
3+ YOEBachelor of Science in Nursing, NJ RN license, minimum 3 years nursing experience; 3+ years utilization review or case management preferred; CCM preferred.
3mo
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Utilization Review Nurse
Albany, New York, United States
$72k-$111k/yr OnsiteFull Time
3+ YOERegistered nurse with NY license; associate degree; 3 years clinical experience; utilization management/case management/ discharge planning experience preferred; PRI and case management certification preferred; strong communication; knowledge of MCG criteria, ICD-10 coding, and Medicare rules.
EMR, MCG criteria, ICD-10 coding, Medicare regulations
1mo
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Utilization Review Nurse I
Wailuku or Honolulu
$68-$79/hr HybridFull Time
Associate Degree in Nursing, active Hawaii RN license and BLS required; performs utilization reviews, consults on medical necessity, and collaborates with clinicians and members for discharge planning.
2mo
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Utilization Management Nurse
United States
$80k-$95k/yr RemoteFull Time
3+ YOERN with 3-5 years in utilization management; risk-based care experience; data-driven decision making; strong communication and leadership.
4d
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Utilization Review Nurse
Little Rock, Arkansas, United States
OnsiteFull Time
3+ YOEActive Arkansas RN license, 3+ years acute care experience, BSN/ADN/diploma accepted; experience in psych, discharge planning, or utilization management preferred.
2mo
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Utilization Review Nurse
United States
$35-$46/hr RemoteFull Time
1+ YOE1+ year of utilization review experience; RN license in the US or compact multistate license; ability to obtain additional state licenses; strong experience with Milliman Care Guidelines (MCG).
Milliman Care Guidelines, MCG
3w
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Utilization Management Nurse
Wilmington, Delaware, United States
HybridFull Time
5+ YOEBSN and active DE RN license required, 5+ years related experience, conducts concurrent utilization reviews, ensures regulatory compliance and coordinates interdisciplinary care using EMR.
EMR
1mo
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Utilization Review Nurse RN
Randallstown, Maryland, United States
$40-$62/hr OnsiteFull Time
3+ YOECurrent Maryland RN license or eligible, Associates Degree in Nursing required (BSN preferred), minimum 3 years related experience, ability to apply utilization review criteria and coordinate with payers and care teams.
2mo
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Utilization Management Nurse
Dalton, Georgia, United States
OnsiteFull Time
3+ YOERN license; 3 years clinical experience preferred; 1-2 years utilization review preferred; proficient in Microsoft Office; NCQA knowledge preferred; ability to manage multiple projects.
Microsoft Office
2w
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Utilization Management Nurse
Chapel Hill, North Carolina, United States
RemoteFull Time
2+ YOEActive RN licensure required, 2+ years UM team experience in managed care, BLS not explicitly stated; proficiency with Microsoft Office, MCG and CMS criteria, utilization review and benefit interpretation skills.
Microsoft Outlook, Microsoft Word, Microsoft Excel, Microsoft PowerPoint, MCG, CMS
3mo
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Utilization Review Nurse
New Orleans, Louisiana, United States
OnsiteFull Time
3+ YOERN licensed in Louisiana with BSN; 3-5 years acute care experience; knowledge of Medicaid/Medicare regulations; experience with utilization review and case management; proficient in MS Office; strong communication and problem-solving skills.
MS Office (Word, Excel, Outlook)
3mo
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Utilization Review Nurse
Morehead, Kentucky, United States
OnsiteFull Time
2+ YOERN with 2+ years nursing experience; bachelor’s degree in nursing; current RN license; UNOS reporting experience preferred.
1mo
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Utilization Review Nurse
Salt Lake City, Utah, United States
OnsiteFull Time
1+ YOEActive Utah RN license (or obtain within 90 days), 1+ year utilization review or case management experience, knowledge of InterQual and payer systems, BLS preferred, strong communication and critical thinking, ability to work rotating shifts.
InterQual, ICD-9, DRG, CPT
2mo
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Utilization Review Nurse
Big Spring, Texas, United States
OnsiteFull Time
5+ YOERN with Texas license; 5 years in clinical nursing; UR experience preferred.
3mo
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Utilization Review Nurse (55697)
El Paso, Texas, United States
OnsiteFull Time
2+ YOE2+ years Utilization Management experience; RN license in Texas; BSN preferred; knowledge of InterQual/DRGs; strong organizational, communication, and IT skills.
InterQual, Milliman Care Guidelines, ICD-10, DRGs, Microsoft Office, HIPAA
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