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3Rd Shift Hca Utilization Review Jobs (NOW HIRING)

University of Utah

Utilization Review Nurse

Applies approved utilization criteria to monitor appropriateness of admissions with associated ... Communication to third-party payers for initial and concurrent clinical review. * Reviews patient ...

Uoflhealth

RN Utilization Review

Louisville, KY · On-site

Salary Shift (United States of America) Summary: UofL Health is a fully integrated regional ... Develops a cooperative, assistive relationship with third-party reviewers, working to facilitate ...

The Meadows

Utilization Review Coordinator

Phoenix, AZ · On-site +1

Nurture positive and professional relationships with external (third-party payers) sources. Education and Experience: * Bachelor's degree required * 3-5 years of experience in utilization review in a ...

Prime Healthcare

Utilization Review Tech

Lynwood, CA · On-site

$21 - $24.45/hr

Utilization review tech is responsible for coordinating phone calls, data entry and tracking data ... Employment Status Full Time Shift Days Equal Employment Opportunity Company is an equal employment ...

Beth Israel Lahey Health

Utilization Review RN

Boston, MA · On-site

$38.11 - $98.61/hr

... third-party payer certification, and denied cases. * Monitors effectiveness/outcomes of the ... Compensation may exceed the base hourly rate depending on shift differentials, call pay, premium ...

Cobalt Benefits Group

Utilization Review Nurse

As a Utilization Review Nurse (UR Nurse), you'll play an important role in helping us offer ... a trusted Third-Party Administrator (TPA) specializing in self-funded benefit plans, Cobalt ...

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How much do 3rd shift hca utilization review jobs pay per hour?

As of Jun 30, 2026, the average hourly pay for 3rd shift hca utilization review in the United States is $42.28, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 per hour, depending on experience, location, and employer.
What are the most commonly searched types of Hca Utilization Review jobs? The most popular types of Hca Utilization Review jobs are:
3Rd Shift Hca Utilization Review jobs near you
Utilization Review Nurse

Utilization Review Nurse

University of Utah

Remote

Other

This job post has expired today. Applications are no longer accepted.

University Of Utah rating

7.2

Company rating: 7.2 out of 10

Based on 157 frontline employees who took The Breakroom Quiz

337th of 544 rated colleges and universities

Job description

Overview
As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, integrity, quality and trust that are integral to our mission. EO/AA
This position is responsible for maintaining the financial integrity of both the patient and the organization through the provision of quality based patient care focusing on the medical necessity and efficiency of the delivery of such care; achieved via managing the cost of care while providing timely and accurate information to third party payers and medical care team. This position may be required to access and administer medications within their scope of practice and according to state law.
Corporate Overview: The University of Utah is a Level 1 Trauma Center and is nationally ranked and recognized for our academic research, quality standards and overall patient experience. Our five hospitals and eleven clinics provide excellence in our comprehensive services, medical advancement, and overall patient outcomes.
Responsibilities
Essential Functions
  • Applies approved utilization criteria to monitor appropriateness of admissions with associated levels of care and continued stay review.
  • Communication to third-party payers for initial and concurrent clinical review.
  • Reviews patient chart to ensure patient continues to meet medical necessity.
  • Documentation of all actions and information shared with care team members or third-party payer.
  • Alerts and discusses with physician/provider and case manager/discharge planner when patient no longer meets medical necessity criteria for the inpatient stay.
  • Discusses with physicians the appropriateness of resource utilization.
  • Tracks length of stay (LOS) and resource utilization to identify at risk patients.
  • Refers to UR committee any case that surpasses expected LOS, expected cost, or over/under-utilization of resources.
  • Performs verbal/fax clinical review with payer as determined by nursing judgment and/or collaboration with the payer per university contractual obligation.
  • Participant in UR Committee as needed.
  • Collects data on variances in LOS, avoidable days, costs/barriers to discharge/transition and denied days.
  • Prepares appeals on denied cases when appropriate.
  • At the discretion of department operational and patient care needs, this position is required to work rotating schedules, which may include variable hours, weekends, nights, and holidays to meet the staffing and patient care demands of a 24/7 complex health system. Regular, reliable, and punctual attendance during assigned shifts is considered an essential function of the role.
Knowledge / Skills / Abilities
  • Demonstrated availability to work variable and rotating shifts, including nights, weekends, and holidays, in a 24/7 patient care environment.
  • Ability to perform the essential functions of the job as outlined above.
  • Demonstrated team leadership, relationship building, critical analysis, and written and verbal communication skills.
  • Demonstrated knowledge of payers, payer systems, cost effective utilization management and InterQual criteria.
  • The ability to demonstrate knowledge of the principles of life span growth and development and the ability to assess data regarding the patient's status and provide care as described in the department's policies and procedures manual.
  • Ability to work autonomously and as a team member.
Qualifications
Required
  • One year Utilization Review or Case Management experience.
Licenses Required
  • Current license to practice as a Registered Nurse in the State of Utah, or obtain one within 90 days of hire under the interstate compact if switching residency to State of Utah. Must maintain current Interstate Compact (multi-state) license if residency is not being changed to Utah.
* Additional license requirements as determined by the hiring department.
Qualifications (Preferred)
Preferred
  • Knowledge of ICD-10, CPT Codes, and medications HCPCS
  • Knowledge of CMS Regulations.
Working Conditions and Physical Demands
Employee must be able to meet the following requirements with or without an accommodation.
  • This is a sedentary position in an office setting that may exert up to 10 pounds and may lift, carry, push, pull or otherwise move objects. This position involves sitting most of the time and is not exposed to adverse environmental conditions. This position does not provide care to patients.

Physical Requirements
Carrying, Color Determination, Crawling, Far Vision, Lifting, Listening, Manual Dexterity, Near Vision, Pulling and/or Pushing, Reaching, Sitting, Speaking, Standing, Stooping and Crouching, Walking

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About University of Utah

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The University of Utah is the state’s flagship institution of higher education, with 18 schools and colleges, more than 100 undergraduate majors and graduate programs, and an enrollment of more than 38,000 students. It is a member of the Association of American Universities—an invitation-only, prestigious group of 71 leading research institutions. The U is advancing a new national model for higher education that delivers societal impact through education, research, health care, and community service, while making social, economic, and cultural contributions that improve lives across Utah and around the world.

Industry

Colleges, universities, and professional schools

Company size

10,000+ Employees

Headquarters location

Salt Lake City, UT, US

Year founded

1850

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