Utilization Review Nurse
$28.85 - $31.25/hr
Provide outpatient or pharmacy services utilization review Qualifications * Current Florida RN License * 3+ years in recent medical/surgical or critical care experience * 3+ years of Utilization ...
Utilization Review Nurse
$28.85 - $31.25/hr
Provide outpatient or pharmacy services utilization review Qualifications * Current Florida RN License * 3+ years in recent medical/surgical or critical care experience * 3+ years of Utilization ...
Under the direction and oversight of the Nurse Supervisor Utilization Review, the Intermediate Care Utilization Review Nurse is responsible for coordination of services for members of Florida Health ...
Under the direction and oversight of the Nurse Supervisor Utilization Review, the Intermediate Care Utilization Review Nurse is responsible for coordination of services for members of Florida Health ...
Under the direction and oversight of the Nurse Supervisor Utilization Review, the Intermediate Care Utilization Review Nurse is responsible for coordination of services for members of Florida Health ...
Under the direction and oversight of the Nurse Supervisor Utilization Review, the Intermediate Care Utilization Review Nurse is responsible for coordination of services for members of Florida Health ...
Under the direction and oversight of the Nurse Supervisor Utilization Review, the Intermediate Care Utilization Review Nurse is responsible for coordination of services for members of Florida Health ...
Under the direction and oversight of the Nurse Supervisor Utilization Review, the Intermediate Care Utilization Review Nurse is responsible for coordination of services for members of Florida Health ...
Utilization Review Nurse
Tampa, FL · On-site
$29 - $30/hr
You, as the Nurse Reviewer will be held responsible for the comprehensive review of the medical ... Utilization Review/Management, HEDIS, Chart Auditing, Medical Record Reviews] Additional ...
Utilization Review Nurse
Tampa, FL · On-site
$29 - $30/hr
You, as the Nurse Reviewer will be held responsible for the comprehensive review of the medical ... Utilization Review/Management, HEDIS, Chart Auditing, Medical Record Reviews] Additional ...
HEDIS Utilization Review Nurse
Winter Haven, FL · On-site
$26.50 - $35/hr
HEDIS Utilization Review Nurse Reports to: Director of Managed Care FLSA Status: Exempt Personnel Supervised: None POSITION SUMMARY: The HEDIS Utilization Review Specialist is responsible for ...
HEDIS Utilization Review Nurse
Winter Haven, FL · On-site
$26.50 - $35/hr
HEDIS Utilization Review Nurse Reports to: Director of Managed Care FLSA Status: Exempt Personnel Supervised: None POSITION SUMMARY: The HEDIS Utilization Review Specialist is responsible for ...
HEDIS Utilization Review Nurse
$26.50 - $35/hr
HEDIS Utilization Review Nurse Reports to: Director of Managed Care FLSA Status: Exempt Personnel Supervised: None POSITION SUMMARY: The HEDIS Utilization Review Specialist is responsible for ...
HEDIS Utilization Review Nurse
$26.50 - $35/hr
HEDIS Utilization Review Nurse Reports to: Director of Managed Care FLSA Status: Exempt Personnel Supervised: None POSITION SUMMARY: The HEDIS Utilization Review Specialist is responsible for ...
... minimum nursing experience *Must have 2 years minimum experience in at least one of the following: utilization review from another managed care company; experience in a medical setting handling ...
... minimum nursing experience *Must have 2 years minimum experience in at least one of the following: utilization review from another managed care company; experience in a medical setting handling ...
Nurse Utilization Review Supervisor
Miami, FL · On-site +1
The University of Miami has a great opportunity for a Nurse Utilization Review Supervisor to work at UTower. POSITION SUMMARY: This position functions as the Supervisor for the Case Management ...
Nurse Utilization Review Supervisor
Miami, FL · On-site +1
The University of Miami has a great opportunity for a Nurse Utilization Review Supervisor to work at UTower. POSITION SUMMARY: This position functions as the Supervisor for the Case Management ...
The University of Miami has a great opportunity for a Nurse Utilization Review Supervisor to work at UTower. POSITION SUMMARY: This position functions as the Supervisor for the Case Management ...
The University of Miami has a great opportunity for a Nurse Utilization Review Supervisor to work at UTower. POSITION SUMMARY: This position functions as the Supervisor for the Case Management ...
Utilization Review Specialist
Boynton Beach, FL · Hybrid
$65K - $80K/yr
Bachelor's degree from an accredited college or university in social work, mental health, nursing, or a related degree required. Utilization Review Specialist Responsibilities: * Manage and perform ...
Utilization Review Specialist
Boynton Beach, FL · Hybrid
$65K - $80K/yr
Bachelor's degree from an accredited college or university in social work, mental health, nursing, or a related degree required. Utilization Review Specialist Responsibilities: * Manage and perform ...
Utilization Review RN
$30 - $32/hr
Are you an experienced Registered Nurse with Utilization Review or Concurrent Review experience looking for a new opportunity with a prestigious Managed Care Company? Do you want the chance to ...
Utilization Review RN
$30 - $32/hr
Are you an experienced Registered Nurse with Utilization Review or Concurrent Review experience looking for a new opportunity with a prestigious Managed Care Company? Do you want the chance to ...
Utilization Review/Outpatient Care RN
$28 - $32/hr
Utilization Review/Outpatient Care RN Are you an experienced Registered Nurse with Utilization Review experience looking for a new opportunity with a prestigious healthcare company? Do you want the ...
Utilization Review/Outpatient Care RN
$28 - $32/hr
Utilization Review/Outpatient Care RN Are you an experienced Registered Nurse with Utilization Review experience looking for a new opportunity with a prestigious healthcare company? Do you want the ...
The Utilization Review Specialist Senior responsibilities include: * Functions as the primary ... Preferred experience includes Critical Care or Emergency Nursing RN. Position details: * Location:
The Utilization Review Specialist Senior responsibilities include: * Functions as the primary ... Preferred experience includes Critical Care or Emergency Nursing RN. Position details: * Location:
The Utilization Review Specialist Senior responsibilities include: * Functions as the primary ... Preferred experience includes Critical Care or Emergency Nursing RN. Position details: * Location:
The Utilization Review Specialist Senior responsibilities include: * Functions as the primary ... Preferred experience includes Critical Care or Emergency Nursing RN. Position details: * Location:
Three (3) years of utilization review, case management, or third-party payer experience. Qualifications * Active Registered Nurse (RN) license with 3+ years of experience in utilization review or ...
Three (3) years of utilization review, case management, or third-party payer experience. Qualifications * Active Registered Nurse (RN) license with 3+ years of experience in utilization review or ...
Three (3) years of utilization review, case management, or third-party payer experience. Qualifications * Active Registered Nurse (RN) license with 3+ years of experience in utilization review or ...
Three (3) years of utilization review, case management, or third-party payer experience. Qualifications * Active Registered Nurse (RN) license with 3+ years of experience in utilization review or ...
Utilization Management Rn - Remote
Miami, FL · Remote
$35 - $39/hr
Review approximately 20 cases a day for medical necessity. * Advocate for and protect members from ... nurses to assist each other and complete cases. Qualifications: * 3+ years of utilization ...
New
Utilization Management Rn - Remote
Miami, FL · Remote
$35 - $39/hr
Review approximately 20 cases a day for medical necessity. * Advocate for and protect members from ... nurses to assist each other and complete cases. Qualifications: * 3+ years of utilization ...
New
Physician Reviewer - Utilization Management
Orlando, FL · Remote
$211.20K/yr
We're hiring a Physician Reviewer to join our Utilization Management team. Oscar is the first ... Receive and review escalated reviews. * Conduct timely peer-to-peer discussions with treating ...
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Physician Reviewer - Utilization Management
Orlando, FL · Remote
$211.20K/yr
We're hiring a Physician Reviewer to join our Utilization Management team. Oscar is the first ... Receive and review escalated reviews. * Conduct timely peer-to-peer discussions with treating ...
Perform onsite review of emergent/urgent and continued stay requests for appropriate care and ... To start with this is a must! -Knowledge of utilization management principles and healthcare ...
Perform onsite review of emergent/urgent and continued stay requests for appropriate care and ... To start with this is a must! -Knowledge of utilization management principles and healthcare ...
Anthem Utilization Review Nurse information
See Florida salary details
$15.99 - $19.22
2% of jobs
$19.22 - $22.45
9% of jobs
$24.67 is the 25th percentile. Wages below this are outliers.
$22.45 - $25.69
21% of jobs
The median wage is $28.31 / hr.
$25.69 - $28.92
23% of jobs
$28.92 - $32.16
13% of jobs
$34.67 is the 75th percentile. Wages above this are outliers.
$32.16 - $35.39
10% of jobs
$35.39 - $38.62
8% of jobs
$38.62 - $41.86
5% of jobs
$41.86 - $45.09
5% of jobs
$45.09 - $48.32
2% of jobs
$48.32 - $51.56
2% of jobs
$15
$31
$51
How much do anthem utilization review nurse jobs pay per hour?
As of May 28, 2026, the average hourly pay for anthem utilization review nurse in Florida is $31.60, according to ZipRecruiter salary data. Most workers in this role earn between $24.95 and $36.30 per hour, depending on experience, location, and employer.
What is an Anthem Utilization Review Nurse job?
An Anthem Utilization Review Nurse evaluates medical services and treatments to ensure they meet established guidelines for medical necessity, cost-effectiveness, and quality care. They review patient records, collaborate with healthcare providers, and determine appropriate levels of care based on insurance policies. This role helps manage healthcare costs while ensuring patients receive necessary treatments. Utilization review nurses typically work remotely or in clinical settings and must have a nursing background with expertise in case management and insurance regulations.
What are the key skills and qualifications needed to thrive in the Anthem Utilization Review Nurse position, and why are they important?
To thrive as an Anthem Utilization Review Nurse, you need an active RN license, clinical care experience, and strong knowledge of medical necessity criteria and healthcare regulations. Familiarity with utilization management software, InterQual or Milliman guidelines, and proficiency in electronic medical records are commonly required. Attention to detail, critical thinking, and excellent written and verbal communication distinguish top performers in this position. These skills ensure thorough and accurate case reviews, support compliance with policy, and facilitate effective communication between healthcare providers, insurers, and patients.
What does a typical day look like for an Anthem Utilization Review Nurse?
A typical day for an Anthem Utilization Review Nurse involves reviewing patient medical records to determine the medical necessity of services, coordinating with healthcare providers via phone or email, and documenting determinations in electronic systems. Nurses in this role often attend team meetings, consult with physicians, and may help educate providers on clinical guidelines and coverage policies. The work is mostly desk-based and may be remote or office-based, depending on Anthem's structure. This position requires balancing productivity targets with careful case analysis, and it offers a predictable schedule with limited direct patient interaction, making it ideal for nurses seeking to apply their expertise in a non-clinical setting.
More about Anthem Utilization Review Nurse jobs
What are the most commonly searched types of Anthem Utilization Review Nurse jobs in Florida? The most popular types of Anthem Utilization Review Nurse jobs in Florida are:
What are popular job titles related to Anthem Utilization Review Nurse jobs in Florida? For Anthem Utilization Review Nurse jobs in Florida, the most frequently searched job titles are:
- Utilization Review Nurse
- Medicare Review Nurse
- Remote Utilization Management Nurse
- Telecommute Hedis Review Nurse
- Utilization Management Nurse Consultant
- Evening Utilization Review Nurse
- Quality Review Nurse
- Non Exempt No Experience Utilization Management Nurse
- Overnight Utilization Review Nurse
- Evening Optum Health Utilization Review
What job categories do people searching Anthem Utilization Review Nurse jobs in Florida look for? The top searched job categories for Anthem Utilization Review Nurse jobs in Florida are:
- Flexible Cigna Utilization Review Nurse
- Remote Rn Utilization Review Nurse
- Lpn Utilization Review Work From Home
- Volunteer Aetna Utilization Review Nurse
- International Utilization Review Nurse
- Full Time Cigna Utilization Review Nurse
- Per Diem Optum Utilization Review
- Utilization Review Manager
- Remote Aetna Utilization Review
- Remote Cigna Utilization Review Nurse
$28.85 - $31.25/hr
Full-time
Medical, Dental, Vision, Retirement, PTO
Posted 23 days ago
Job description
Company Description
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!
Job Description
- Conducts pre-admission, concurrent and retrospective acute care, sub-acute, hospice, qualification of transitional care and long-term care needs for medical necessity
- Perform case reviews and complete all required documentation in appropriate database
- Collaborate with primary or attending physician, case managers, patient and/or family to provide continuity and quality of care in the most cost-effective manner.
- Timely completion of admission reviews (within 48-hours for weekday, 72-hours for weekend)
- Provide outpatient or pharmacy services utilization review
Qualifications
- Current Florida RN License
- 3+ years in recent medical/surgical or critical care experience
- 3+ years of Utilization Review / Case Management experience
- Strong reasoning ability: define problems, collect data, establish facts, and draw conclusions
Additional Information
 Hours for this Position:
- M-F 8-5
Advantages of this Opportunity:
Competitive salaryÂ
- $28.85/hr - $31.25/hr pending experience
- Excellent Medical benefits Offered, Medical, Dental, Vision, 401k, and PTO
- Growth potential
- Fun and positive work environment
About Healthcare Support
Sourced by ZipRecruiter
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!Healthcare Support Staffing, Inc. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.
Industry
Recruiting and staffing services
Company size
201 - 500 Employees
Headquarters location
Maitland, FL, US
Year founded
2003