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Apprentice Utilization Management Nurse Jobs in Delaware

UHS

PRN Utilization Management Coordinator

Dover, DE · On-site

... Diem Utilization Management Coordinator position. In this role, you will proactively monitor ... MSW or MS in a recognized mental health field or a Registered Nursing License * One (1) year ...

UHS

Lead UR Coordinator

Dover, DE · On-site

... Nursing License * One (1) year experience in case management and/or hospital experience Preferred: * One (1) year experience as a Utilization Management Coordinator at a long-term care facility About ...

UHS

Lead UR Coordinator

Dover, DE · On-site

... Nursing License * One (1) year experience in case management and/or hospital experience Preferred: * One (1) year experience as a Utilization Management Coordinator at a long-term care facility About ...

Pharmacy Careers

Appeals Pharmacist (Remote)

Newark, DE · On-site +1

$56 - $68.25/hr

Collaborate with physicians, nurses, and medical directors during case reviews. * Track, document ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...

Pharmacy Careers

Appeals Pharmacist (Remote)

Dover, DE · On-site +1

$57.25 - $69.75/hr

Collaborate with physicians, nurses, and medical directors during case reviews. * Track, document ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...

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Apprentice Utilization Management Nurse information

See Delaware salary details

$39K

$89.6K

$163.1K

How much do apprentice utilization management nurse jobs pay per year?

As of May 28, 2026, the average yearly pay for apprentice utilization management nurse in Delaware is $89,560.00, according to ZipRecruiter salary data. Most workers in this role earn between $64,600.00 and $104,600.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as an Apprentice Utilization Management Nurse, and why are they important?

To thrive as an Apprentice Utilization Management Nurse, you need a foundational understanding of nursing principles, strong analytical skills, and typically an RN license or progression toward one. Familiarity with utilization management software, electronic health records (EHR), and knowledge of insurance guidelines such as Medicare or Medicaid are often required. Attention to detail, critical thinking, and effective communication are essential soft skills for collaborating with healthcare teams and conveying clinical information. These competencies ensure accurate patient care reviews, compliance with regulations, and effective support in healthcare cost management.

What are some common challenges faced by Apprentice Utilization Management Nurses, and how can they be addressed?

Apprentice Utilization Management Nurses often encounter challenges such as learning to interpret complex medical records, understanding insurance policies, and adhering to strict regulatory guidelines. Balancing patient advocacy with cost-effective care decisions can also be demanding. These challenges can be addressed by actively participating in mentorship programs, seeking regular feedback from experienced colleagues, and utilizing ongoing training resources provided by employers. Developing strong communication and organizational skills will also help manage the workload and foster effective collaboration with physicians, case managers, and insurance representatives.

What is an Apprentice Utilization Management Nurse?

An Apprentice Utilization Management Nurse is a nursing professional in training who assists with the review and evaluation of healthcare services to ensure they are medically necessary and cost-effective. They work under the supervision of experienced utilization management nurses and follow established guidelines to assess patient care plans, medical records, and insurance policies. Their role is crucial in helping healthcare organizations maintain quality care while managing costs, and they may interact with physicians, patients, and insurance companies to clarify or justify treatment decisions. As apprentices, they are gaining hands-on experience to develop their skills and knowledge in utilization management.

What is the difference between Apprentice Utilization Management Nurse vs Utilization Management Nurse?

AspectApprentice Utilization Management NurseUtilization Management Nurse
CredentialsLicensed RN, in training or early certification stageLicensed RN with certification in utilization review
Work EnvironmentSupervised training setting, often in healthcare or insurance companiesIndependent review in healthcare or insurance organizations
Job ResponsibilitiesAssisting with case reviews, learning utilization review processesConducting case assessments, making coverage decisions

The Apprentice Utilization Management Nurse is in training, focusing on learning review procedures under supervision, while the Utilization Management Nurse is fully qualified, responsible for independent case evaluations and decision-making. The apprentice role is a stepping stone toward becoming a licensed Utilization Management Nurse.

What are popular job titles related to Apprentice Utilization Management Nurse jobs in Delaware? For Apprentice Utilization Management Nurse jobs in Delaware, the most frequently searched job titles are:
What job categories do people searching Apprentice Utilization Management Nurse jobs in Delaware look for? The top searched job categories for Apprentice Utilization Management Nurse jobs in Delaware are:
What cities in Delaware are hiring for Apprentice Utilization Management Nurse jobs? Cities in Delaware with the most Apprentice Utilization Management Nurse job openings:
Apprentice Utilization Management Nurse jobs near you
Infographic showing various Apprentice Utilization Management Nurse job openings in Delaware as of May 2026, with employment types broken down into 42% Full Time, 52% Part Time, 3% Temporary, and 3% Contract. Highlights an 96% Physical, and 4% Remote job distribution, with an average salary of $89,560 per year, or $43.1 per hour.

PRN Utilization Management Coordinator

Alan B. Miller Medical Center

Dover, DE

Per diem

Posted 20 days ago

Job description

Per Diem Utilization Management Coordinator

Dover Behavioral Health System is a 104-bed, acute care psychiatric hospital located in the beautiful Dover, Delaware area. Dover Behavioral Health System features individual units for adolescents and adults and offers inpatient acute care, partial hospitalization, and intensive outpatient programs. On average, over 10,000 patients receive care from our compassionate health care team each year at Dover Behavioral Health System. This opportunity offers working at a hospital known for its outstanding patient satisfaction, including ranking 6th for highest patient satisfaction in 2020 compared to over 200+ psychiatric hospitals. We attribute this success to our talented and dedicated staff. Dover Behavioral Health system is seeking qualified candidates for our Per Diem Utilization Management Coordinator position. In this role, you will proactively monitor utilization of continuum services and optimize reimbursement. Responsibilities will include:

  • Conduct admission reviews working with Assessment and Referral Services to stay abreast of admissions.
  • Conduct concurrent and extended stay reviews on appropriate day and/or specified time.
  • Prepare and submit appeals to third party payors, effectively coordinating collection of all pertinent data to support the hospital and patient's position.
  • Call/fax discharge information to insurance companies within 24 hours of discharge to ensure the facility is paid for the hospital stay.
  • Maintain and update logs of review and maintain other appropriate records of the Utilization Review department.
  • Communicate pertinent third party payors issues to doctor and treatment team.
  • Attend daily treatment team meetings to discuss acuity issues, third party payors needs and gather information for reviews.
  • Work independently in gathering information for reviews from the patient record, taking the initiative to seek information from members of the treatment team.
  • Understand and communicate insurance information to team members, including benefits and levels of care offered.
  • Perform internal utilization reviews as indicated.
  • Identify, document, and report any and all instances of adult or child abuse and neglect to the appropriate parties including a member of management, the police, and state agencies

Qualifications Minimum: MSW or MS in a recognized mental health field or a Registered Nursing License One (1) year experience in case management and/or hospital experience Preferred: One (1) year experience as a Utilization Management Coordinator at a long-term care facility

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