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Commission Anthem Utilization Review Jobs (NOW HIRING)

Fusion HCR

Utilization Review Nurse

Las Vegas, NV

Strong knowledge of Joint Commission and CMS guidelines Why Apply * Competitive pay * Stable, high-demand role * Collaborative healthcare environment Apply Now If you have strong Utilization Review ...

Apply Early

Fusion HCR

Utilization Review Nurse

Las Vegas, NV · On-site

Strong knowledge of Joint Commission and CMS guidelines Why Apply * Competitive pay * Stable, high-demand role * Collaborative healthcare environment Apply Now If you have strong Utilization Review ...

Global Force USA

Utilization Review Nurse

Las Vegas, NV · On-site

Reviews patient admissions for appropriateness, efficiency of resource utilization and compliance ... Joint Commission Accredited Health care Organizations standards, state statutes governing hospital ...

Apply Early

MNCP Staffing

Utilization Review Nurse

Las Vegas, NV · On-site

Reviews patient admissions for appropriateness, efficiency of resource utilization and compliance ... Joint Commission Accredited Health care Organizations standards, state statutes governing hospital ...

Apply Early

Prime Staffing

Travel Utilization Review RN

Hayward, CA · On-site

Utilization review, care coordination, acute hospital, ER/ICU, audits, data abstraction, quality improvement, HIPAA, Joint Commission preparationRequired experience: 5 years - 6.Experience in Quality ...

UHS

Utilization Review Manager

Grand Rapids, MI

We are licensed by the State of Michigan, fully accredited by The Joint Commission and we bring ... Utilization Review Manager. Position Description: The Utilization Manager is responsible for ...

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All JobsCommission Anthem Utilization Review Jobs

Commission Anthem Utilization Review information

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$68

How much do commission anthem utilization review jobs pay per hour?

As of Jul 6, 2026, the average hourly pay for commission anthem 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 is the difference between Commission Anthem Utilization Review vs Commission Anthem Claims Processor?

AspectCommission Anthem Utilization ReviewCommission Anthem Claims Processor
CertificationsTypically requires healthcare or insurance-related certificationsUsually requires claims processing or insurance administration certifications
Work EnvironmentHealthcare facilities, insurance companies, or remoteInsurance offices, call centers, or remote
Employer & Industry UsageUsed in healthcare and insurance sectors for review of medical necessityUsed in insurance companies for processing claims and payments

While both roles are part of the insurance industry, Commission Anthem Utilization Review focuses on evaluating the necessity of medical services, whereas Commission Anthem Claims Processor handles the processing and payment of insurance claims. Understanding these differences helps clarify job responsibilities and required skills in the insurance sector.

More about Commission Anthem Utilization Review jobs
What cities are hiring for Commission Anthem Utilization Review jobs? Cities with the most Commission Anthem Utilization Review job openings:
What are the most commonly searched types of Anthem Utilization Review jobs? The most popular types of Anthem Utilization Review jobs are:
What states have the most Commission Anthem Utilization Review jobs? States with the most job openings for Commission Anthem Utilization Review jobs include:
What job categories do people searching Commission Anthem Utilization Review jobs look for? The top searched job categories for Commission Anthem Utilization Review jobs are:
Commission Anthem Utilization Review jobs near you
Infographic showing various Commission Anthem Utilization Review job openings in the United States as of June 2026, with employment types broken down into 1% As Needed, 96% Full Time, and 3% Part Time. Highlights an 90% Physical, 2% Hybrid, and 8% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.
Utilization Review Nurse

Utilization Review Nurse

Fusion HCR

Las Vegas, NV

Full-time

Posted 28 days ago

Be an early applicant

Job description

Fusion HCR is hiring!  Direct Hire – Utilization Review Nurse, this is an onsite position, working with our client in Acute Care. 
Overview
Seeking an experienced Utilization Review Nurse (RN) to review patient admissions for medical necessity, appropriate level of care, and compliance with payer guidelines. This role works closely with clinical teams to ensure efficient resource utilization and quality patient outcomes.
Responsibilities
  • Review admissions using InterQual and/or Milliman criteria
  • Evaluate medical necessity, level of care, and documentation accuracy
  • Ensure compliance with Medicare, Medicaid, and regulatory guidelines
  • Collaborate with physicians, case management, and care teams
  • Support discharge planning and care coordination
  • Document findings and communicate recommendations
Requirements
  • Active RN license (Nevada)
  • 5+ years acute care nursing experience
  • 3+ years Utilization Review experience
  • 3+ years discharge planning experience (acute care)
  • Experience with InterQual (must be able to pass exam)
  • Experience with Milliman guidelines
Preferred
  • Background in Case Management or CDI
  • Strong knowledge of Joint Commission and CMS guidelines
Why Apply
  • Competitive pay
  • Stable, high-demand role
  • Collaborative healthcare environment
Apply Now
If you have strong Utilization Review, InterQual, and acute care experience, we want to hear from you!