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Contract Utilization Review Nurse Jobs (NOW HIRING)

Fusion HCR

Utilization Review Nurse

Las Vegas, NV · On-site

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 ...

US Tech Solutions

Utilization Review Nurse

Canton, MA · On-site

$55 - $60/hr

$55-$60 per hour Canton, MA Contract Duration: 6 Month Contract (Possibility of Extension) Position ... Nurse to support outpatient utilization review and prior authorization activities for a leading ...

Acrisure LLC

Utilization Review Nurse

Bradenton, FL · On-site

Acrisure is seeking a Utilization Review Nurse, LPN to evaluate treatment requests and help ensure injured workers receive appropriate, timely care in accordance with applicable clinical guidelines ...

Acrisure

Utilization Review Nurse

Bradenton, FL · On-site

Acrisure is seeking a Utilization Review Nurse, LPN to evaluate treatment requests and help ensure injured workers receive appropriate, timely care in accordance with applicable clinical guidelines ...

Acrisure

Utilization Review Nurse

Bradenton, FL

Acrisure is seeking a Utilization Review Nurse, LPN to evaluate treatment requests and help ensure injured workers receive appropriate, timely care in accordance with applicable clinical guidelines ...

Global Force

Utilization Review Nurse

Las Vegas, NV · On-site

About the job Utilization Review Nurse Sign on bonus may apply up to $15,000 Position Summary: Reviews patient admissions for appropriateness, efficiency of resource utilization and compliance with ...

US Tech Solutions

Utilization Review Nurse

Chicago, IL · On-site

Chicago, IL Contract * Participates in the development and ongoing implementation of QM Work Plan ... Do you have experience with Utilization Review? * Do you have an Active Registered Nurse License?

Oscar Health

Utilization Review Nurse

Miami, FL · Remote

$35 - $45.94/hr

We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You will perform frequent case reviews, check medical records and speak with care providers regarding ...

Oscar Health

Utilization Review Nurse

Dallas, TX · Remote

$35 - $45.94/hr

We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You will perform frequent case reviews, check medical records and speak with care providers regarding ...

Oscar Health

Utilization Review Nurse

Tempe, AZ · Remote

$35 - $45.94/hr

We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You will perform frequent case reviews, check medical records and speak with care providers regarding ...

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Contract Utilization Review Nurse information

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How much do contract utilization review nurse jobs pay per hour?

As of Aug 22, 2026, the average hourly pay for contract utilization review nurse 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 a contract utilization review nurse?

A Contract Utilization Review Nurse is a registered nurse who works on a contractual basis to review medical records and health care services for appropriateness, necessity, and efficiency. Their primary role is to ensure that patients receive the right care while helping healthcare organizations comply with regulations and control costs. These nurses often work for insurance companies, hospitals, or third-party review organizations, and they assess requests for medical procedures, hospital admissions, and ongoing treatments. They use established guidelines and clinical criteria to make determinations and frequently interact with healthcare providers to gather additional information. Contract positions may offer flexibility and the opportunity to work remotely.

What are the key skills and qualifications needed to thrive as a contract utilization review nurse?

To thrive as a Contract Utilization Review Nurse, you need a current RN license, strong clinical knowledge, and experience in medical record review and case management. Familiarity with utilization management software, InterQual or MCG guidelines, and health insurance regulations is typically required. Excellent analytical thinking, attention to detail, and effective communication skills help in collaborating with providers and ensuring compliance. These abilities are essential for delivering accurate utilization reviews, optimizing patient outcomes, and supporting cost-effective healthcare operations.

What are some common challenges faced by contract utilization review nurses, and how can they be addressed?

Contract Utilization Review Nurses often face the challenge of managing high caseloads while maintaining accuracy and timeliness in their reviews. Working remotely or across multiple facilities can require strong organizational skills and effective communication with interdisciplinary teams. Adapting quickly to different payer guidelines and documentation systems is also essential. Staying current with changes in healthcare regulations and leveraging technology can help overcome these challenges, ensuring both compliance and quality patient care.

What is the difference between Contract Utilization Review Nurse vs Utilization Review Nurse?

AspectContract Utilization Review NurseUtilization Review Nurse
CredentialsRN license, certification in case management or utilization review often preferredRN license, certification in case management or utilization review often preferred
Work EnvironmentTypically contracted for specific projects or timeframes, often remote or in healthcare facilitiesUsually employed full-time by healthcare organizations, hospitals, or insurance companies
Employer & Industry UsageContract agencies, healthcare facilities, insurance companiesHospitals, insurance companies, healthcare organizations

The main difference is that Contract Utilization Review Nurses work on a temporary, contract basis, often through agencies, while Utilization Review Nurses are usually employed full-time by healthcare or insurance organizations. Both roles require similar credentials and focus on reviewing medical necessity and appropriateness of care.

More about Contract Utilization Review Nurse jobs

What cities are hiring for Contract Utilization Review Nurse jobs?

Cities with the most Contract Utilization Review Nurse job openings:

What are the most commonly searched types of Utilization Review Nurse jobs?

The most popular types of Utilization Review Nurse jobs are:

What states have the most Contract Utilization Review Nurse jobs?

States with the most job openings for Contract Utilization Review Nurse jobs include:

What job categories do people searching Contract Utilization Review Nurse jobs look for?

The top searched job categories for Contract Utilization Review Nurse jobs are:

Contract Utilization Review Nurse jobs near you
Infographic showing various Contract Utilization Review Nurse job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 83% Full Time, 13% Part Time, and 3% Contract. Highlights an 91% Physical, 2% Hybrid, and 7% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

Utilization Review Nurse

Fusion HCR

Las Vegas, NV • On-site

Other

Re-posted 15 days ago

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!

Apply