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 ...
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 ...
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 ...
Quick apply
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 ...
Utilization Review Nurse
Manhattan, NY · Remote
$95K - $105K/yr
RN- Utilization Review Nurse Inpatient *Hybrid* Must reside within the New York Tri-State Area - N ... Frequently collaborates and communicates with physician peer reviewers and medical directors in ...
Quick apply
Utilization Review Nurse
Manhattan, NY · Remote
$95K - $105K/yr
RN- Utilization Review Nurse Inpatient *Hybrid* Must reside within the New York Tri-State Area - N ... Frequently collaborates and communicates with physician peer reviewers and medical directors in ...
Utilization Review Nurse
New York, NY · On-site
Utilization Review Nurse Apply now Job No: 497118 Department: Medical Care Review Local Title: Utilization Review Nurse Budget Title: Teaching Hospital Quality Assurance Senior Coordinator Work Type ...
Utilization Review Nurse
New York, NY · On-site
Utilization Review Nurse Apply now Job No: 497118 Department: Medical Care Review Local Title: Utilization Review Nurse Budget Title: Teaching Hospital Quality Assurance Senior Coordinator Work Type ...
Utilization Review Nurse
Manhattan, NY · On-site
$95K - $105K/yr
RN- Utilization Review Nurse Inpatient *Hybrid* Must reside within the New York Tri-State Area - N ... Frequently collaborates and communicates with physician peer reviewers and medical directors in ...
Utilization Review Nurse
Manhattan, NY · On-site
$95K - $105K/yr
RN- Utilization Review Nurse Inpatient *Hybrid* Must reside within the New York Tri-State Area - N ... Frequently collaborates and communicates with physician peer reviewers and medical directors in ...
Utilization Review Nurse
Las Vegas, NV · On-site
Salary: $40-$63 Utilization Review Nurse (RN) Las Vegas, NV | Full-Time Salary: $40 $63/hour Position Summary Reviews patient admissions for medical necessity, appropriate resource utilization, and ...
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Utilization Review Nurse
Las Vegas, NV · On-site
Salary: $40-$63 Utilization Review Nurse (RN) Las Vegas, NV | Full-Time Salary: $40 $63/hour Position Summary Reviews patient admissions for medical necessity, appropriate resource utilization, and ...
Utilization Review Nurse
$35.50 - $53.25/hr
... Utilization Review Nurse (RN) - per diem role Position Summary The Utilization Review Nurse is ... Partners with managers, physicians, medical directors, and treatment teams to address patient care ...
New
Utilization Review Nurse
$35.50 - $53.25/hr
... Utilization Review Nurse (RN) - per diem role Position Summary The Utilization Review Nurse is ... Partners with managers, physicians, medical directors, and treatment teams to address patient care ...
New
Utilization Review Nurse
Oxford, NC · On-site
... to Director when needed. Screens all cases against high risk screens for discharge planning ... Three years clinical nursing experience. One year utilization and review experience. Experience ...
Utilization Review Nurse
Oxford, NC · On-site
... to Director when needed. Screens all cases against high risk screens for discharge planning ... Three years clinical nursing experience. One year utilization and review experience. Experience ...
Utilization Review Nurse
Carmichael, CA · On-site
Job Summary and Responsibilities The Utilization Review RN is responsible for the review of medical ... Thrive in a fast paced, self-directed environment and ability to work as a team player and assist ...
Utilization Review Nurse
Carmichael, CA · On-site
Job Summary and Responsibilities The Utilization Review RN is responsible for the review of medical ... Thrive in a fast paced, self-directed environment and ability to work as a team player and assist ...
Utilization Review Nurse
Omaha, NE · Hybrid
The Utilization Review Nurse ensures all aspects of an injured worker's treatment are effective, efficient, and in accordance with applicable legal requirements. This is a full-time, permanent ...
Utilization Review Nurse
Omaha, NE · Hybrid
The Utilization Review Nurse ensures all aspects of an injured worker's treatment are effective, efficient, and in accordance with applicable legal requirements. This is a full-time, permanent ...
Utilization Review Nurse
Omaha, NE · Hybrid
Utilization Review Nurse We have openings in our Omaha, Nebraska office for Utilization Review Nurses. The Utilization Review Nurse ensures all aspects of an injured worker's treatment are effective ...
Utilization Review Nurse
Omaha, NE · Hybrid
Utilization Review Nurse We have openings in our Omaha, Nebraska office for Utilization Review Nurses. The Utilization Review Nurse ensures all aspects of an injured worker's treatment are effective ...
Utilization Review Nurse
Omaha, NE · On-site
The Utilization Review Nurse ensures all aspects of an injured worker's treatment are effective, efficient, and in accordance with applicable legal requirements. This is a full-time, permanent ...
Utilization Review Nurse
Omaha, NE · On-site
The Utilization Review Nurse ensures all aspects of an injured worker's treatment are effective, efficient, and in accordance with applicable legal requirements. This is a full-time, permanent ...
Utilization Review Nurse
New Orleans, LA · On-site
The Utilization Review Nurse ensures appropriate utilization of health services by performing initial, concurrent and retrospective clinical case reviews. This role collaborates and communicates with ...
Utilization Review Nurse
New Orleans, LA · On-site
The Utilization Review Nurse ensures appropriate utilization of health services by performing initial, concurrent and retrospective clinical case reviews. This role collaborates and communicates with ...
Utilization Review Nurse
North Charleston, SC · On-site
... Medical Director for review and final determination Communicates with providers to initiate ... utilization review RN must have two years of experience in an acute care hospital. Additional ...
Utilization Review Nurse
North Charleston, SC · On-site
... Medical Director for review and final determination Communicates with providers to initiate ... utilization review RN must have two years of experience in an acute care hospital. Additional ...
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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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 ...
The Utilization Review Nurse ensures appropriate utilization of health services by performing initial, concurrent and retrospective clinical case reviews. This role collaborates and communicates with ...
The Utilization Review Nurse ensures appropriate utilization of health services by performing initial, concurrent and retrospective clinical case reviews. This role collaborates and communicates with ...
... to Director when needed. Screens all cases against high risk screens for discharge planning ... Three years clinical nursing experience. One year utilization and review experience. Experience ...
... to Director when needed. Screens all cases against high risk screens for discharge planning ... Three years clinical nursing experience. One year utilization and review experience. Experience ...
Hours: 8:30-5:30, Monday - Friday At Houston Methodist, the Utilization Review Nurse (URN) position ... Reviews H&Ps and admitting orders of all direct, transfer, and emergency care patients designated ...
Hours: 8:30-5:30, Monday - Friday At Houston Methodist, the Utilization Review Nurse (URN) position ... Reviews H&Ps and admitting orders of all direct, transfer, and emergency care patients designated ...
Utilization Review Nurse
Omaha, NE · Hybrid
The Utilization Review Nurse ensures all aspects of an injured worker's treatment are effective, efficient, and in accordance with applicable legal requirements. This is a full-time, permanent ...
Utilization Review Nurse
Omaha, NE · Hybrid
The Utilization Review Nurse ensures all aspects of an injured worker's treatment are effective, efficient, and in accordance with applicable legal requirements. This is a full-time, permanent ...
Utilization Review Nurse
New Orleans, LA · On-site
The Utilization Review Nurse ensures appropriate utilization of health services by performing initial, concurrent and retrospective clinical case reviews. This role collaborates and communicates with ...
Utilization Review Nurse
New Orleans, LA · On-site
The Utilization Review Nurse ensures appropriate utilization of health services by performing initial, concurrent and retrospective clinical case reviews. This role collaborates and communicates with ...
Director Anthem Utilization Review Nurse information
See salary details
$21.39 - $25.72
2% of jobs
$25.72 - $30.05
9% of jobs
$33.01 is the 25th percentile. Wages below this are outliers.
$30.05 - $34.38
21% of jobs
The median wage is $37.88 / hr.
$34.38 - $38.70
23% of jobs
$38.70 - $43.03
13% of jobs
$46.39 is the 75th percentile. Wages above this are outliers.
$43.03 - $47.36
10% of jobs
$47.36 - $51.68
8% of jobs
$51.68 - $56.01
5% of jobs
$56.01 - $60.34
5% of jobs
$60.34 - $64.66
2% of jobs
$64.66 - $68.99
2% of jobs
$21
$42
$68
How much do director anthem utilization review nurse jobs pay per hour?
Other
Posted 19 days ago
Job description
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.
- 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
- 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
- Background in Case Management or CDI
- Strong knowledge of Joint Commission and CMS guidelines
- Competitive pay
- Stable, high-demand role
- Collaborative healthcare environment
If you have strong Utilization Review, InterQual, and acute care experience, we want to hear from you!
About Fusion HCR
Sourced by ZipRecruiter
Industry
Human resources consulting services
Company size
11 - 50 Employees
Headquarters location
Springboro, OH, US
Year founded
2012