ZipRecruiter

Log In

2

Entry Level Medical Utilization Review Physician Jobs

Acrisure LLC

Utilization Review Nurse

Bradenton, FL · On-site

Acrisure is seeking a Utilization Review Nurse, LPN to evaluate treatment requests and help ensure ... physicians for review * Evaluate medical records and treatment information to support timely and ...

Acrisure

Utilization Review Nurse

Bradenton, FL

Acrisure is seeking a Utilization Review Nurse, LPN to evaluate treatment requests and help ensure ... physicians for review * Evaluate medical records and treatment information to support timely and ...

Acrisure

Utilization Review Nurse

Bradenton, FL · On-site

Acrisure is seeking a Utilization Review Nurse, LPN to evaluate treatment requests and help ensure ... physicians for review * Evaluate medical records and treatment information to support timely and ...

next page

Showing results 1-20

All JobsHealthcare JobsNursing JobsNurse Case Manager JobsEntry Level Medical Utilization Review Physician Jobs

Entry Level Medical Utilization Review Physician information

See salary details

$41.5K

$233.5K

$315.5K

How much do entry level medical utilization review physician jobs pay per year?

As of Aug 29, 2026, the average yearly pay for entry level medical utilization review physician in the United States is $233,521.00, according to ZipRecruiter salary data. Most workers in this role earn between $220,000.00 and $261,000.00 per year, depending on experience, location, and employer.

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

The most popular types of Medical Utilization Review Physician jobs are:

Entry Level Medical Utilization Review Physician jobs near you
Infographic showing various Entry Level Medical Utilization Review Physician job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 79% Full Time, 14% Part Time, and 6% Contract. Highlights an 87% Physical, 1% Hybrid, and 12% Remote job distribution, with an average salary of $233,521 per year, or $112.3 per hour.

Utilization Review Nurse Corporate UM

Bala Cynwyd, PA • On-site

Pennsylvania Medicine

7.6

Company rating: 7.6 out of 10

Based on 352 frontline employees who took The Breakroom Quiz

190th of 895 rated healthcare providers

People enjoy working here

Good employer

Recommended by students

Learn more about Pennsylvania Medicineexternal

Full-time

This job post has expired today. Applications are no longer accepted.

Job description

Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines.
Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work?
Entity: Corporate Services
Department: Corp Utilization Management
Location: Bala Cynwyd, PA/ remote
Summary:
The Utilization Review Nurse is responsible for conducting timely and accurate utilization review activities to support appropriate patient status determination, medical necessity review, and compliance with regulatory and payer requirements. This role applies clinical expertise and evidence-based criteria to evaluate the appropriateness of admissions, continued stays, and resource utilization while promoting quality patient care and efficient use of healthcare resources.
Working within Penn Medicine's centralized Utilization Management department the Utilization Review Nurse collaborates with physicians, Physician Advisors, case management, revenue cycle, and interdisciplinary care teams to facilitate appropriate level-of-care determinations, authorization management, denial prevention, and compliance with federal, state, accreditation, and payer requirements.
Responsibilities:
  • Conduct medical necessity reviews and patient status determinations using approved clinical criteria, regulatory requirements, and organizational policies.
  • Perform admission, concurrent, continued stay, and retrospective utilization reviews to ensure appropriate level of care and resource utilization.
  • Manage payer authorization and notification processes to promote timely approvals and reduce financial risk.
  • Identify and escalate cases that require secondary review, physician advisor involvement, or additional clinical documentation.
  • Collaborate with physicians, case managers, social workers, and interdisciplinary teams to support appropriate patient progression, discharge planning, and utilization management goals.
  • Ensure accurate and timely documentation of utilization review activities, authorization determinations, and payer communications within designated systems.
  • Assist with denial prevention activities through proactive identification of medical necessity, documentation, authorization, and patient status concerns.
  • Monitor and maintain compliance with CMS regulations, payer requirements, accreditation standards, organizational policies, and utilization management workflows.
  • Performs duties in accordance with Penn Medicine and entity values, policies, and procedures
  • Other duties as assigned to support the unit, department, entity, and health system organization UPHS Organizational
Credentials:
  • Registered Nurse is required.
  • Certified Case Manager (CCM) or Accredited Case Manager (ACM) is preferred.
Education or Equivalent Experience:
  • Bachelor's degree is required.
  • 2+ years of Acute Hospital Care experience is required.
  • Experience with Interqual and MCG is preferred.
  • Previous Utilization Management, Appeals, or Denials Management experience is preferred.
We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region. Penn Medicine employees are actively engaged and committed to our mission. Together we will continue to make medical advances that help people live longer, healthier lives.
Live Your Life's Work
We are an Equal Opportunity employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law.

What Penn Medicine employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply