... Nurse required. Prior leadership experience preferred. One year of case management and/or utilization management work experience preferred. Staff hired prior to July 1, 2013 will be grandfathered in ...
... Nurse required. Prior leadership experience preferred. One year of case management and/or utilization management work experience preferred. Staff hired prior to July 1, 2013 will be grandfathered in ...
... Nurse required. Prior leadership experience preferred. One year of case management and/or utilization management work experience preferred. Staff hired prior to July 1, 2013 will be grandfathered in ...
... Nurse required. Prior leadership experience preferred. One year of case management and/or utilization management work experience preferred. Staff hired prior to July 1, 2013 will be grandfathered in ...
Utilization Management Nurse Consultant
$29.10 - $62.32/hr
Utilization Management Nurse Consultant (RN) Join a team that makes a difference in healthcare outcomes. We are seeking an experienced Registered Nurse (RN) to support our Utilization Management team ...
Utilization Management Nurse Consultant
$29.10 - $62.32/hr
Utilization Management Nurse Consultant (RN) Join a team that makes a difference in healthcare outcomes. We are seeking an experienced Registered Nurse (RN) to support our Utilization Management team ...
Utilization Management Nurse Consultant
$32.01 - $68.55/hr
Registered Nurse (RN) - Utilization Management (24/7 Operations) Step away from bedside care and make a system-wide impact. Join our Utilization Management team and help ensure members receive the ...
Utilization Management Nurse Consultant
$32.01 - $68.55/hr
Registered Nurse (RN) - Utilization Management (24/7 Operations) Step away from bedside care and make a system-wide impact. Join our Utilization Management team and help ensure members receive the ...
Utilization Management Nurse Consultant
New York, NY · Remote
$32.01 - $68.55/hr
Registered Nurse (RN) - Utilization Management Join a dynamic healthcare team and make an impact on patient care from wherever you work. We are seeking an experienced Registered Nurse (RN) to support ...
Utilization Management Nurse Consultant
New York, NY · Remote
$32.01 - $68.55/hr
Registered Nurse (RN) - Utilization Management Join a dynamic healthcare team and make an impact on patient care from wherever you work. We are seeking an experienced Registered Nurse (RN) to support ...
... Nurse required. Prior leadership experience preferred. One year of case management and/or utilization management work experience preferred. Staff hired prior to July 1, 2013 will be grandfathered in ...
... Nurse required. Prior leadership experience preferred. One year of case management and/or utilization management work experience preferred. Staff hired prior to July 1, 2013 will be grandfathered in ...
... Nurse required. Prior leadership experience preferred. One year of case management and/or utilization management work experience preferred. Staff hired prior to July 1, 2013 will be grandfathered in ...
... Nurse required. Prior leadership experience preferred. One year of case management and/or utilization management work experience preferred. Staff hired prior to July 1, 2013 will be grandfathered in ...
Blue Eagle is looking for Pre-Cert Nurse(s) to assist with inpatient and outpatient PA reviews.
Blue Eagle is looking for Pre-Cert Nurse(s) to assist with inpatient and outpatient PA reviews.
Utilization Management Nurse Consultant
$29.10 - $62.32/hr
Registered Nurse (RN) - Utilization Management Remote | Afternoon/Evening Shifts Available | 24/7 Operations Are you an experienced RN looking to bring your clinical expertise to a fast-paced ...
Utilization Management Nurse Consultant
$29.10 - $62.32/hr
Registered Nurse (RN) - Utilization Management Remote | Afternoon/Evening Shifts Available | 24/7 Operations Are you an experienced RN looking to bring your clinical expertise to a fast-paced ...
Utilization Management Nurse Consultant
$32.01 - $68.55/hr
... N licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include weekends, holidays, and evening hours Preferred Qualifications - 2+ years of clinical ...
Utilization Management Nurse Consultant
$32.01 - $68.55/hr
... N licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include weekends, holidays, and evening hours Preferred Qualifications - 2+ years of clinical ...
Utilization Management Nurse Consultant
$32.01 - $68.55/hr
Registered Nurse (RN) - Utilization Management (24/7 Operations) Step away from bedside care and make a system-wide impact. Join our Utilization Management team and help ensure members receive the ...
Utilization Management Nurse Consultant
$32.01 - $68.55/hr
Registered Nurse (RN) - Utilization Management (24/7 Operations) Step away from bedside care and make a system-wide impact. Join our Utilization Management team and help ensure members receive the ...
Utilization Management Nurse Consultant
$29.10 - $62.32/hr
Registered Nurse (RN) - Utilization Management Make a difference in healthcare from a clinical review and care coordination perspective. We are seeking an experienced Registered Nurse (RN) to join ...
Utilization Management Nurse Consultant
$29.10 - $62.32/hr
Registered Nurse (RN) - Utilization Management Make a difference in healthcare from a clinical review and care coordination perspective. We are seeking an experienced Registered Nurse (RN) to join ...
Utilization Management Nurse Consultant
$29.10 - $62.32/hr
Registered Nurse (RN) - Utilization Management Join a team that makes a difference in healthcare delivery. We are seeking an experienced Registered Nurse (RN) to support Utilization Management by ...
Utilization Management Nurse Consultant
$29.10 - $62.32/hr
Registered Nurse (RN) - Utilization Management Join a team that makes a difference in healthcare delivery. We are seeking an experienced Registered Nurse (RN) to support Utilization Management by ...
Utilization Management Nurse Consultant
$26.01 - $56.14/hr
... N licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include weekends, holidays, and evening hours Preferred Qualifications - 2+years of clinical ...
Utilization Management Nurse Consultant
$26.01 - $56.14/hr
... N licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include weekends, holidays, and evening hours Preferred Qualifications - 2+years of clinical ...
Utilization Management Nurse Consultant
$26.01 - $56.14/hr
... N licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include weekends, holidays, and evening hours Preferred Qualifications - 2+years of clinical ...
Utilization Management Nurse Consultant
$26.01 - $56.14/hr
... N licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include weekends, holidays, and evening hours Preferred Qualifications - 2+years of clinical ...
Utilization Management Nurse Consultant
Harrisburg, PA · On-site
$29.10 - $62.32/hr
Registered Nurse (RN) - Utilization Management Remote | Afternoon/Evening Shifts Available | 24/7 Operations Are you an experienced RN looking to bring your clinical expertise to a fast-paced ...
Utilization Management Nurse Consultant
Harrisburg, PA · On-site
$29.10 - $62.32/hr
Registered Nurse (RN) - Utilization Management Remote | Afternoon/Evening Shifts Available | 24/7 Operations Are you an experienced RN looking to bring your clinical expertise to a fast-paced ...
Utilization Management Nurse in Newark, DE
Newark, DE · On-site
$85K - $137K/yr
RN Utilization Management - Day Shift Registered Nurse (RN) - Utilization Management FT Day Shift (Hrs.: 8a-4:30p) - On-site Newark, DE ChristianaCare Hospital in Newark, DE, is seeking a Utilization ...
Utilization Management Nurse in Newark, DE
Newark, DE · On-site
$85K - $137K/yr
RN Utilization Management - Day Shift Registered Nurse (RN) - Utilization Management FT Day Shift (Hrs.: 8a-4:30p) - On-site Newark, DE ChristianaCare Hospital in Newark, DE, is seeking a Utilization ...
Utilization Management Nurse Consultant
$29.10 - $62.32/hr
Registered Nurse (RN) - Utilization Management Remote | Afternoon/Evening Shifts Available | 24/7 Operations Are you an experienced RN looking to bring your clinical expertise to a fast-paced ...
Utilization Management Nurse Consultant
$29.10 - $62.32/hr
Registered Nurse (RN) - Utilization Management Remote | Afternoon/Evening Shifts Available | 24/7 Operations Are you an experienced RN looking to bring your clinical expertise to a fast-paced ...
Utilization Management Nurse Consultant
Home, PA · On-site
$29.10 - $62.32/hr
Registered Nurse (RN) - Utilization Management Remote | Afternoon/Evening Shifts Available | 24/7 Operations Are you an experienced RN looking to bring your clinical expertise to a fast-paced ...
Utilization Management Nurse Consultant
Home, PA · On-site
$29.10 - $62.32/hr
Registered Nurse (RN) - Utilization Management Remote | Afternoon/Evening Shifts Available | 24/7 Operations Are you an experienced RN looking to bring your clinical expertise to a fast-paced ...
... utilization management Support for appropriate level of care and decreased inpatient bed day ... Graduate of an accredited school of Nursing (Required) * Bachelor's Degree (Preferred) Work ...
... utilization management Support for appropriate level of care and decreased inpatient bed day ... Graduate of an accredited school of Nursing (Required) * Bachelor's Degree (Preferred) Work ...
Entry Level Utilization Management Nurse information
See salary details
$39K - $50.3K
15% of jobs
$50.3K - $61.5K
8% of jobs
$63.2K is the 25th percentile. Wages below this are outliers.
$61.5K - $72.8K
15% of jobs
The median wage is $79.9K / yr.
$72.8K - $84.1K
20% of jobs
$84.1K - $95.4K
11% of jobs
$101K is the 75th percentile. Wages above this are outliers.
$95.4K - $106.6K
13% of jobs
$106.6K - $117.9K
5% of jobs
$117.9K - $129.2K
3% of jobs
$129.2K - $140.5K
4% of jobs
$140.5K - $151.7K
3% of jobs
$151.7K - $163K
3% of jobs
$39K
$89.5K
$163K
How much do entry level utilization management nurse jobs pay per year?
As of Aug 21, 2026, the average yearly pay for entry level utilization management nurse in the United States is $89,483.00, according to ZipRecruiter salary data. Most workers in this role earn between $64,500.00 and $104,500.00 per year, depending on experience, location, and employer.
What is an entry level utilization management nurse?
An Entry Level Utilization Management Nurse is a registered nurse who works within healthcare organizations or insurance companies to review medical cases and ensure that patients receive appropriate, cost-effective care. They assess treatment plans, evaluate the necessity of medical procedures, and help coordinate services to avoid unnecessary hospitalizations. These nurses use clinical guidelines and their medical knowledge to make recommendations, often working closely with physicians, healthcare providers, and insurance representatives. The position is typically suited for nurses who are early in their careers and interested in the intersection of clinical practice and healthcare administration.
What are the key skills and qualifications needed to thrive as an entry level utilization management nurse?
To thrive as an Entry Level Utilization Management Nurse, you need an active RN license, a solid understanding of clinical guidelines, and a basic knowledge of healthcare regulations such as Medicare and Medicaid. Familiarity with utilization review software, electronic health records (EHRs), and clinical documentation systems is typically required. Strong analytical thinking, attention to detail, effective communication, and the ability to collaborate with healthcare teams are essential soft skills in this role. These skills and qualifications ensure accurate patient care reviews, compliance with regulations, and the delivery of cost-effective, quality healthcare.
What are some common challenges faced by entry level utilization management nurses during their first year on the job?
Entry Level Utilization Management Nurses often encounter challenges such as adapting to the fast-paced decision-making required in assessing medical necessity, interpreting insurance policies, and learning to communicate effectively with both providers and insurance representatives. Navigating complex healthcare regulations and documentation requirements can also be overwhelming at first. However, most organizations provide thorough onboarding, mentorship, and ongoing training to help new nurses build confidence and proficiency in these areas.
What is the difference between Entry Level Utilization Management Nurse vs Utilization Review Nurse?
| Aspect | Entry Level Utilization Management Nurse | Utilization Review Nurse |
|---|---|---|
| Certifications | RN license, possibly some utilization management training | RN license, often additional certifications like CCM or URAC |
| Work Environment | Hospitals, insurance companies, healthcare organizations | Insurance companies, healthcare facilities, third-party review organizations |
| Job Focus | Assessing patient needs for appropriate care, initial review | Reviewing medical necessity, approving or denying services |
While both roles involve reviewing healthcare services, the Entry Level Utilization Management Nurse typically focuses on initial assessments and coordinating patient care, whereas the Utilization Review Nurse often concentrates on detailed reviews for approval or denial of services, often requiring additional certifications.
More about Entry Level Utilization Management Nurse jobs
What cities are hiring for Entry Level Utilization Management Nurse jobs?
Cities with the most Entry Level Utilization Management Nurse job openings:
What are the most commonly searched types of Utilization Management Nurse jobs?
The most popular types of Utilization Management Nurse jobs are:
What states have the most Entry Level Utilization Management Nurse jobs?
States with the most job openings for Entry Level Utilization Management Nurse jobs include:
What job categories do people searching Entry Level Utilization Management Nurse jobs look for?
The top searched job categories for Entry Level Utilization Management Nurse jobs are:
- Internship Rn Utilization Review Nurse
- Prior Authorization Review Nurse
- Rn Utilization Review Nurse
- Commission Optum Utilization Review
- Utilization Management Review Nurse
- Aetna Utilization Review Nurse
- Volunteer Rn Utilization Review Nurse
- Remote Navihealth Utilization Review
- Remote Optum Utilization Review
- International Utilization Review Rn
Full-time
Medical, Dental, Vision, Life, Retirement, PTO
Posted 14 days ago
MUSC Health rating
7.0
Based on 201 frontline employees who took The Breakroom Quiz
414th of 891 rated healthcare providers
Job description
Job Description Summary
MUSC Community Physicians (MCP) is an entity within the Medical University of South Carolina (MUSC) that provides healthcare to patients within the rural health network throughout the state of South Carolina.Conducts utilization reviews to determine if patients are receiving care appropriate to illness or condition.
Entity
MUSC Community Physicians (MCP)Worker Type
EmployeeWorker Sub-Type
RegularCost Center
CC005921 MCP - Utilization ManagementPay Rate Type
HourlyPay Grade
Health-28Scheduled Weekly Hours
32Work Shift
Job Description
Conducts utilization reviews to determine if patients are receiving care appropriate to illness or condition. Monitors patient charts and records to evaluate care concurrent with the patients treatment. Reviews treatment plans and status of approvals from insurers. Collects and complies data as required and according to applicable policies and regulations. Consults with physicians as needed.
Bachelor's degree in Nursing from an accredited school of nursing and three years’ work experience as a Registered Nurse required. Prior leadership experience preferred. One year of case management and/or utilization management work experience preferred. Staff hired prior to July 1, 2013 will be grandfathered in regards to education requirement. Must possess excellent verbal and written communication skills. Familiarity with InterQual or Milliman and Robinson screening criteria desired. Licensure as a registered nurse by the state of South Carolina or compact state required.
Additional Job Description
Benefits:
- Health, dental, vision, and life insurance
- Employer Sponsored Retirement Plan
- Paid time off and extended sick leave
- Paid Parental Leave
- Disability insurance plan options
- Continuous professional and clinical training
- Competitive pay
- Annual Merit Increase
- Wellbeing resources
- Tuition Reimbursement
- Employee perks and discounts
- Employee referral program
- Flexible schedule options
- Certification incentive program
If you like working with energetic enthusiastic individuals, you will enjoy your career with us!
The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need.
Medical University of South Carolina participates in the federal E-Verify program to confirm the identity and employment authorization of all newly hired employees. For further information about the E-Verify program, please click here: http://www.uscis.gov/e-verify/employees
What MUSC Health employees say
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About MUSC Health
Sourced by ZipRecruiter
MUSC is located in Charleston, SC, frequently named one of the best places in America to live. If charming, historic, vibrant, cultural, and coastal are adjectives that you find appealing, it's all here. In Charleston, you might find yourself dining at a world class restaurant tonight and relaxing on a boat as you explore our many waterways tomorrow. You might stroll along cobblestone streets, amidst centuries old homes by day and attend a jazz concert by night. Charleston is a place where you can live your life to its fullest.
Industry
Hospitality services
Company size
10,000+ Employees
Headquarters location
Charleston, SC, US
Year founded
1824