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Executive Nurse Practitioner Utilization Review Jobs

Acrisure LLC

Utilization Review Nurse

Bradenton, FL ยท On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

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 ...

Fusion HCR

Utilization Review Nurse

Las Vegas, NV ยท 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 ...

Acrisure

Utilization Review Nurse

Bradenton, FL

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

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 ยท On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

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 ...

Bestica Healthcare

RN Utilization Review

Tuba City, AZ ยท On-site

... nurse practitioners, nurse midwives, CRNA, and community health medics. Position Summary The ... Utilization Review (UR) Nurse ensures that patients receive appropriate care by verifying medical ...

Tuba City Regional

Utilization Review

Tuba City, AZ ยท On-site

Rn - Utilization Review Cure Healthcare is seeking a RN - Utilization Review for positions in Tuba City, Arizona. Current Arizona license and AHA BLS and ACLS required and additional certifications ...

Penn Medicine

Utilization Review Nurse

West Chester, PA ยท On-site

The Utilization Review Nurse will provide utilization review for authorization, concurrent review and discharge review services using InterQual criteria guidelines to validate medical necessity and ...

Oscar Health

Utilization Review Nurse

Tempe, AZ ยท 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 ยท 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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Executive Nurse Practitioner Utilization Review information

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$71K

$134.4K

$210.5K

How much do executive nurse practitioner utilization review jobs pay per year?

As of Aug 19, 2026, the average yearly pay for executive nurse practitioner utilization review in the United States is $134,369.00, according to ZipRecruiter salary data. Most workers in this role earn between $111,000.00 and $152,500.00 per year, depending on experience, location, and employer.

What is an Executive Nurse Practitioner Utilization Review?

Executive Nurse Practitioner Utilization Review professionals are advanced practice nurses who oversee and manage the evaluation of medical services to ensure they are necessary, efficient, and cost-effective. They combine clinical expertise with leadership skills to review patient care plans, monitor compliance with healthcare policies, and improve the quality of care. These professionals often work with insurance companies, hospitals, or healthcare organizations to assess the appropriateness of treatments and coordinate care delivery. Their role is essential in balancing patient needs with organizational resources while maintaining regulatory standards.

What are the key skills and qualifications needed to thrive as an Executive Nurse Practitioner Utilization Review?

To excel as an Executive Nurse Practitioner Utilization Review, you need advanced clinical expertise, a graduate nursing degree (DNP or MSN), board certification as a nurse practitioner, and in-depth knowledge of healthcare regulations and utilization management. Familiarity with utilization review software, electronic health records (EHRs), and data analytics tools is essential, along with certifications such as Certified Utilization Review Specialist (CURN) or similar. Strong leadership, analytical thinking, and communication skills set top performers apart in collaborating with interdisciplinary teams and driving process improvements. These skills are vital for ensuring evidence-based, cost-effective care while maintaining regulatory compliance and optimizing patient outcomes.

What are some common challenges faced by Executive Nurse Practitioner Utilization Review professionals, and how can they be addressed?

Executive Nurse Practitioner Utilization Review professionals often encounter challenges such as balancing clinical judgment with organizational cost-containment goals, staying current with changing regulations and payer requirements, and effectively communicating decisions to both clinical teams and patients. To address these challenges, it's important to maintain strong collaboration with interdisciplinary teams, participate in ongoing education on healthcare policies, and develop excellent communication and negotiation skills. Leveraging technology and evidence-based guidelines can also help streamline the review process and support sound decision-making.

What is the difference between Executive Nurse Practitioner Utilization Review vs Nurse Practitioner Utilization Review?

AspectExecutive Nurse Practitioner Utilization ReviewNurse Practitioner Utilization Review
CredentialsMaster's or Doctorate in Nursing, Nurse Practitioner certification, additional leadership or executive trainingMaster's or Doctorate in Nursing, Nurse Practitioner certification
Work EnvironmentLeadership roles, strategic planning, policy development in healthcare organizationsClinical review, case assessments, utilization decisions in healthcare settings
Employer & Industry UsageHospitals, insurance companies, healthcare management firmsHospitals, clinics, insurance companies, utilization review organizations

The main difference is that Executive Nurse Practitioner Utilization Review professionals often hold leadership responsibilities, focusing on strategic and policy aspects, while Nurse Practitioner Utilization Review roles are more clinical, concentrating on case reviews and utilization decisions. Both roles require advanced nursing credentials, but the executive position involves additional management and organizational skills.

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