ZipRecruiter

Log In

1

Flexible 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 ...

Acrisure

Utilization Review Nurse

Bradenton, FL · On-site

Acrisure is seeking a Utilization Review Nurse, LPN to evaluate treatment requests and help ensure ... Health Savings Account (HSA) and Flexible Spending Account (FSA) options; commuter benefits; and ...

Acrisure

Utilization Review Nurse

Bradenton, FL · On-site

Acrisure is seeking a Utilization Review Nurse, LPN to evaluate treatment requests and help ensure ... Health Savings Account (HSA) and Flexible Spending Account (FSA) options; commuter benefits; and ...

Acrisure LLC

Utilization Review Nurse

Bradenton, FL · On-site

Acrisure is seeking a Utilization Review Nurse, LPN to evaluate treatment requests and help ensure ... Health Savings Account (HSA) and Flexible Spending Account (FSA) options; commuter benefits; and ...

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

Canton, MA · On-site

$55 - $60/hr

... Nurse to support outpatient utilization review and prior authorization activities for a leading healthcare organization. The ideal candidate will have a strong background in managed care, utilization ...

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 ...

AbsoluteCare

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 ...

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 ...

next page

Showing results 1-20

All JobsHealthcare JobsNursing JobsNurse Case Manager JobsFlexible Utilization Review Nurse Jobs

Flexible Utilization Review Nurse information

See salary details

$21

$42

$68

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

As of Aug 29, 2026, the average hourly pay for flexible 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 flexible utilization review nurse?

A Flexible Utilization Review Nurse is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services, procedures, and facilities, often with the ability to work flexible hours or remotely. These nurses typically review patient records, coordinate with healthcare providers, and ensure that treatments meet established guidelines and insurance requirements. The 'flexible' aspect refers to their adaptable work schedules or settings, making this role appealing for those seeking work-life balance.

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

To thrive as a Flexible Utilization Review Nurse, you need a nursing degree, active RN license, and experience in clinical settings, along with a strong understanding of healthcare regulations and insurance guidelines. Familiarity with utilization management software, electronic health records (EHRs), and knowledge of CMS or NCQA standards is typically required. Exceptional critical thinking, time management, and communication skills help you excel in remote or variable environments and collaborate effectively with providers and payers. These competencies ensure accurate care assessments, regulatory compliance, and efficient resource utilization in a dynamic healthcare landscape.

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

Flexible Utilization Review Nurses often navigate challenges such as managing fluctuating caseloads, adapting to varied healthcare settings, and staying current with changing regulations. Time management and organization are essential, as work hours may shift and patient volume can vary. Building strong communication skills helps in collaborating remotely with physicians, case managers, and insurance representatives. Proactively seeking ongoing education and connecting with supportive colleagues can make these challenges more manageable and enhance job satisfaction.

What cities are hiring for Flexible Utilization Review Nurse jobs?

Cities with the most Flexible 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 Flexible Utilization Review Nurse jobs?

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

Flexible Utilization Review Nurse jobs near you

Utilization Review Nurse

Las Vegas, NV • On-site

Fusion HCR
Human Resources Consulting Services • 11 - 50 employees
Learn more about Fusion HCRexternal

Other

Re-posted 22 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