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Full Time Anthem Utilization Review Nurse Jobs (NOW HIRING)

Acrisure

Utilization Review Nurse

Bradenton, FL · On-site

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

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 ...

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 ... Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 ...

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 ... Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 ...

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 ... Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 ...

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

Atlanta, GA · Remote

$35 - $45.94/hr

We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 ...

silvercross

Utilization Review Nurse

$34.73 - $45.15/hr

Nurse, Registered (RN) licensure * BSN preferred. 2-5 years previous Utilization Review experience ... for Full-time and Part-time employees which includes: Medical, Dental and Vision plans Life ...

Silver Cross Hospital

Utilization Review Nurse

New Lenox, IL · On-site +1

$34.73 - $45.15/hr

Nurse, Registered (RN) licensure * BSN preferred. 2-5 years previous Utilization Review experience ... Full-time and Part-time employees which includes: • Medical, Dental and Vision plans • Life ...

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Full Time Anthem Utilization Review Nurse information

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How much do full time anthem utilization review nurse jobs pay per hour?

As of Aug 31, 2026, the average hourly pay for full time anthem 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 full time Anthem utilization review nurse?

A Full Time Anthem Utilization Review Nurse is a registered nurse employed by Anthem, a major health insurance company, to assess the medical necessity and appropriateness of healthcare services. Their primary role is to review clinical information, ensure that care provided to patients meets established guidelines, and determine if services are covered under the patient’s insurance plan. These nurses work closely with healthcare providers, patients, and insurance representatives to facilitate care while controlling costs. Full-time positions typically require standard business hours, with some roles offering remote or hybrid work options.

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

To thrive as a Full Time Anthem Utilization Review Nurse, you need a current RN license, strong clinical judgment, and experience in utilization management or case review. Proficiency with utilization review software, electronic health records (EHRs), and knowledge of insurance guidelines such as InterQual or Milliman is typically required. Excellent analytical skills, attention to detail, and effective communication are crucial for collaborating with healthcare providers and ensuring appropriate care. These abilities are vital for balancing quality patient outcomes with compliance to healthcare regulations and cost efficiency.

What are some common challenges faced by full time Anthem utilization review nurses, and how can they be managed?

Full Time Anthem Utilization Review Nurses often encounter challenges such as managing a high volume of case reviews and navigating complex insurance policies while ensuring timely and accurate determinations. Staying organized, keeping up with policy changes, and leveraging strong communication skills when coordinating with providers and members can help address these challenges. Additionally, working closely with a multidisciplinary team and utilizing Anthem's training resources can support effective decision-making and professional growth.

What is the difference between Full Time Anthem Utilization Review Nurse vs Part Time Anthem Utilization Review Nurse?

AspectFull Time Anthem Utilization Review NursePart Time Anthem Utilization Review Nurse
Work ScheduleTypically 40 hours/week, full-time hoursFewer hours, usually less than 20 hours/week
CertificationsRN license, utilization review certification often preferredRN license, utilization review certification often preferred
Work EnvironmentOffice-based, remote or onsiteOffice-based, remote or onsite
Employer & IndustryHealth insurance, managed care companiesHealth insurance, managed care companies

Full Time Anthem Utilization Review Nurses work standard hours and often have more consistent schedules, while Part Time roles offer flexibility with fewer hours. Both positions require RN licensure and utilization review certifications, and they operate in similar healthcare environments within the managed care industry.

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Cities with the most Full Time Anthem Utilization Review Nurse job openings:

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The most popular types of Anthem Utilization Review Nurse jobs are:

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The top searched job categories for Full Time Anthem Utilization Review Nurse jobs are:

Full Time Anthem Utilization Review Nurse jobs near you
Infographic showing various Full Time Anthem Utilization Review Nurse job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 14% Part Time, 3% Contract, and 1% Nights. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

Utilization Review Nurse

Access Healthcare Staffing & Recruitment

Las Vegas, NV • On-site

$40 - $63/hr

Full-time

Re-posted 24 days ago

Job description

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 compliance with payer guidelines. Analyzes medical records to ensure care meets established clinical and regulatory standards.


Requirements:

Education/Experience:

  • Graduate of an accredited nursing program
  • 5+ years of acute care nursing experience
  • At least 1 year in Utilization Management, Case Management, or CDI
  • Minimum 3 years of Utilization Management experience
  • 3+ years of discharge planning experience in acute care


Licensure:

  • Active Nevada RN license


Additional Requirements:

  • Experience with InterQual (must be able to pass exam)
  • Experience with Milliman criteria


Key Skills & Knowledge

  • Utilization review criteria (InterQual/Milliman), Medicare/Medicaid guidelines
  • Chart review and clinical documentation analysis
  • Regulatory compliance and hospital standards
  • Strong communication, collaboration, and analytical skills


Work Environment

  • Office-based with extended sitting and computer use
  • May require shifts and weekends