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Full Time Anthem Utilization Review Jobs (NOW HIRING)

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 ...

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 ...

Umpqua Health

Utilization Review Specialist

Winston, OR · On-site

$41K - $47K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Utilization Review Specialist HYBRID, must be able to travel to 3031 NE STEPHENS ST ... ROSEBURG, OR 97470 EMPLOYMENT TYPE- Full-Time, Exempt About Umpqua Health At Umpqua Health, we're ...

Axiom Care

Utilization Review Coordinator

Phoenix, AZ · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Job Type Full-time Description The UR Coordinator's primary responsibility is managing, reviewing, and monitoring utilization of patient resources and obtaining payor authorization as required for ...

Lifepoint Health

Utilization Review Specialist

Englewood, CO · On-site

$26 - $33/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

As a Utilization Review Specialist joining our team, you're embracing a vital mission dedicated to ... Multiple levels of medical, dental and vision coverage for full-time and part-time employees.

Silver Cross Hospital

Utilization Review Nurse

New Lenox, IL · On-site +1

$34.73 - $45.15/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

BSN preferred. 2-5 years previous Utilization Review experience preferred. * Current CPR * Relevant ... Full-time and Part-time employees which includes: • Medical, Dental and Vision plans • Life ...

Lifepoint Health

Utilization Review Specialist

Englewood, CO · On-site

$26 - $33/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

As a Utilization Review Specialist joining our team, you're embracing a vital mission dedicated to ... Multiple levels of medical, dental and vision coverage for full-time and part-time employees.

silvercross

Utilization Review Nurse

$34.73 - $45.15/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

BSN preferred. 2-5 years previous Utilization Review experience preferred. * Current CPR * Relevant ... for Full-time and Part-time employees which includes: Medical, Dental and Vision plans Life ...

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Showing results 21-40

All JobsAnthem Utilization Review JobsFull Time Anthem Utilization Review Jobs

Full Time Anthem Utilization Review information

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$21

$42

$68

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

As of Aug 17, 2026, the average hourly pay for full time anthem utilization review 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 the difference between Full Time Anthem Utilization Review vs Full Time Medicaid Utilization Review?

AspectFull Time Anthem Utilization ReviewFull Time Medicaid Utilization Review
CertificationsTypically requires certifications like CCM or URAC accreditationOften requires similar certifications, with additional Medicaid-specific knowledge
Work EnvironmentCorporate healthcare setting, insurance company officesGovernment or Medicaid agency offices, healthcare providers
Employer & IndustryInsurance companies, healthcare payersState Medicaid agencies, government healthcare programs
Job FocusReviewing insurance claims for Anthem members, ensuring coverage complianceReviewing Medicaid claims, eligibility, and coverage for state programs

Full Time Anthem Utilization Review primarily involves insurance claim assessments within a corporate setting, focusing on Anthem members. In contrast, Full Time Medicaid Utilization Review centers on government-funded Medicaid programs, requiring knowledge of state-specific policies. Both roles require similar certifications but differ in employer type and scope of coverage.

What cities are hiring for Full Time Anthem Utilization Review jobs?

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

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States with the most job openings for Full Time Anthem Utilization Review jobs include:

Full Time Anthem Utilization Review jobs near you

Utilization Review Nurse

Oscar Health

Dallas, TX • Remote

$35 - $45.94/hr

Full-time

Posted 25 days ago

Oscar Health rating

6.9

Company rating: 6.9 out of 10

Based on 6 frontline employees who took The Breakroom Quiz

257th of 309 rated insurance

Job description

Hi, we're Oscar. 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 treatment as needed. You will make recommendations regarding the appropriateness of care for identified diagnoses based on the research results for those conditions.

You will report into the Supervisor, Utilization Review.

Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois; Iowa; Kansas; Michigan; Missouri; Nebraska; New Jersey; North Carolina; Ohio; Oklahoma; Pennsylvania; South Carolina; Tennessee; Texas; or Virginia. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events.

Pay Transparency: The base pay for this role is: $35.00 - $45.94 per hour. You are also eligible for employee benefits and monthly vacation accrual at a rate of 15 days per year.

Responsibilities:

  • Complete medical necessity reviews and level of care reviews for requested services using clinical judgment and Oscar Clinical Guidelines, Milliman Care Guidelines
  • Obtain the information necessary (via telephone and fax) to assess a member's clinical condition, and apply the appropriate evidence-based guidelines
  • Meet required decision-making SLAs
  • Refer members for further care engagement when needed
  • Compliance with all applicable laws and regulations
  • Other duties as assigned

Requirements:

  • Active, unrestricted RN licensure from the United States in [state], OR, active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC)
  • Associate Degree - Nursing or Graduate of Accredited School of Nursing Or Successful completion of Nursing Diploma Program in Accredited School of Nursing
  • Ability to obtain additional state licenses to meet business needs
  • 1+ year of utilization review experience in a managed care setting
  • Strong experience utilizating MCG (Milliman Care Gudielines)
  • 1+ years of clinical experience (including at least 1+ year clinical practice in an acute care setting, i.e., ER or hospital)
  • Weekend availability is required; all applicants must be able to work at least one weekend day (Saturday or Sunday) each week.

Bonus points:

  • BSN
  • Previous experience conducting concurrent or inpatient reviews for a managed care plan

This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.

At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.

Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.

Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known.

California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.

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