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International Utilization Review Nurse Jobs (NOW HIRING)

Sentara Health Plans

UTILIZATION REVIEW NURSE

Norfolk, VA · On-site

$65 - $85/hr

The Utilization Review Nurse is responsible for utilization management services within the scope of licensure. Conducts primary functions of prior authorization, retrospective review, medical ...

Sentara Health Plans

$65 - $85/hr

The Utilization Review Nurse is responsible for utilization management services within the scope of licensure. Conducts primary functions of prior authorization, retrospective review, medical ...

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, LLC

Utilization Review Nurse

Bradenton, FL · On-site

$55 - $90/hr

Utilization Review Nurse, LPN** to evaluate treatment requests and help ensure injured workers receive appropriate, timely care in accordance with applicable clinical guidelines and regulatory ...

Acrisure, LLC

$55 - $90/hr

Utilization Review Nurse, LPN** to evaluate treatment requests and help ensure injured workers receive appropriate, timely care in accordance with applicable clinical guidelines and regulatory ...

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 ...

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 ...

Merrimack Health

Utilization Review Nurse

Lawrence, MA · On-site

... they relate to utilization review and discharge planning and payer regulations. MINIMUM EDUCATION AND EXPERIENCE: Required: * Graduate of an accredited professional nursing school * Current ...

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International Utilization Review Nurse information

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

As of Sep 6, 2026, the average hourly pay for international 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 an international utilization review nurse?

An International Utilization Review Nurse evaluates medical records to ensure healthcare services are necessary, efficient, and compliant with guidelines across different countries. They collaborate with medical teams, insurance providers, and regulatory agencies to review treatment plans and medical necessity. Their role helps control costs, prevent insurance fraud, and ensure patients receive appropriate care. Strong knowledge of global healthcare policies and insurance regulations is essential for success in this position.

What are some common challenges faced by international utilization review nurses?

International Utilization Review Nurses often encounter challenges such as navigating various international healthcare regulations, dealing with differences in medical terminology, and adapting to local policies or practices. The role may require frequent collaboration with multidisciplinary teams across different countries and time zones, which can be logistically complex but deeply rewarding. Cultural sensitivity and flexibility are essential to ensure effective communication and accurate review of patient cases. These challenges ultimately help International Utilization Review Nurses develop strong problem-solving skills and broaden their professional expertise in global healthcare management.

What are the key skills and qualifications needed to thrive in the international utilization review nurse position, and why are they important?

To thrive as an International Utilization Review Nurse, you need strong clinical assessment abilities, a thorough understanding of international healthcare regulations, and an active RN license, often with a bachelor's degree or higher. Familiarity with utilization management software, coding systems like ICD-10, and certifications such as CCM (Certified Case Manager) are highly beneficial. Excellent communication, cultural sensitivity, and analytical skills help you navigate diverse healthcare systems and collaborate across borders. These skills ensure accurate review of medical necessity, effective cross-cultural communication, and improved healthcare outcomes on a global scale.

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International Utilization Review Nurse jobs near you
Infographic showing various International 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, 1% Temporary, and 3% Contract. Highlights an 88% Physical, 3% Hybrid, and 9% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

Utilization Review Nurse

Health Business Solutions LLC

Cooper City, FL

Full-time

Re-posted 29 days ago

Job description

Job Summary: We are seeking a highly motivated and experienced Utilization Review Nurse to join our team. The Utilization Review Nurse will play a crucial role in supporting our clients in the healthcare industry by providing expert clinical guidance, facilitating effective utilization management, and ensuring revenue cycle efficiency. This position offers a unique opportunity to combine clinical expertise with revenue cycle management knowledge.

Key Responsibilities:

·       Clinical Assessment: Conduct comprehensive clinical assessments of medical records to ensure patients are receiving appropriate care at the correct level of service.

  • Care Coordination: Collaborate with interdisciplinary healthcare teams to coordinate patient care and treatment plans, ensuring the most cost-effective and clinically appropriate care is provided.
  • Revenue Cycle Management: Utilize clinical expertise to support revenue cycle processes, including accurate coding, documentation improvement, and compliance with healthcare regulations.
  • Utilization Review:

a) Apply medical necessity screening criteria and clinical knowledge to ensure appropriateness of admissions and length of stays

b) Conduct initial admission, continuing stay, and 23-hour observations reviews for all patients

c) Support Utilization Review Coordinator team members on cases escalated for level of care determinations

d) Screen cases for Physician Advisor review

e) Collaborate with insurance companies on concurrently denied and high risk for denial cases

  •  Documentation Improvement: Identify opportunities for improving clinical documentation to support accurate coding and billing processes, ultimately improving reimbursement.


  • Data Analysis: Analyze clinical and financial data to identify trends, opportunities for improvement, and areas of potential cost savings for clients.


  • Compliance: Stay up-to-date with healthcare regulations, guidelines, and policies to ensure all patient care and revenue cycle processes are in compliance with industry standards and regulatory requirements to ensure appropriate reimbursement.

Qualifications:

·       Registered Nurse (RN) licensure required; must hold a USRN multi-state/compact nursing license.

·       Bachelor of Science in Nursing (BSN) preferred.

·       Case Management Certification (e.g., CCM) is a plus.

·       Minimum of 3 years of clinical nursing experience, preferably in a hospital or acute care setting.

·       Minimum 2 years of work experience in Utilization Review

·       Strong understanding of revenue cycle management and healthcare reimbursement.

·       Proficiency in medical coding and clinical documentation improvement.

·       Excellent communication, interpersonal, and teamwork skills.

·       Ability to work independently and make sound clinical and financial decisions.

·       Strong analytical and problem-solving skills.

·       Proficient in using healthcare information systems and technology.

·       Commitment to maintaining patient confidentiality and ethical standards.