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Internship Anthem 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 LLC

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 · 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 ...

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

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 ...

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

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 ...

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

As of Aug 29, 2026, the average hourly pay for internship anthem utilization review nurse in the United States is $16.77, according to ZipRecruiter salary data. Most workers in this role earn between $14.42 and $18.75 per hour, depending on experience, location, and employer.

What is an Internship Anthem Utilization Review Nurse?

An Internship Anthem Utilization Review Nurse is a nursing student or recent graduate working in a learning capacity within Anthem’s Utilization Review department. Their primary role is to assist in evaluating medical necessity, appropriateness, and efficiency of healthcare services and procedures. Under the supervision of licensed nurses, they review clinical documentation, learn about health insurance policies, and help ensure that patients receive the right care at the right time. This internship provides hands-on experience in case management, healthcare policy, and the insurance review process, preparing interns for future roles as Utilization Review Nurses.

What are the typical responsibilities and learning opportunities for an Internship Anthem Utilization Review Nurse?

As an Internship Anthem Utilization Review Nurse, you can expect to assist with reviewing medical records, evaluating the necessity and appropriateness of healthcare services, and supporting the coordination of care between providers and insurance teams. Interns often learn how to apply evidence-based criteria to utilization decisions and gain exposure to the insurance side of healthcare, which is valuable experience for future roles in case management or utilization management. You’ll frequently collaborate with experienced nurses, physicians, and administrative staff, which helps develop both clinical and communication skills. This role offers a unique perspective on healthcare delivery while providing mentorship and professional growth opportunities within a large organization.

What are the key skills and qualifications needed to thrive as an Internship Anthem Utilization Review Nurse, and why are they important?

To thrive as an Internship Anthem Utilization Review Nurse, you need a solid foundation in nursing principles, strong analytical skills, and preferably an active RN license or enrollment in a nursing program. Familiarity with utilization review software, electronic health records (EHRs), and knowledge of insurance guidelines are commonly required. Excellent communication, attention to detail, and critical thinking are valuable soft skills for collaborating with providers and ensuring accurate assessments. These skills and qualities are essential to ensure appropriate care, cost-effective resource use, and regulatory compliance within a healthcare insurance setting.

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Internship Anthem Utilization Review Nurse jobs near you

UTILIZATION REVIEW NURSE

Norfolk, VA • On-site, Remote

Sentara Healthcare
Hospitals • 10K+ employees

6.7

Company rating: 6.7 out of 10

Based on 414 frontline employees who took The Breakroom Quiz

532nd of 895 rated healthcare providers

People enjoy working here

Recommended by students

Good schedule notice

Learn more about Sentara Healthcareexternal

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 4 days ago

Job description

City/State
Norfolk, VA
Work Shift
First (Days)
Overview:
Sentara Health Plans Community Care is looking to hire a Utilization Review Nurse.
The Utilization Review Nurse is responsible for utilization management services within the scope of licensure. Conducts primary functions of prior authorization, retrospective review, medical director referrals and execution of member/provider approval and/or denial letter. Reviews provider requests for services requiring authorization. Conducts pre-certification, care coordination for appropriateness of treatment, set reviews to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts.
Responsible for written and/or verbal notification to members and providers. Ensures medical director written decision is consistent with criteria (CMS, state, medical policy, clinical criteria). Facilitates accreditation by knowing, understanding, correctly interpreting, and accurately applying accrediting and regulatory requirements and standards.
Education:
• BSN (preferred)
Certification:
• Registered Nurse (required)
Experience:
• 3 years of acute care clinical experience (required)
• Previous Utilization Review experience (preferred)
• Milliman experience (preferred)
• Knowledge of NCQA (preferred)
• Microsoft suite (Word, Excel, Outlook) (preferred)
• Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills
Keywords: Talroo- Health, Utilization Review Nurse, RN, Care Coordination, or Discharge Planning, Case Management, Milliman, NCQA
Benefits: Caring For Your Family and Your Career
• Medical, Dental, Vision plans
• Adoption, Fertility and Surrogacy Reimbursement up to 10,000
• Paid Time Off and Sick Leave
• Paid Parental & Family Caregiver Leave
• Emergency Backup Care
• Long-Term, Short-Term Disability, and Critical Illness plans
• Life Insurance
• 401k/403B with Employer Match
• Tuition Assistance - 5,250/year and discounted educational opportunities through Guild Education
• Student Debt Pay Down - 10,000
• Pet Insurance
• Legal Resources Plan
• Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.
Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
In support of our mission "to improve health every day," this is a tobacco-free environment.
For positions that are available as remote work, Sentara Health employs associates in the following states:
Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.

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