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Internship Nurse Practitioner Utilization Review Jobs

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

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 ...

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 ...

Bestica Healthcare

RN Utilization Review

Tuba City, AZ · On-site

... nurse practitioners, nurse midwives, CRNA, and community health medics. Position Summary The ... Utilization Review (UR) Nurse ensures that patients receive appropriate care by verifying medical ...

Tuba City Regional

Utilization Review

Tuba City, AZ · On-site

Rn - Utilization Review Cure Healthcare is seeking a RN - Utilization Review for positions in Tuba City, Arizona. Current Arizona license and AHA BLS and ACLS required and additional certifications ...

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 ...

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 ...

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

As of Aug 21, 2026, the average hourly pay for internship nurse practitioner utilization review 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 nurse practitioner utilization review?

An Internship Nurse Practitioner Utilization Review is a temporary position where a nurse practitioner in training is involved in evaluating the necessity, efficiency, and appropriateness of healthcare services and treatments. The role typically involves reviewing medical records, collaborating with healthcare teams, and ensuring that patient care meets established guidelines and standards. This internship provides hands-on experience in the utilization review process, helping future nurse practitioners develop important skills in clinical assessment, decision-making, and healthcare management.

What are the typical responsibilities of an internship nurse practitioner utilization review, and how does this role support the healthcare team?

As an Internship Nurse Practitioner in Utilization Review, your main responsibilities include reviewing patient records, assessing the appropriateness of medical services, and ensuring treatments meet established guidelines for medical necessity. You will collaborate closely with physicians, nurses, and case managers to coordinate care and may participate in interdisciplinary meetings to discuss complex cases. This role provides valuable exposure to healthcare policy, insurance processes, and quality assurance, all while supporting the healthcare team in delivering cost-effective and appropriate care.

What are the key skills and qualifications needed to thrive as an internship nurse practitioner utilization review, and why are they important?

Success as an Internship Nurse Practitioner Utilization Review requires a strong clinical background, familiarity with healthcare regulations, and an advanced nursing degree or enrollment in a nurse practitioner program. Proficiency with utilization management software, electronic health records, and knowledge of CMS guidelines is essential. Critical thinking, attention to detail, and effective communication help interns collaborate with healthcare teams and justify care decisions. These skills ensure appropriate, cost-effective patient care while maintaining compliance and quality standards.

What is the difference between Internship Nurse Practitioner Utilization Review vs Nurse Practitioner Utilization Review?

AspectInternship Nurse Practitioner Utilization ReviewNurse Practitioner Utilization Review
CredentialsEnrolled in or recently completed nurse practitioner internshipLicensed Nurse Practitioner with certification
Work EnvironmentSupervised internship setting, training-focusedIndependent or team-based utilization review in healthcare settings
Employer & IndustryHospitals, clinics, or healthcare organizations during trainingInsurance companies, healthcare providers, utilization review organizations

Internship Nurse Practitioner Utilization Review roles are typically training positions for students or recent graduates gaining practical experience. In contrast, Nurse Practitioner Utilization Review positions require full licensure and involve independent review of healthcare services for appropriateness and coverage. The internship is a learning phase, while the full role focuses on decision-making and compliance in healthcare utilization management.

What cities are hiring for Internship Nurse Practitioner Utilization Review jobs?

Cities with the most Internship Nurse Practitioner Utilization Review job openings:

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

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

What states have the most Internship Nurse Practitioner Utilization Review jobs?

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

Internship Nurse Practitioner Utilization Review jobs near you

Utilization Review Nurse

Maniilaq Association

Kotzebue, AK • On-site

Other

Posted 18 days ago

Job description

Maniilaq Association is a P.L. 93-638 Native/Indian Preference/EEO Employer
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Utilization Review Nurse Job Code: 2026:OTZ-201 Location: Kotzebue, Alaska Program: Nursing Division FT/PT Status: Full Time Job Responsibilities:
MANIILAQ ASSOCIATION
5/2026
Title: Utilization Management Nurse Pay Grade: 31
Program: Nursing Status: Exempt
Housing Priority: 3 Covered: Yes
POSITION SUMMARY
The Utilization Management Nurse (UMN) is responsible for performing Utilization Review and managing risk, coordinates and facilitates with departmental staff on Durable Medical Equipment (DME), and pharmacy prior authorizations. THE UMN works with the medical treatment and case management team in the coordination of patient care including the development of new operational changes and new services to ensure compliance and risk mitigation. The UMN will use a process that includes screening and case finding, comprehensive multidimensional assessment, connection with available resources, implementation of the plan and ongoing monitoring and re-assessment/follow-up. The UMN assists with the Quality and Case Management programs and, coordinates the IPC4 program. This position reports directly to the Chief Nursing Officer or designee.
PRINCIPAL DUTIES AND RESPONSIBILITIES
  1. Coordinates the IPC4 process in Medicare/Medicaid and private insurances.
  2. Assists in revenue procurement by:making sure insurance approvals are completed correctly with no penalty; helping to identify alternate resources of funding such as VA, Denali Kid Care, Medicare, and Medicaid; and monitoring the appeal process when claims are denied.
  3. Chairs Quarterly Utilization Review Committee meetings to improve utilization of resources and improve patient care.
  4. Submits Quarterly reports to CMO and CNO for Board of Director meetings.
  5. Works closely with Coders and Billers to insure accurate, timely billing information.
  6. Completes Utilization Review processes as assigned.
  7. Oversees development and maintenance of a resource database of Federal, State, community, and institutional resources.
  8. Assists in arranging team conferences and networks for relationship building and resource development with village leaders, Community Health Aides/Practitioners, MHC Medical Staff, MHC Nursing Staff, private insurance contacts, Medicaid/Medicare contacts, ANMC Providers, and the CM/SC/UR Team.
  9. Participates on improvement projects as assigned.
  10. Participates in Medicaid Task Force committee through Alaska Native Health Board.
  11. Completes Quality Improvement, Quality Assurance and Performance Improvement projects and tasks as assigned.
  12. Utilizes team building, problem solving skills and lean principles in the on-going quality improvement initiatives.
  13. Identify, assess, and monitor potential clinical, operational, and compliance risks within the Utilization Review and Case Management programs.
  14. Report and document incidents, near-misses, and adverse events in accordance with organizational policy and regulatory standards.
  15. Participate in root cause analyses and collaborate with leadership to implement corrective action plans to mitigate future risks.
  16. Collaborate with the Risk Management team to review, update, and communicate policies and procedures relevant to utilization review and patient care coordination.
  17. Educate clinical and administrative staff on risk awareness, safety protocols, and compliance requirements.
  18. Coordinate and facilitate prior authorizations for DME by collaborating with patients, clinical staff and providers to ensure clients' needs are met.
  19. Collaborate with providers and pharmacist process prior authorizations for specialized high-cost medications; monitor appeal process if claims are denied.
Job Qualifications:
MINIMUM REQUIREMENTS
Current licensure as a RN with at least two years of Case Management, Utilization Review, Discharge Planning or Quality Improvement experience preferred. Knowledge of acute and chronic illnesses, specialty clinic procedures, and community health nursing. Must be able to pass the core competencies assigned to this position and maintain the educational requirements of the program. Ability to utilize various computer programs, including Cerner and Microsoft Office. Demonstrates a wide theory base in order to interact in an effective manner with physicians, health team members, community agencies, and clients/families with diverse opinions, values, and religious and cultural ideals. Ability to work autonomously with little direction and be directly accountable for practice. Knowledge of and experience working with all regulatory, state, and federal agencies.
Other Job Information (if applicable):
DISCLAIMER
The above statements are intended to describe the general nature and level of work being performed by people assigned to this job. They are not intended to be considered an exhaustive list of all responsibilities, duties and skills required of personnel in this job, and the employer reserves the right to revise or change this description. This description does not constitute a written or implied contract of employment. To perform this job successfully, an individual must be able to satisfactorily perform each of the above essential duties and meet physical demands. Reasonable accommodations may be made to enable individuals with disabilities to meet those conditions.

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