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Internship Nurse Practitioner Utilization Review Jobs

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

Atlanta, GA · 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 ...

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 ...

Shannon Health

Utilization Review Nurse

Big Spring, TX · On-site

Job Summary The Utilization Review (UR) Nurse has acute knowledge and skills in areas of utilization management (UM), medical necessity, and patient status determination. This individual supports the ...

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 ...

Shannon Health

Utilization Review Nurse

Big Spring, TX · On-site

Job Summary The Utilization Review (UR) Nurse has acute knowledge and skills in areas of utilization management (UM), medical necessity, and patient status determination. This individual supports the ...

Netsmart

Utilization Review Nurse

Review, analyze, and identify utilization patterns and trends, problems, or inappropriate utilization of resources Qualifications Required * Current and unrestricted RN license * At least 3 years ...

McBee Associates

Utilization Review Nurse

Review, analyze, and identify utilization patterns and trends, problems, or inappropriate utilization of resources Qualifications Required * Current and unrestricted RN license * At least 3 years ...

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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

Oscar Health

Miami, FL • Remote

$35 - $45.94/hr

Full-time

Posted 29 days ago

Oscar Health rating

6.9

Company rating: 6.9 out of 10

Based on 6 frontline employees who took The Breakroom Quiz

260th of 311 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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