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Nicu Utilization Review Jobs (NOW HIRING)

NICU

NICU- Clinical Nurse Specialist

Riverside, CA · On-site

Clinical Nurse Specialist The Clinical Nurse Specialist shall be responsible for directing the clinical nursing practice in the NICU & Pediatric Unit. Coordination and assessment of educational ...

JobRx, Inc.

Clinical NICU Pharmacist

Odessa, TX · On-site

$100.56 - $121.23/hr

Clinical NICU Pharmacist Position Details * Full-Time Position * Monday - Friday (9:00am - 5:30pm ... Conducts drug utilization review studies * Consults with medical practitioners on medication orders ...

New

St. David's HealthCare

Neonatal ICU (NICU)

Austin, TX · On-site

Neonatal Icu (nicu) Rn Travel Job Genie Healthcare is looking for a RN to work in Neonatal ICU (NICU) for a 13 weeks travel assignment located in Austin, TX for the Shift (3x12 nights, 19:00:00-07:00 ...

ICONMA

RN - Neonatal ICU - NICU

Brighton, MA · On-site

RN - Neonatal ICU - NICU Our Client, a Medical Center company, is looking for a RN - Neonatal ICU - NICU for their Brighton, MA location. Responsibilities: * The Registered Nurse in the NICU provides ...

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How much do nicu utilization review jobs pay per hour?

As of Aug 21, 2026, the average hourly pay for nicu 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 a NICU Utilization Review?

A NICU Utilization Review job involves assessing the medical necessity, efficiency, and appropriateness of neonatal intensive care unit (NICU) services. Professionals in this role review patient records, insurance policies, and hospital guidelines to ensure that care aligns with best practices and payer requirements. They collaborate with medical teams and insurance providers to support optimal patient outcomes while managing healthcare costs. Strong clinical knowledge, attention to detail, and communication skills are essential for this role.

What are the primary responsibilities of a NICU Utilization Review specialist on a typical day?

A NICU Utilization Review specialist is responsible for reviewing neonatal patient cases to ensure medical necessity for continued hospitalization, appropriateness of care, and compliance with payer requirements. Daily tasks include analyzing clinical documentation, communicating with NICU care teams and physicians, and preparing reports or recommendations for insurance authorization. You may also interact with families regarding coverage and participate in case conferences. This role requires close collaboration with both clinical and administrative staff to optimize patient outcomes while managing healthcare resources efficiently.

What are the key skills and qualifications needed to thrive in the NICU Utilization Review position, and why are they important?

To excel as a NICU Utilization Review professional, you need a background in neonatal or pediatric nursing, a thorough understanding of clinical guidelines, and experience with healthcare utilization management. Familiarity with medical coding systems (such as ICD-10, CPT), electronic medical record (EMR) platforms, and often certification such as CCM (Certified Case Manager) or URAC accreditation is highly valued. Outstanding analytical thinking, communication skills, and attention to detail are essential for reviewing complex cases and collaborating with multidisciplinary teams. These skills are critical to ensure appropriate resource use, regulatory compliance, and the delivery of optimal patient care in the neonatal intensive care unit setting.

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Nicu Utilization Review jobs near you
Infographic showing various Nicu Utilization Review job openings in the United States as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

NICU- Clinical Nurse Specialist

NICU

Riverside, CA • On-site

Other

Posted 18 days ago

Job description

Clinical Nurse Specialist

The Clinical Nurse Specialist shall be responsible for directing the clinical nursing practice in the NICU & Pediatric Unit. Coordination and assessment of educational development and clinical competency of the nursing staff in the NICU; and for ensuring continued neonatal critical care nursing competency through educational programs for both the newly-hired and experienced nursing staff. Consultation with staff on complex neonatal critical care nursing issues. Oversight of comprehensive parent and or primary caretaker education activities. Ensuring the implementation of a coordinated and effective discharge planning program. Evaluation of NICU based on Accrediting and Regulatory Agencies.

Coordination and assessment of educational development and clinical competency of the nursing staff in the Pediatric Unit; and for ensuring continued Pediatric nursing competency through educational programs for both the newly-hired and experienced nursing staff. Consultation with staff on Pediatric nursing issues. Oversight of comprehensive parent and or primary caretaker education activities. Ensuring the implementation of a coordinated and effective discharge planning program.

Evaluation of Pediatric Unit based on Accrediting and Regulatory Agencies.

RN licensed by the State of California.

Certified by the California State Board of Registered Nursing as a CNS.

Masters of Science Degree in Nursing.

Three years of clinical experience in neonatal nursing care, at least one of which shall have been in a facility with an NICU that is equivalent to a Regional or Community NICU.

Current certification in Neonatal Intensive Care Nursing from a nationally recognized accrediting organization, i.e. the NCC; and

Current successful completion of the Neonatal Resuscitation Program of the AAP and AHA.

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