ZipRecruiter

Log In

2

No Experience Utilization Management Nurse Jobs (NOW HIRING)

Solis Health Plans

Utilization Management Nurse

Miami, FL · On-site

$60K - $70K/yr

Solis was born out of a desire to provide a more personal experience throughout all levels of the ... Under the supervision of the Health Services Director, the Utilization Management Nurse (LPN or RN) ...

HealthCheck360

Utilization Management Nurse

Dubuque, IA · On-site

Utilization Management Nurse Location : Onsite in Dubuque, IA. Also accepting remote applicants. We ... Qualified candidates will have strong multitasking skills, RN and clinical experience, preferably ...

Medical University of South Carolina

... Nurse required ... Prior leadership experience preferred. One year of case management and/or utilization management ...

Medical University of South Carolina

... Nurse required ... Prior leadership experience preferred. One year of case management and/or utilization management ...

Medical University of South Carolina

... Nurse required ... Prior leadership experience preferred. One year of case management and/or utilization management ...

Medical University of South Carolina

... Nurse required ... Prior leadership experience preferred. One year of case management and/or utilization management ...

next page

Showing results 1-20

All JobsUtilization Management Nurse JobsNo Experience Utilization Management Nurse Jobs

No Experience Utilization Management Nurse information

See salary details

$39K

$89.5K

$163K

How much do no experience utilization management nurse jobs pay per year?

As of Aug 15, 2026, the average yearly pay for no experience utilization management nurse in the United States is $89,483.00, according to ZipRecruiter salary data. Most workers in this role earn between $64,500.00 and $104,500.00 per year, depending on experience, location, and employer.

What types of training and support can I expect as a no experience utilization management nurse?

As a No Experience Utilization Management Nurse, you'll typically receive comprehensive onboarding and training focused on utilization review protocols, clinical documentation requirements, and the use of review software tools. Many employers pair new nurses with mentors or experienced team members to guide you through the early learning curve and help you get comfortable with non-bedside aspects of nursing. Regular team meetings and ongoing education opportunities are common, allowing you to build expertise in reviewing medical necessity, insurance guidelines, and collaboration with physicians and case managers. This supportive environment is designed to help you confidently transition into the field and grow your skills in utilization management nursing.

What is a no experience utilization management nurse?

A No Experience Utilization Management Nurse job is an entry-level role for registered nurses (RNs) transitioning into utilization management without prior experience in the field. These nurses review medical records, evaluate the necessity of treatments, and coordinate care to ensure patients receive appropriate services while managing healthcare costs. They typically work for insurance companies, hospitals, or healthcare organizations, often in remote or office-based settings. Training and mentorship are usually provided to help new nurses develop the required skills for the role.

What are the key skills and qualifications needed to thrive as a no experience utilization management nurse?

To thrive as a No Experience Utilization Management Nurse, you generally need a current RN license, a strong understanding of clinical nursing concepts, and a willingness to learn about healthcare review processes. Familiarity with electronic health records (EHRs), utilization management software, and standard coding systems like ICD-10 is advantageous, though training is often provided for entry-level candidates. Attention to detail, critical thinking, strong organizational skills, and clear communication are important soft skills in this field. These qualifications ensure you can accurately review patient cases, coordinate effectively with healthcare teams, and make appropriate coverage determinations based on clinical criteria.

More about No Experience Utilization Management Nurse jobs

What cities are hiring for No Experience Utilization Management Nurse jobs?

Cities with the most No Experience Utilization Management Nurse job openings:

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

The most popular types of Utilization Management Nurse jobs are:

What states have the most No Experience Utilization Management Nurse jobs?

States with the most job openings for No Experience Utilization Management Nurse jobs include:

What job categories do people searching No Experience Utilization Management Nurse jobs look for?

The top searched job categories for No Experience Utilization Management Nurse jobs are:

No Experience Utilization Management Nurse jobs near you
Infographic showing various No Experience Utilization Management Nurse job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 76% Full Time, 19% Part Time, and 4% Contract. Highlights an 94% Physical, 2% Hybrid, and 4% Remote job distribution, with an average salary of $89,483 per year, or $43 per hour.

Utilization Management Nurse

SIHO Insurance Services

Columbus, IN • On-site

Full-time

Re-posted 18 days ago

Job description

Job Title:  Utilization Management Nurse
Reports To: Manager of Utilization Management
Employment Type:  Full-Time, Exempt 

Brief Description of Duties:     
This position is reserved for a licensed Registered Nurse who will perform the Utilization Management (UM) services for SIHO (and affiliated business lines’) members. This individual’s primary role is to ensure that health care services are administered with quality, cost effectiveness, and compliance to plan guidelines are maintained. By performing review of services prospectively, retrospectively, and throughout the episode of care, the UM nurse will make coverage determinations influencing how services are allocated to SIHO’s various member populations.  A candidate’s ability to perform quality reviews within strict efficiency standards is required for this position.  Key responsibilities are as follows: 
- Pre-service, concurrent, and post-service review of necessity of health care services utilizing enrollee medical records and established guidelines set by SIHO and/or state and federal (CMS) guidelines
- Interaction with the member, health care provider, and/or other care team members to complete reviews in most time-efficient manner
- Interaction with the SIHO Medical Director as needed to ensure proper medical necessity decisions are made in a timely manner
- Appropriate documentation of the entire review process utilizing the established documentation system and desk procedures to guarantee accurate reporting metrics and data integrity
- Complete case review and elevation to determinations that are rendered within the contractual and regulatory turnaround times established by SIHO and CMS
- Assist to resolve problems and provide guidance to members of the team and cohorts
-Interpret and abide by organizational policies and procedures; review work regularly to ensure that policies and guidelines are appropriately applied
-Act as a clinical resource to the department and other organization members for services pertaining to medical management, utilization review, and medical necessity
- Act and perform within the scope of professional nursing practice; is responsible in supporting and participating in department strategies and efforts focused on quality improvement
- Responsible for the early identification and assessment of members for inclusion in disease management or care management programs
- Assist in the identification and reporting of Potential Quality of Care concerns and Fraud, Waste and Abuse incidents
- Work as an interdisciplinary team member within Medical Management for all lines of business and commercial group plans 

Minimum Skills Requirement: 
- Registered Nurse with current, unrestricted license in primary state of employment (position may require additional licensing in other states as necessary)Previous UM or Health Plan experience highly preferred
- Desire to work in a fast-paced environment with focus on efficiency while maintaining quality
- Self-directed organization and prioritization skills, and independent time management skills required
- Sound clinical background with experience in the clinical field
- Excellent verbal and written communication skills
- Microsoft Office Experience: Outlook, Word, Excel

We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.