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No Experience Utilization Management Nurse Jobs (NOW HIRING)

HealthONE

Utilization Management Nurse

Dalton, GA · On-site

Job Title Utilization Management Nurse The Utilization Management Nurse performs comprehensive ... Other duties as may be assigned Qualifications * 3 years Clinical experience preferred * 1-2 years ...

Access Dubuque

Utilization Management Nurse

Dubuque, IA · On-site

Utilization Management Nurse Cottingham & Butler/ SISCO 1 Positions ID: 4627707008 Posted On 07/01 ... 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 ...

Oak St. Health

Utilization Management Nurse Consultant

$32.01 - $68.55/hr

Utilizes clinical experience and skills in a collaborative process to assess, plan, implement ... N licensure in state of residence Utilization Management is a 24/7 operation and work schedules ...

CVS Health

Utilization Management Nurse Consultant

Home, KS · On-site

$26.01 - $56.14/hr

Utilizes clinical experience and skills in a collaborative process to assess, plan, implement ... N licensure in state of residence * Utilization Management is a 24/7 operation and work schedules ...

Christiana Care Health Services

$85K - $137K/yr

Presents "Letters of Non-Coverage" (LON) to patients and/or families when the acute stay is no ... Education & Experience Requirements: * DE RN licensure or compact state RN licensure. * Bachelor ...

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No Experience Utilization Management Nurse information

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$39K

$89.5K

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

As of Aug 11, 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

HealthONE

Dalton, GA • On-site

Other

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 19 days ago

Job description

Job Title

Utilization Management Nurse

Job Description

The Utilization Management Nurse performs comprehensive clinical reviews of requested services utilizing clinical criteria, received through various mechanisms.

Essential Job Duties
  • Initiate referrals to ensure appropriate coordination of care.
  • Seek the advice of the Medical Director when appropriate, according to policy.
  • Assists non-clinical staff in performance of administrative reviews.
  • Performing comprehensive provider and member appeals, denial interpretation for letters, retrospective claim review, special review requests, and UM pre-certifications and appeals, utilizing medical appropriateness criteria, clinical judgement, and contractual eligibility.
  • Regular and predictable attendance.
  • Consistently demonstrates compliance with HIPAA regulations, professional conduct, and ethical practice.
  • Works to encourage and promote Company culture throughout the organization.
  • Other duties as may be assigned
Qualifications
  • 3 years Clinical experience preferred
  • 1-2 years of Utilization Review preferred
  • Proficient in Microsoft Office (Outlook, Word, Excel)
  • Working knowledge of NCQA preferred
  • Must be able to work in an independent and creative manner.
  • Ability to manage multiple projects and priorities
  • Adaptive to high pace and changing environment
  • Customer service oriented
  • Proficient in interpreting benefits, contract language and medical policy/medical review criteria
  • Current, active Compact State license in Nursing (RN)
Physical Requirements

Prolonged periods of sitting at a desk and working on a computer. Moderate to significant amount of stress in meeting deadlines and dealing with day-to-day responsibilities. Must be able to drive a vehicle and daytime/overnight travel as required.

Benefits
  • 401K (4% Match, Immediate Vesting)
  • Accident insurance
  • Competitive salary
  • Critical Illness Insurance
  • Dental Insurance
  • Employee Assistance Program
  • Flexible Spending Account
  • Health & Wellness Program
  • Health Savings Account
  • Life & AD&D Insurance
  • Long Term Disability
  • Medical Insurance
  • Paid Time Off
  • Pet Insurance
  • Short Term Disability
  • Vision Insurance
Pre-Employment Screening

Drug Screen and Background Check Required

Company Statement

HealthOne is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, disability, sex, age, ethnic or national origin, marital status, sexual orientation, gender identity or presentation, pregnancy, genetics, veteran status, or any other status protected by state or federal law.

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