ZipRecruiter

Log In

1

Nurse Practitioner Utilization Management Jobs (NOW HIRING)

Intus Care

Utilization Management Nurse

$80K - $95K/yr

Utilization Management Nurse IntusCare is the only end-to-end ecosystem built specifically to help Programs of All-Inclusive Care for the Elderly (PACE) programs deliver exceptional care, strengthen ...

Intus, Inc

Utilization Management Nurse

$80K - $95K/yr

Role Overview The Utilization Management Nurse plays a critical role in ensuring high-quality, cost-effective, and compliant care for PACE participants supported by IntusCare. This individual ...

INTUS INC

Utilization Management Nurse

$80K - $95K/yr

Role Overview The Utilization Management Nurse plays a critical role in ensuring high-quality, cost-effective, and compliant care for PACE participants supported by IntusCare. This individual ...

UF Health

RN, Utilization Management

Saint Johns, FL · On-site

Registered Nurse (RN) license with 3+ years experience in utilization review or case management. Knowledge of healthcare utilization guidelines and compliance. Experience evaluating medical necessity ...

next page

Showing results 1-20

All JobsHealthcare JobsNursing JobsNurse Practitioner JobsNurse Practitioner Utilization Management Jobs

Nurse Practitioner Utilization Management information

See salary details

$71K

$134.4K

$210.5K

How much do nurse practitioner utilization management jobs pay per year?

As of Sep 12, 2026, the average yearly pay for nurse practitioner utilization management in the United States is $134,369.00, according to ZipRecruiter salary data. Most workers in this role earn between $111,000.00 and $152,500.00 per year, depending on experience, location, and employer.

What is the difference between Nurse Practitioner Utilization Management vs Nurse Practitioner Case Management?

AspectNurse Practitioner Utilization ManagementNurse Practitioner Case Management
CertificationsNP license, possibly certifications in utilization reviewNP license, case management certifications often preferred
Work EnvironmentInsurance companies, health plans, utilization review departmentsHospitals, clinics, outpatient facilities, patient advocacy
Employer & Industry UsagePrimarily in insurance and managed care organizationsHealthcare providers, hospitals, outpatient centers

Both roles involve patient care and clinical expertise, but Nurse Practitioner Utilization Management focuses on reviewing medical necessity and optimizing resource use, while Nurse Practitioner Case Management emphasizes coordinating patient care and discharge planning. Understanding these differences helps in choosing the right career path or job search focus.

What cities are hiring for Nurse Practitioner Utilization Management jobs?

Cities with the most Nurse Practitioner Utilization Management job openings:

What states have the most Nurse Practitioner Utilization Management jobs?

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

What are popular job titles related to Nurse Practitioner Utilization Management jobs?

For Nurse Practitioner Utilization Management jobs, the most frequently searched job titles are:

Nurse Practitioner Utilization Management jobs near you

RN, Utilization Management | Utilization Management

The Villages, FL • On-site

UF Health
Health Care and Social Assistance • 10K+ employees
Learn more about UF Healthexternal

Full-time

Re-posted 17 days ago

Job description

Overview

Join an onsite clinical team focused on ensuring the right care at the right time for every patient.

???? Work Style: Onsite
???? Location: The Villages, FL
???? FTE: Full-Time (1.0 FTE)
????️ Schedule: Monday – Friday (occasional weekends required)

Evaluates patient medical records to determine the medical necessity and appropriateness of healthcare services in alignment with utilization management guidelines. Collaborates with healthcare providers to support compliance, optimize treatment plans, and promote efficient resource utilization.

Communicates authorization decisions clearly and monitors patient progress to support timely discharge planning. Analyzes utilization data to identify trends and opportunities for process improvement.

Partners with interdisciplinary teams to enhance care coordination, ensure accurate documentation, and maintain compliance with regulatory and organizational standards.


Responsibilities

Key Responsibilities

  • Evaluates patient medical records to ensure the necessity and appropriateness of healthcare services.
  • Coordinates with healthcare providers to ensure compliance with utilization management guidelines.
  • Supports the optimization of treatment plans to promote effective patient care and appropriate resource utilization.
  • Communicates authorization decisions clearly and supports timely discharge planning.
  • Analyzes utilization data to identify trends and opportunities to improve care coordination.
  • Collaborates with interdisciplinary teams to ensure accurate documentation and regulatory compliance.

Qualifications

Education & Experience:


Registered Nurse (RN) with a current Florida license required.

  • Three (3) years of critical care nursing experience, or
  • Five (5) years of medical-surgical nursing experience, or
  • Three (3) years of utilization review, case management, or third-party payer experience.

Qualifications

  • Active Registered Nurse (RN) license with 3+ years of experience in utilization review or case management.
  • Strong knowledge of healthcare utilization management guidelines and regulatory compliance.
  • Experience evaluating medical necessity and optimizing treatment plans.
  • Excellent communication skills with the ability to clearly convey authorization decisions.
  • Ability to analyze utilization data and support effective care coordination.
  • Strong organizational skills with the ability to manage multiple priorities simultaneously.
  • Ability to work independently and collaboratively with multidisciplinary teams.
  • Strong attention to detail and innovative problem-solving skills.
  • Flexibility to adjust work hours and days based on departmental needs.

Motor Vehicle Operator Designation:
Employees in this position will not operate vehicles for an assigned business purpose.

Note: Please indicate the appropriate operator designation on the Request for Personnel (RFP) form at the time of submission.

Licensure/Certification/Registration:

  • Registered Nurse (RN) with a current Florida license required.

Apply