Utilization Review Nurse
Methuen, MA · On-site
Utilization Review Nurse Responsible for determining the appropriateness of hospital admission, utilization of resources and medical necessity for continued stay. Responsible for working with the ...
Utilization Review Nurse
Methuen, MA · On-site
Utilization Review Nurse Responsible for determining the appropriateness of hospital admission, utilization of resources and medical necessity for continued stay. Responsible for working with the ...
Utilization Review Nurse
Methuen, MA · On-site
... they relate to utilization review and discharge planning and payer regulations. MINIMUM EDUCATION AND EXPERIENCE: Required: * Graduate of an accredited professional nursing school * Current ...
Utilization Review Nurse
Methuen, MA · On-site
... they relate to utilization review and discharge planning and payer regulations. MINIMUM EDUCATION AND EXPERIENCE: Required: * Graduate of an accredited professional nursing school * Current ...
... they relate to utilization review and discharge planning and payer regulations. MINIMUM EDUCATION AND EXPERIENCE: Required: * Graduate of an accredited professional nursing school * Current ...
... they relate to utilization review and discharge planning and payer regulations. MINIMUM EDUCATION AND EXPERIENCE: Required: * Graduate of an accredited professional nursing school * Current ...
Utilization Review Nurse
Methuen, MA · On-site
... they relate to utilization review and discharge planning and payer regulations. MINIMUM EDUCATION AND EXPERIENCE: Required: * Graduate of an accredited professional nursing school * Current ...
Utilization Review Nurse
Methuen, MA · On-site
... they relate to utilization review and discharge planning and payer regulations. MINIMUM EDUCATION AND EXPERIENCE: Required: * Graduate of an accredited professional nursing school * Current ...
Utilization Review Nurse
Methuen, MA · On-site
... they relate to utilization review and discharge planning and payer regulations. MINIMUM EDUCATION AND EXPERIENCE: Required: * Graduate of an accredited professional nursing school * Current ...
Utilization Review Nurse
Methuen, MA · On-site
... they relate to utilization review and discharge planning and payer regulations. MINIMUM EDUCATION AND EXPERIENCE: Required: * Graduate of an accredited professional nursing school * Current ...
Utilization Review Nurse
Methuen, MA · On-site
... they relate to utilization review and discharge planning and payer regulations. MINIMUM EDUCATION AND EXPERIENCE: Required: * Graduate of an accredited professional nursing school * Current ...
Utilization Review Nurse
Methuen, MA · On-site
... they relate to utilization review and discharge planning and payer regulations. MINIMUM EDUCATION AND EXPERIENCE: Required: * Graduate of an accredited professional nursing school * Current ...
UTILIZATION REVIEW NURSE
Norfolk, VA · On-site
$10K/mo
The Utilization Review Nurse is responsible for utilization management services within the scope of licensure. Conducts primary functions of prior authorization, retrospective review, medical ...
UTILIZATION REVIEW NURSE
Norfolk, VA · On-site
$10K/mo
The Utilization Review Nurse is responsible for utilization management services within the scope of licensure. Conducts primary functions of prior authorization, retrospective review, medical ...
... they relate to utilization review and discharge planning and payer regulations. MINIMUM EDUCATION AND EXPERIENCE: Required: * Graduate of an accredited professional nursing school * Current ...
... they relate to utilization review and discharge planning and payer regulations. MINIMUM EDUCATION AND EXPERIENCE: Required: * Graduate of an accredited professional nursing school * Current ...
Utilization Review Nurse
Methuen, MA · On-site
... they relate to utilization review and discharge planning and payer regulations. MINIMUM EDUCATION AND EXPERIENCE: Required: * Graduate of an accredited professional nursing school * Current ...
Utilization Review Nurse
Methuen, MA · On-site
... they relate to utilization review and discharge planning and payer regulations. MINIMUM EDUCATION AND EXPERIENCE: Required: * Graduate of an accredited professional nursing school * Current ...
Utilization Review Nurse
Lawrence, MA · On-site
... they relate to utilization review and discharge planning and payer regulations. MINIMUM EDUCATION AND EXPERIENCE: Required: * Graduate of an accredited professional nursing school * Current ...
Utilization Review Nurse
Lawrence, MA · On-site
... they relate to utilization review and discharge planning and payer regulations. MINIMUM EDUCATION AND EXPERIENCE: Required: * Graduate of an accredited professional nursing school * Current ...
Utilization Review Nurse
Lawrence, MA · On-site
... they relate to utilization review and discharge planning and payer regulations. MINIMUM EDUCATION AND EXPERIENCE: Required: * Graduate of an accredited professional nursing school * Current ...
Utilization Review Nurse
Lawrence, MA · On-site
... they relate to utilization review and discharge planning and payer regulations. MINIMUM EDUCATION AND EXPERIENCE: Required: * Graduate of an accredited professional nursing school * Current ...
UTILIZATION REVIEW NURSE
Norfolk, VA · On-site +1
The Utilization Review Nurse is responsible for utilization management services within the scope of licensure. Conducts primary functions of prior authorization, retrospective review, medical ...
UTILIZATION REVIEW NURSE
Norfolk, VA · On-site +1
The Utilization Review Nurse is responsible for utilization management services within the scope of licensure. Conducts primary functions of prior authorization, retrospective review, medical ...
Utilization Review Nurse
West Chester, PA · On-site
The Utilization Review Nurse will provide utilization review for authorization, concurrent review and discharge review services using InterQual criteria guidelines to validate medical necessity and ...
Utilization Review Nurse
West Chester, PA · On-site
The Utilization Review Nurse will provide utilization review for authorization, concurrent review and discharge review services using InterQual criteria guidelines to validate medical necessity and ...
Utilization Review Nurse
$29 - $30/hr
Responds in a timely manner to the providers and/or practitioners if there is a request for ... Utilization Review/Management, HEDIS, Chart Auditing, Medical Record Reviews] Additional ...
Utilization Review Nurse
$29 - $30/hr
Responds in a timely manner to the providers and/or practitioners if there is a request for ... Utilization Review/Management, HEDIS, Chart Auditing, Medical Record Reviews] Additional ...
$10K/mo
The Utilization Review Nurse is responsible for utilization management services within the scope of licensure. Conducts primary functions of prior authorization, retrospective review, medical ...
$10K/mo
The Utilization Review Nurse is responsible for utilization management services within the scope of licensure. Conducts primary functions of prior authorization, retrospective review, medical ...
UTILIZATION REVIEW NURSE
Norfolk, VA · On-site
$10K/mo
The Utilization Review Nurse is responsible for utilization management services within the scope of licensure. Conducts primary functions of prior authorization, retrospective review, medical ...
UTILIZATION REVIEW NURSE
Norfolk, VA · On-site
$10K/mo
The Utilization Review Nurse is responsible for utilization management services within the scope of licensure. Conducts primary functions of prior authorization, retrospective review, medical ...
Utilization Review Nurse
West Chester, PA · On-site
The Utilization Review Nurse will provide utilization review for authorization, concurrent review and discharge review services using InterQual criteria guidelines to validate medical necessity and ...
Utilization Review Nurse
West Chester, PA · On-site
The Utilization Review Nurse will provide utilization review for authorization, concurrent review and discharge review services using InterQual criteria guidelines to validate medical necessity and ...
Utilization Review Nurse
West Chester, PA · On-site
The Utilization Review Nurse will provide utilization review for authorization, concurrent review and discharge review services using InterQual criteria guidelines to validate medical necessity and ...
Utilization Review Nurse
West Chester, PA · On-site
The Utilization Review Nurse will provide utilization review for authorization, concurrent review and discharge review services using InterQual criteria guidelines to validate medical necessity and ...
Must be an RN Utilization Review background in either Managed Care of Provider environment (at least one year) Interqual experience Other basic computer skills necessary: Microsoft Office, Data Entry ...
Must be an RN Utilization Review background in either Managed Care of Provider environment (at least one year) Interqual experience Other basic computer skills necessary: Microsoft Office, Data Entry ...
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 ...
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 ...
Nurse Practitioner Utilization Review information
See salary details
$71K - $83.7K
3% of jobs
$83.7K - $96.4K
7% of jobs
$96.4K - $109K
12% of jobs
$110K is the 25th percentile. Wages below this are outliers.
$109K - $121.7K
34% of jobs
$121.7K - $134.4K
9% of jobs
$145.4K is the 75th percentile. Wages above this are outliers.
$134.4K - $147.1K
12% of jobs
$147.1K - $159.8K
6% of jobs
$159.8K - $172.5K
5% of jobs
$172.5K - $185.1K
5% of jobs
$185.1K - $197.8K
3% of jobs
$197.8K - $210.5K
3% of jobs
$71K
$134.4K
$210.5K
How much do nurse practitioner utilization review jobs pay per year?
As of Sep 12, 2026, the average yearly pay for nurse practitioner utilization review 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 a nurse practitioner utilization review?
A Nurse Practitioner Utilization Review (NP UR) job involves evaluating medical records to ensure treatments are medically necessary, cost-effective, and compliant with healthcare guidelines. NP UR professionals work with insurance companies, healthcare organizations, or government agencies to review patient care decisions, approve or deny claims, and recommend alternative treatments when needed. They use clinical expertise to assess whether services align with best practices and healthcare policies. This role is typically non-clinical, involving case reviews, documentation, and collaboration with healthcare providers. It helps improve patient care efficiency while controlling costs.
What are common day-to-day responsibilities for a nurse practitioner utilization review?
A Nurse Practitioner Utilization Review typically spends their day evaluating patient records, determining medical necessity of treatments, and ensuring care meets established guidelines and payer requirements. This role involves frequent collaboration with physicians, case managers, and insurance representatives to clarify or appeal decisions as needed. You may also participate in team meetings, develop recommendations for optimizing utilization, and provide education to clinical staff regarding documentation or policy changes. The work is often remote or office-based, with a predictable schedule and minimal direct patient contact. This structure allows for a balanced workload and a focus on analytical aspects of patient care.
What are the key skills and qualifications needed to thrive in the nurse practitioner utilization review position, and why are they important?
To thrive as a Nurse Practitioner Utilization Review, you need advanced clinical knowledge, current NP licensure, and expertise in reviewing medical records for appropriateness of care. Familiarity with utilization management software, ICD-10/CPT coding, and case management systems is typically required, along with relevant certifications such as URAC or CCM. Strong analytical thinking, attention to detail, effective written communication, and collaboration skills help you excel in evaluating care plans and working with multi-disciplinary teams. These abilities ensure accurate assessment of healthcare services, optimal resource use, and regulatory compliance within healthcare organizations.
More about Nurse Practitioner Utilization Review jobs
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Cities with the most 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:
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States with the most job openings for Nurse Practitioner Utilization Review jobs include:
What are popular job titles related to Nurse Practitioner Utilization Review jobs?
For Nurse Practitioner Utilization Review jobs, the most frequently searched job titles are:
Utilization Review Nurse
Methuen, MA • On-site
Merrimack Health
Other
Posted 15 days ago
Job description
Utilization Review Nurse
Responsible for determining the appropriateness of hospital admission, utilization of resources and medical necessity for continued stay. Responsible for working with the Clinical Care Coordinator and Complex Care Manager to facilitate timely discharge, assure medical documentation accurately reflects the patient's severity of illness; and ensures compliance with the conditions of participation as they relate to utilization review and discharge planning and payer regulations.
Minimum Education and Experience:
Required:
- Graduate of an accredited professional nursing school
- Current Massachusetts Nursing license
- Five years clinical nursing experience
- Demonstrated verbal, written skills
- Computer skills
Preferred:
- Master's degree.