ZipRecruiter

Log In

1

Overnight Nurse Practitioner Utilization Review Jobs

Fusion HCR

Utilization Review Nurse

Las Vegas, NV · On-site

Direct Hire - Utilization Review Nurse, this is an onsite position, working with our client in Acute Care. Overview Seeking an experienced Utilization Review Nurse (RN) to review patient admissions ...

Tuba City Regional

Utilization Review

Tuba City, AZ · On-site

  • Medical

  • Dental

  • Vision

  • Retirement

RN - Utilization Review Ready for your next adventure? Axis Medical Staffing, one of the leading Travel Nursing Companies in the nation, has an immediate Monday - Friday from 8am - 5pm. Callback on ...

Oscar Health

Utilization Review Nurse

Tempe, AZ · Remote

$35 - $45.94/hr

We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You will perform frequent case reviews, check medical records and speak with care providers regarding ...

US Tech Solutions

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 ...

Shannon Health

Utilization Review Nurse

Big Spring, TX · On-site

Job Summary The Utilization Review (UR) Nurse has acute knowledge and skills in areas of utilization management (UM), medical necessity, and patient status determination. This individual supports the ...

Oscar Health

Utilization Review Nurse

Atlanta, GA · Remote

$35 - $45.94/hr

We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You will perform frequent case reviews, check medical records and speak with care providers regarding ...

Oscar Health

Utilization Review Nurse

Miami, FL · Remote

$35 - $45.94/hr

We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You will perform frequent case reviews, check medical records and speak with care providers regarding ...

Oscar Health

Utilization Review Nurse

Dallas, TX · Remote

$35 - $45.94/hr

We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You will perform frequent case reviews, check medical records and speak with care providers regarding ...

next page

Showing results 1-20

All JobsNurse Practitioner Utilization Review JobsOvernight Nurse Practitioner Utilization Review Jobs

Overnight Nurse Practitioner Utilization Review information

See salary details

$71K

$134.4K

$210.5K

How much do overnight nurse practitioner utilization review jobs pay per year?

As of Aug 13, 2026, the average yearly pay for overnight 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 are some unique challenges faced by Overnight Nurse Practitioner Utilization Review professionals, and how can they best manage them?

Overnight Nurse Practitioner Utilization Review professionals often face challenges such as managing high caseloads with limited immediate support, handling urgent authorization requests, and maintaining focus during extended night shifts. To manage these challenges, it is essential to develop strong time-management skills, utilize effective communication tools for collaborating with off-site colleagues, and prioritize self-care to prevent fatigue. Staying updated on the latest clinical guidelines and payer policies also helps ensure accurate and timely reviews.

What does an Overnight Nurse Practitioner Utilization Review do?

An Overnight Nurse Practitioner Utilization Review is responsible for assessing the medical necessity, appropriateness, and efficiency of healthcare services provided to patients during the overnight hours. They review patient records, treatment plans, and insurance documentation to ensure that care meets established guidelines and standards. These practitioners play a vital role in managing healthcare costs and ensuring patients receive the right care at the right time, while also working closely with physicians, case managers, and insurance companies. Their work helps prevent unnecessary hospitalizations and supports quality patient outcomes.

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

AspectOvernight Nurse Practitioner Utilization ReviewOvernight Nurse Practitioner Case Management
Primary FocusReviewing medical necessity and appropriateness of servicesCoordinating patient care and discharge planning
Work EnvironmentHospitals, insurance companies, healthcare facilitiesHospitals, clinics, outpatient settings
CredentialsNurse Practitioner license, certification in utilization reviewNurse Practitioner license, case management certification
Common TasksReview medical records, determine coverage, ensure complianceAssess patient needs, coordinate services, discharge planning

While both roles involve Nurse Practitioners working overnight, Utilization Review focuses on evaluating the necessity of care for insurance and compliance purposes, whereas Case Management emphasizes coordinating patient care and discharge planning. Understanding these differences helps healthcare organizations assign the right responsibilities to NPs based on their expertise.

What are the key skills and qualifications needed to thrive as an Overnight Nurse Practitioner Utilization Review?

A successful Overnight Nurse Practitioner Utilization Review professional requires advanced clinical knowledge, an active NP license, and experience in utilization management or case review. Familiarity with medical necessity criteria (e.g., InterQual or MCG), electronic medical records (EMRs), and payer authorization systems is crucial. Outstanding critical thinking, attention to detail, and effective communication are essential soft skills for evaluating cases and collaborating with healthcare teams remotely. These qualifications ensure accurate, timely care decisions and compliance with insurance and regulatory standards, even during off-hours.
What cities are hiring for Overnight Nurse Practitioner Utilization Review jobs? Cities with the most Overnight 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:
What states have the most Overnight Nurse Practitioner Utilization Review jobs? States with the most job openings for Overnight Nurse Practitioner Utilization Review jobs include:
Overnight Nurse Practitioner Utilization Review jobs near you

Utilization Review Nurse

Maniilaq Association

Kotzebue, AK • On-site

Other

Posted 10 days ago

Job description

Maniilaq Association is a P.L. 93-638 Native/Indian Preference/EEO Employer
Start Over with Job Search
RETURNING APPLICANT? Login Now

Utilization Review Nurse Job Code: 2026:OTZ-201 Location: Kotzebue, Alaska Program: Nursing Division FT/PT Status: Full Time Job Responsibilities:
MANIILAQ ASSOCIATION
5/2026
Title: Utilization Management Nurse Pay Grade: 31
Program: Nursing Status: Exempt
Housing Priority: 3 Covered: Yes
POSITION SUMMARY
The Utilization Management Nurse (UMN) is responsible for performing Utilization Review and managing risk, coordinates and facilitates with departmental staff on Durable Medical Equipment (DME), and pharmacy prior authorizations. THE UMN works with the medical treatment and case management team in the coordination of patient care including the development of new operational changes and new services to ensure compliance and risk mitigation. The UMN will use a process that includes screening and case finding, comprehensive multidimensional assessment, connection with available resources, implementation of the plan and ongoing monitoring and re-assessment/follow-up. The UMN assists with the Quality and Case Management programs and, coordinates the IPC4 program. This position reports directly to the Chief Nursing Officer or designee.
PRINCIPAL DUTIES AND RESPONSIBILITIES
  1. Coordinates the IPC4 process in Medicare/Medicaid and private insurances.
  2. Assists in revenue procurement by:making sure insurance approvals are completed correctly with no penalty; helping to identify alternate resources of funding such as VA, Denali Kid Care, Medicare, and Medicaid; and monitoring the appeal process when claims are denied.
  3. Chairs Quarterly Utilization Review Committee meetings to improve utilization of resources and improve patient care.
  4. Submits Quarterly reports to CMO and CNO for Board of Director meetings.
  5. Works closely with Coders and Billers to insure accurate, timely billing information.
  6. Completes Utilization Review processes as assigned.
  7. Oversees development and maintenance of a resource database of Federal, State, community, and institutional resources.
  8. Assists in arranging team conferences and networks for relationship building and resource development with village leaders, Community Health Aides/Practitioners, MHC Medical Staff, MHC Nursing Staff, private insurance contacts, Medicaid/Medicare contacts, ANMC Providers, and the CM/SC/UR Team.
  9. Participates on improvement projects as assigned.
  10. Participates in Medicaid Task Force committee through Alaska Native Health Board.
  11. Completes Quality Improvement, Quality Assurance and Performance Improvement projects and tasks as assigned.
  12. Utilizes team building, problem solving skills and lean principles in the on-going quality improvement initiatives.
  13. Identify, assess, and monitor potential clinical, operational, and compliance risks within the Utilization Review and Case Management programs.
  14. Report and document incidents, near-misses, and adverse events in accordance with organizational policy and regulatory standards.
  15. Participate in root cause analyses and collaborate with leadership to implement corrective action plans to mitigate future risks.
  16. Collaborate with the Risk Management team to review, update, and communicate policies and procedures relevant to utilization review and patient care coordination.
  17. Educate clinical and administrative staff on risk awareness, safety protocols, and compliance requirements.
  18. Coordinate and facilitate prior authorizations for DME by collaborating with patients, clinical staff and providers to ensure clients' needs are met.
  19. Collaborate with providers and pharmacist process prior authorizations for specialized high-cost medications; monitor appeal process if claims are denied.
Job Qualifications:
MINIMUM REQUIREMENTS
Current licensure as a RN with at least two years of Case Management, Utilization Review, Discharge Planning or Quality Improvement experience preferred. Knowledge of acute and chronic illnesses, specialty clinic procedures, and community health nursing. Must be able to pass the core competencies assigned to this position and maintain the educational requirements of the program. Ability to utilize various computer programs, including Cerner and Microsoft Office. Demonstrates a wide theory base in order to interact in an effective manner with physicians, health team members, community agencies, and clients/families with diverse opinions, values, and religious and cultural ideals. Ability to work autonomously with little direction and be directly accountable for practice. Knowledge of and experience working with all regulatory, state, and federal agencies.
Other Job Information (if applicable):
DISCLAIMER
The above statements are intended to describe the general nature and level of work being performed by people assigned to this job. They are not intended to be considered an exhaustive list of all responsibilities, duties and skills required of personnel in this job, and the employer reserves the right to revise or change this description. This description does not constitute a written or implied contract of employment. To perform this job successfully, an individual must be able to satisfactorily perform each of the above essential duties and meet physical demands. Reasonable accommodations may be made to enable individuals with disabilities to meet those conditions.

Apply