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Overnight Utilization Review Nurse Jobs (NOW HIRING)

Sentara Health Plans

$65 - $85/hr

The Utilization Review Nurse is responsible for utilization management services within the scope of licensure. Conducts primary functions of prior authorization, retrospective review, medical ...

New

Sentara Health Plans

UTILIZATION REVIEW NURSE

Norfolk, VA · On-site

$65 - $85/hr

The Utilization Review Nurse is responsible for utilization management services within the scope of licensure. Conducts primary functions of prior authorization, retrospective review, medical ...

New

Acrisure, LLC

Utilization Review Nurse

Bradenton, FL · On-site

$55 - $90/hr

Utilization Review Nurse, LPN** to evaluate treatment requests and help ensure injured workers receive appropriate, timely care in accordance with applicable clinical guidelines and regulatory ...

Acrisure

Utilization Review Nurse

Bradenton, FL · On-site

Acrisure is seeking a Utilization Review Nurse, LPN to evaluate treatment requests and help ensure injured workers receive appropriate, timely care in accordance with applicable clinical guidelines ...

Acrisure, LLC

$55 - $90/hr

Utilization Review Nurse, LPN** to evaluate treatment requests and help ensure injured workers receive appropriate, timely care in accordance with applicable clinical guidelines and regulatory ...

New

Acrisure

Utilization Review Nurse

Bradenton, FL

Acrisure is seeking a Utilization Review Nurse, LPN to evaluate treatment requests and help ensure injured workers receive appropriate, timely care in accordance with applicable clinical guidelines ...

AbsoluteCare

Utilization Review Nurse

New Orleans, LA · On-site

The Utilization Review Nurse ensures appropriate utilization of health services by performing initial, concurrent and retrospective clinical case reviews. This role collaborates and communicates with ...

Merrimack Health

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 ...

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Overnight Utilization Review Nurse information

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$42

$68

How much do overnight utilization review nurse jobs pay per hour?

As of Sep 2, 2026, the average hourly pay for overnight utilization review nurse in the United States is $42.28, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 per hour, depending on experience, location, and employer.

What does an Overnight Utilization Review nurse do?

An Overnight Utilization Review Nurse is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services provided to patients during overnight hours. They review medical records, treatment plans, and insurance requirements to ensure that care meets established guidelines and is medically necessary. By working overnight, these nurses help healthcare facilities maintain 24/7 compliance with regulations and facilitate timely patient care decisions. Their role is critical in managing healthcare costs, preventing unnecessary treatments, and ensuring that patients receive appropriate care without delay.

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

To thrive as an Overnight Utilization Review Nurse, you need a solid clinical background, critical thinking skills, and an active RN license, often with experience in case management or utilization review. Familiarity with medical necessity criteria (such as InterQual or MCG), electronic health records (EHRs), and utilization management software is typically required. Excellent written communication, attention to detail, and the ability to work independently during overnight hours are valuable soft skills. These competencies ensure accurate assessment of care appropriateness, regulatory compliance, and efficient coordination between healthcare providers during non-traditional hours.

What are some unique challenges faced by overnight utilization review nurses, and how can they be managed?

Overnight Utilization Review Nurses often work independently during off-hours, which can present challenges such as limited immediate access to clinical teams and support staff. Managing urgent authorizations and coordinating care with providers who may not be readily available requires strong communication and problem-solving skills. Staying organized and utilizing clear documentation help ensure continuity of care between night and day shifts. Developing proficiency with electronic health record systems and maintaining effective handoff procedures are essential for success in this role.

What is the difference between Overnight Utilization Review Nurse vs Utilization Review Nurse?

AspectOvernight Utilization Review NurseUtilization Review Nurse
CertificationsRegistered Nurse (RN), possibly case management certificationRegistered Nurse (RN), possibly case management certification
Work EnvironmentNight shifts, hospital or insurance setting, remote or onsiteDay shifts, hospital, insurance, or healthcare facility
Employer & IndustryHospitals, insurance companies, healthcare organizationsHospitals, insurance companies, healthcare organizations

The main difference is that the Overnight Utilization Review Nurse works primarily during night shifts, focusing on reviewing patient cases overnight, while the Utilization Review Nurse typically works during daytime hours. Both roles require similar credentials and are found in similar settings, but their schedules and shift timings distinguish them.

More about Overnight Utilization Review Nurse jobs

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

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Overnight Utilization Review Nurse jobs near you
Infographic showing various Overnight Utilization Review Nurse job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 14% Part Time, 1% Temporary, and 3% Contract. Highlights an 88% Physical, 3% Hybrid, and 9% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

UTILIZATION REVIEW NURSE

Sentara Healthcare

Norfolk, VA • On-site, Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 8 days ago

Sentara Health rating

6.8

Company rating: 6.8 out of 10

Based on 416 frontline employees who took The Breakroom Quiz

498th of 898 rated healthcare providers

Job description

City/State
Norfolk, VA
Work Shift
First (Days)
Overview:
Sentara Health Plans Community Care is looking to hire a Utilization Review Nurse.
The Utilization Review Nurse is responsible for utilization management services within the scope of licensure. Conducts primary functions of prior authorization, retrospective review, medical director referrals and execution of member/provider approval and/or denial letter. Reviews provider requests for services requiring authorization. Conducts pre-certification, care coordination for appropriateness of treatment, set reviews to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts.
Responsible for written and/or verbal notification to members and providers. Ensures medical director written decision is consistent with criteria (CMS, state, medical policy, clinical criteria). Facilitates accreditation by knowing, understanding, correctly interpreting, and accurately applying accrediting and regulatory requirements and standards.
Education:
• BSN (preferred)
Certification:
• Registered Nurse (required)
Experience:
• 3 years of acute care clinical experience (required)
• Previous Utilization Review experience (preferred)
• Milliman experience (preferred)
• Knowledge of NCQA (preferred)
• Microsoft suite (Word, Excel, Outlook) (preferred)
• Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills
Keywords: Talroo- Health, Utilization Review Nurse, RN, Care Coordination, or Discharge Planning, Case Management, Milliman, NCQA
Benefits: Caring For Your Family and Your Career
• Medical, Dental, Vision plans
• Adoption, Fertility and Surrogacy Reimbursement up to 10,000
• Paid Time Off and Sick Leave
• Paid Parental & Family Caregiver Leave
• Emergency Backup Care
• Long-Term, Short-Term Disability, and Critical Illness plans
• Life Insurance
• 401k/403B with Employer Match
• Tuition Assistance - 5,250/year and discounted educational opportunities through Guild Education
• Student Debt Pay Down - 10,000
• Pet Insurance
• Legal Resources Plan
• Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.
Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
In support of our mission "to improve health every day," this is a tobacco-free environment.
For positions that are available as remote work, Sentara Health employs associates in the following states:
Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.

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