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Per Diem Nurse Practitioner Utilization Review information

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$71K

$134.4K

$210.5K

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

As of Aug 26, 2026, the average yearly pay for per diem 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 per diem nurse practitioner utilization review?

A Per Diem Nurse Practitioner Utilization Review is a healthcare professional who works on a flexible, as-needed basis to assess the medical necessity and efficiency of healthcare services provided to patients. Their primary role is to review patient records, clinical documentation, and treatment plans to ensure they meet established guidelines and standards. They help optimize healthcare resource use and improve patient outcomes by collaborating with providers, insurance companies, and other stakeholders. This position typically offers flexible hours and may involve remote or on-site work depending on the employer.

What are some common challenges faced by per diem nurse practitioners in utilization review positions?

Per Diem Nurse Practitioners in Utilization Review often encounter challenges such as balancing fluctuating caseloads, adapting quickly to different team workflows, and staying current with changing insurance guidelines and clinical protocols. Since the role typically involves remote work and collaboration with multidisciplinary teams, strong communication and time management skills are essential. Additionally, as per diem staff, building rapport and integrating seamlessly with full-time colleagues can require extra effort, but it also offers valuable exposure to diverse cases and work environments.

What are the key skills and qualifications needed to thrive as a per diem nurse practitioner utilization review, and why are they important?

To thrive as a Per Diem Nurse Practitioner Utilization Review, you need advanced clinical knowledge, a current NP license, and experience in case management or utilization review. Familiarity with utilization management software, electronic health records (EHRs), and certification such as CCM (Certified Case Manager) are often required. Strong analytical thinking, attention to detail, and effective communication are vital soft skills for evaluating medical necessity and collaborating with providers. These skills ensure accurate, evidence-based decisions that optimize patient outcomes while controlling healthcare costs.

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

AspectPer Diem Nurse Practitioner Utilization ReviewPer Diem Nurse Practitioner Case Management
CredentialsRN, NP, certification in utilization reviewRN, NP, case management certification
Work EnvironmentInsurance companies, hospitals, review organizationsHospitals, clinics, insurance companies, patient coordination
Primary FocusAssessing medical necessity for services and coverageCoordinating patient care and discharge planning
Usage in IndustryCommonly used for insurance and payer reviewsCommonly used for patient care coordination

While both roles involve nurse practitioners working in a per diem capacity, the Utilization Review focuses on evaluating the necessity of services for insurance coverage, whereas Case Management emphasizes coordinating patient care and discharge planning. Understanding these differences helps in choosing the right role based on your skills and career goals.

What cities are hiring for Per Diem Nurse Practitioner Utilization Review jobs?

Cities with the most Per Diem 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 Per Diem Nurse Practitioner Utilization Review jobs?

States with the most job openings for Per Diem Nurse Practitioner Utilization Review jobs include:

Per Diem Nurse Practitioner Utilization Review jobs near you
Infographic showing various Per Diem Nurse Practitioner Utilization Review job openings in the United States as of July 2026, with employment types broken down into 1% Locum Tenens, 19% As Needed, 36% Full Time, 22% Part Time, and 22% Contract. Highlights an 99% Physical, and 1% Remote job distribution, with an average salary of $134,369 per year, or $64.6 per hour.

Utilization Review RN - Per Diem*

Gardnerville, NV • On-site

CARSON VALLEY HEALTH
Health Care and Social Assistance • 501 - 1,000 employees

8.9

Company rating: 8.9 out of 10

Based on 8 frontline employees who took The Breakroom Quiz

Great coworkers

People enjoy working here

Good employer

Learn more about CARSON VALLEY HEALTHexternal

Other

Re-posted 29 days ago

Job description

Utilization Review RN - Per Diem

*IMPORTANT NOTE: In lieu of benefits due to "per diem" status, 15% will be added to the hourly rate. Per diem employees are offered work on an "as-needed" basis.

Position Summary:

Performs clinically orientated medical chart reviews and other administrative tasks to meet the requirements of the medical center's utilization review plan, state and federal regulations, insurance company requirements for reimbursement.

Position Requirements:

Minimum Education

  • A Bachelor's Degree in Nursing preferred; three (3) years of clinical care or nursing experience; OR an equivalent combination of education and experience AND (2) two years' experience Utilization Review.

Certificate Preferred

  • CCM (certification in case management) is preferred.

License Required

  • Must be licensed as a Registered Nurse by the State of Nevada, and remain active with all annual licensing requirements.

Minimum Work Experience

  • Minimum of 1 year of case management or utilization management experience.
  • Knowledge of InterQual or McKesson criteria preferred.
  • Knowledge in conducting a medical record review for medical necessity.
  • Knowledge of basic ICD-10, CPT coding knowledge preferred.
  • Basic knowledge of regulations as set forth by The Centers for Medicare Medicaid Services.
  • Skill in operating a personal computer utilizing a variety of software applications.
  • Strong written and oral communication skills
  • Skill and ability to work independently
Position Essential Functions:

Chart Review

  • Conducts chart review to determine that InterQual-based care criteria is met.
  • Assist in determining if patients are in the correct hospital setting
  • Review elective surgery schedule
  • Review outpatient charts (observation)
  • Obtains appropriate patient records as required by payor agencies and initiates the UR Medical Director as necessary for unwarranted admissions

Hospital Reimbursements

  • Understand and demonstrate the requirements needed to maximize reimbursement to the hospital
  • Assist in obtaining authorizations as needed; including follow-up
  • Respond to insurance providers in a timely and thorough manner
  • Communicates with various hospital departments in a meaningful manner
  • Assists in ensuring appropriate room charges, patient status, discharge disposition, etc.
  • Reviews denials and collaborates on appeals of denials
  • Communicates with HIM staff and resolves discrepancies

Knowledge

  • Condition 44 documentation and requirement; HINN notification letters, ABN-advance beneficiary notice, Important Letter from Medicare, etc
  • Maintains practices consistent with the hospital's utilization review (UR) plan
  • Reviews the plans components and is a member of the utilization review committee
  • Obtains data and statistics addressed in the hospital's UR plan and presents information as needed
  • Ensures appropriate and cost-effective healthcare services to patients

Documentation

  • Demonstrates understanding and supports clinical documentation improvement strategies
  • Ability to efficiently locate priority clinical information in a medical record, and to critically interpret that information as part of a treatment plan.
  • Analyze clinical information to identify areas with potential for documentation improvement
  • Demonstrates collaborative work relationship with coding staff to assure documentation of discharge diagnosis and co-morbidities are complete and accurately reflect the patient's clinical status and care.
  • Reviews medical records concurrently, recognizes opportunities for documentation improvement, and follows up with appropriate staff.
  • Facilitates modifications to clinical documentation through collaborative interactions with physicians, nurses, and ancillary staff.

Carson Valley Health is proud to be recognized as a finalist in the "Best Places to Work" - Northern Nevada, 2021, 2022, 2024, 2025 & 2026!

We look forward to welcoming you to our team!

Per diem positions have no guaranteed hours or set schedule. The position will fill in for individuals who take unplanned and/or planned time off.

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