Utilization Review Nurse
Troy, MI · On-site
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
Troy, MI · On-site
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
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 ...
Quick apply
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 ...
Senior Nurse Practitioner
$158K - $192K/yr
... Senior Nurse Practitioner to join our patient-centered clinical team within Family Medicine and ... The Board may review transcripts to determine eligibility. Proof of education or licensure is ...
Senior Nurse Practitioner
$158K - $192K/yr
... Senior Nurse Practitioner to join our patient-centered clinical team within Family Medicine and ... The Board may review transcripts to determine eligibility. Proof of education or licensure is ...
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 ...
Quick apply
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 ...
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 ...
Quick apply
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 ...
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 ...
Quick apply
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 ...
The Utilization Review Specialist Senior responsibilities include: * Functions as the primary ... Preferred experience includes Critical Care or Emergency Nursing RN. Position details: * Location:
The Utilization Review Specialist Senior responsibilities include: * Functions as the primary ... Preferred experience includes Critical Care or Emergency Nursing RN. Position details: * Location:
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 ...
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 ...
This role requires strong collaboration with surgeons, physician assistants, nurse practitioners ... Utilization Review or Case Management experience Required License/Registration/Certification:
This role requires strong collaboration with surgeons, physician assistants, nurse practitioners ... Utilization Review or Case Management experience Required License/Registration/Certification:
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 ...
New
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 ...
New
Sr Nurse Practitioner (Emergency Medicine) - #Staff
Baltimore, MD · On-site
$108K - $152K/yr
Prepare chart documentation for review and counter signature by the physician. * Determine ... Remain proficient in the utilization of commonly used clinical protocols and guidelines. * Remain ...
Sr Nurse Practitioner (Emergency Medicine) - #Staff
Baltimore, MD · On-site
$108K - $152K/yr
Prepare chart documentation for review and counter signature by the physician. * Determine ... Remain proficient in the utilization of commonly used clinical protocols and guidelines. * Remain ...
Prepare chart documentation for review and counter signature by the physician. * Determine ... Remain proficient in the utilization of commonly used clinical protocols and guidelines. * Remain ...
Prepare chart documentation for review and counter signature by the physician. * Determine ... Remain proficient in the utilization of commonly used clinical protocols and guidelines. * Remain ...
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 ...
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 ...
Travel Utilization Review
Tuba City, AZ · On-site
Reliable Nurse Staffing is seeking a travel Utilization Review for a travel job in Tuba City, Arizona. & Requirements * Specialty: Utilization Review * Discipline: Therapy * Start Date: 09/07/2026
Travel Utilization Review
Tuba City, AZ · On-site
Reliable Nurse Staffing is seeking a travel Utilization Review for a travel job in Tuba City, Arizona. & Requirements * Specialty: Utilization Review * Discipline: Therapy * Start Date: 09/07/2026
Senior Nurse Practitioner
Modesto, CA · On-site
$158K - $192K/yr
The Senior Nurse Practitioner classification is distinguished from the Staff Nurse by an additional ... The Board may review transcripts to determine eligibility. Proof of education or licensure is ...
Senior Nurse Practitioner
Modesto, CA · On-site
$158K - $192K/yr
The Senior Nurse Practitioner classification is distinguished from the Staff Nurse by an additional ... The Board may review transcripts to determine eligibility. Proof of education or licensure is ...
Utilization Review Nurse
Syracuse, NY · On-site
Utilization Review Experience, the nurse can come from a Hospital, Home Health, or Managed Care company/ health plan Additional Information Hello! My name is Krishna Gapuz and I am a R ecruiting ...
Utilization Review Nurse
Syracuse, NY · On-site
Utilization Review Experience, the nurse can come from a Hospital, Home Health, or Managed Care company/ health plan Additional Information Hello! My name is Krishna Gapuz and I am a R ecruiting ...
Utilization Review Nurse
Omaha, NE · On-site
Utilization Review Nurse We have openings in our Omaha, Nebraska office for Utilization Review Nurses. The Utilization Review Nurse ensures all aspects of an injured worker's treatment are effective ...
Utilization Review Nurse
Omaha, NE · On-site
Utilization Review Nurse We have openings in our Omaha, Nebraska office for Utilization Review Nurses. The Utilization Review Nurse ensures all aspects of an injured worker's treatment are effective ...
Utilization Review Nurse
Las Vegas, NV · On-site
About the job Utilization Review Nurse Sign on bonus may apply up to $15,000 Position Summary: Reviews patient admissions for appropriateness, efficiency of resource utilization and compliance with ...
Utilization Review Nurse
Las Vegas, NV · On-site
About the job Utilization Review Nurse Sign on bonus may apply up to $15,000 Position Summary: Reviews patient admissions for appropriateness, efficiency of resource utilization and compliance with ...
Prepare chart documentation for review and counter signature by the physician. * Determine ... Remain proficient in the utilization of commonly used clinical protocols and guidelines. * Remain ...
Prepare chart documentation for review and counter signature by the physician. * Determine ... Remain proficient in the utilization of commonly used clinical protocols and guidelines. * Remain ...
Utilization Review Nurse
Miami, FL · On-site
Utilization Review Nurse Job Summary The Utilization Nurse is responsible for conducting prospective, concurrent, and retrospective clinical reviews to determine medical necessity, level of care, and ...
Utilization Review Nurse
Miami, FL · On-site
Utilization Review Nurse Job Summary The Utilization Nurse is responsible for conducting prospective, concurrent, and retrospective clinical reviews to determine medical necessity, level of care, and ...
Senior Nurse Practitioner Utilization Review information
See salary details
$21.39 - $25.72
2% of jobs
$25.72 - $30.05
9% of jobs
$33.01 is the 25th percentile. Wages below this are outliers.
$30.05 - $34.38
21% of jobs
The median wage is $37.88 / hr.
$34.38 - $38.70
23% of jobs
$38.70 - $43.03
13% of jobs
$46.39 is the 75th percentile. Wages above this are outliers.
$43.03 - $47.36
10% of jobs
$47.36 - $51.68
8% of jobs
$51.68 - $56.01
5% of jobs
$56.01 - $60.34
5% of jobs
$60.34 - $64.66
2% of jobs
$64.66 - $68.99
2% of jobs
$21
$42
$68
How much do senior nurse practitioner utilization review jobs pay per hour?
As of Aug 10, 2026, the average hourly pay for senior nurse practitioner utilization review 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 a senior nurse practitioner utilization review do?
A Senior Nurse Practitioner Utilization Review is responsible for evaluating medical records and treatment plans to ensure that healthcare services provided to patients are medically necessary, appropriate, and efficient. They use clinical expertise to review cases, collaborate with physicians and insurance companies, and help determine the level of care required. This role also involves identifying potential areas for improvement in patient care and contributing to policy development to enhance healthcare quality and resource management.
What are the key skills and qualifications needed to thrive as a senior nurse practitioner utilization review, and why are they important?
To excel as a Senior Nurse Practitioner Utilization Review, you need advanced clinical expertise, a graduate nursing degree (MSN or DNP), active NP licensure, and experience in case management or utilization review. Familiarity with utilization management software, electronic health records (EHRs), and knowledge of payer guidelines and regulatory standards like CMS are typically required. Strong analytical thinking, communication, and negotiation skills help in decision-making and collaborating with healthcare teams and insurance providers. These competencies ensure appropriate resource utilization, compliance, and optimal patient outcomes while balancing cost-effectiveness and care quality.
How does a senior nurse practitioner utilization review typically collaborate with physicians and other healthcare professionals?
Senior Nurse Practitioners in Utilization Review frequently work in multidisciplinary teams, collaborating closely with physicians, case managers, and insurance representatives. They review patient records, assess the medical necessity of treatments, and communicate recommendations or decisions to ensure alignment with clinical guidelines. Building strong working relationships and maintaining clear, professional communication is essential, as these interactions help streamline care delivery, resolve discrepancies, and advocate for optimal patient outcomes.
What is the difference between Senior Nurse Practitioner Utilization Review vs Nurse Practitioner Utilization Review?
| Aspect | Senior Nurse Practitioner Utilization Review | Nurse Practitioner Utilization Review |
|---|---|---|
| Credentials | Master's or Doctorate in Nursing, Nurse Practitioner license, Certification in Utilization Review | Master's or Doctorate in Nursing, Nurse Practitioner license, Certification in Utilization Review |
| Work Environment | Hospitals, insurance companies, healthcare organizations | Hospitals, insurance companies, healthcare organizations |
| Responsibilities | Oversees utilization review processes, mentors staff, handles complex cases | Performs utilization reviews, assesses patient necessity, documents findings |
Both roles require advanced nursing credentials and certification in utilization review. The senior role typically involves leadership, oversight, and handling complex cases, while the standard Nurse Practitioner Utilization Review focuses on performing reviews and documentation. The roles are often found in similar healthcare settings and serve complementary functions within utilization management.
What cities are hiring for Senior Nurse Practitioner Utilization Review jobs? Cities with the most Senior 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 Senior Nurse Practitioner Utilization Review jobs? States with the most job openings for Senior Nurse Practitioner Utilization Review jobs include:
Contractor
Re-posted 12 days ago
Job description
Company Description
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!
Job Description
Company: Molina Healthcare
Location: 880 Long Lake Rd Suite 600 Troy, Michigan 48098
Shift: Daytime hours
Employment: Contract: 1-2 months (possibility of going longer depending on business needs)
Company Job Description/Day to Day Duties:
Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Molina Healthcare members with the right care at the right place at the right time. Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review. Assesses services for Molina Members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines
Provider appeals and Utilization reviews and assist with Denial Letters
Provides concurrent review and prior authorizations (as needed) according to Molina policy for Molina members as part of the Utilization Management team.
Identifies appropriate benefits, eligibility, and expected length of stay for members requesting treatments and/or procedures.
Participates in interdepartmental integration and collaboration to enhance the continuity of care for Molina members including Behavioral Health and Long Term Care.
Qualifications
Minimum Education/Qualifications/Licensures:
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, etc.
Minimum 2-4 years of clinical practice. Preferably hospital nursing, utilization management, and/or case management.
Also has a background in patient, skilled nurses facilities, rehab, and home healthcare.
Additional Information
Apply now for immediate consideration. After applying, a recruiting consultant will contact you for pre-screening. Please provide your best phone number to contact.
Thanks and look forward to hearing from you!
About Healthcare Support
Sourced by ZipRecruiter
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!Healthcare Support Staffing, Inc. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.
Industry
Recruiting and staffing services
Company size
201 - 500 Employees
Headquarters location
Maitland, FL, US
Year founded
2003