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Trainee Rn Utilization Review Nurse Jobs (NOW HIRING)

Midland Health

Nurse Utilization Review

Midland, TX · On-site

The utilization review (UR) nurse serves to maximize the quality and cost efficiency of health care ... The UR nurse will also assist Registered Nurse (RN) Case Managers and Social Workers with helping ...

Seh

Summary The Utilization Review Nurse screens medical records in accordance with contractual ... Current Registered Nurse license in the State of Alabama Minimum Education Preferred * Bachelor ...

Cobalt Benefits Group

Utilization Review Nurse

Current, unrestricted RN license (State license required). * Minimum 3 years of clinical nursing experience. * Minimum 1 year of Utilization Management (UM) or Utilization Review (UR) experience.

Southeast Health

Utilization Review Nurse

Dothan, AL · On-site

Summary The Utilization Review Nurse screens medical records in accordance with contractual ... Current Registered Nurse license in the State of Alabama Minimum Education Preferred * Bachelor ...

Midland Health

Nurse Utilization Review

Midland, TX · On-site

The utilization review (UR) nurse serves to maximize the quality and cost efficiency of health care ... The UR nurse will also assist Registered Nurse (RN) Case Managers and Social Workers with helping ...

Houston Methodist

At Houston Methodist, the Utilization Review Nurse (URN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and concurrent medical record review for medical ...

Wood County Hospital

Elevate your career at Wood County Hospital, where you're not just a number - you're a vital part of a team making a real difference. RN Utilization Review / Utilization Review / Per Diem Reviews ...

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$39K

$89.5K

$163K

How much do trainee rn utilization review nurse jobs pay per year?

As of Jun 29, 2026, the average yearly pay for trainee rn utilization review nurse in the United States is $89,483.00, according to ZipRecruiter salary data. Most workers in this role earn between $64,500.00 and $104,500.00 per year, depending on experience, location, and employer.

What is the difference between Trainee Rn Utilization Review Nurse vs Registered Nurse in Utilization Review?

AspectTrainee Rn Utilization Review NurseRegistered Nurse in Utilization Review
CredentialsLicensed RN, in training or early in careerLicensed RN with experience in utilization review
Work EnvironmentSupervised training setting, often in healthcare or insurance companiesIndependent review, case analysis, and decision-making in healthcare or insurance
Job ResponsibilitiesAssisting with reviews, learning policies, supporting senior staffConducting utilization reviews, making coverage decisions, ensuring compliance

The main difference is that the Trainee Rn Utilization Review Nurse is in training and gaining experience, while the Registered Nurse in Utilization Review is a fully qualified professional responsible for independent review and decision-making. The trainee role focuses on learning, whereas the registered nurse role involves applying expertise to evaluate patient care and insurance coverage.

What cities are hiring for Trainee Rn Utilization Review Nurse jobs? Cities with the most Trainee Rn Utilization Review Nurse job openings:
What are the most commonly searched types of Rn Utilization Review Nurse jobs? The most popular types of Rn Utilization Review Nurse jobs are:
What states have the most Trainee Rn Utilization Review Nurse jobs? States with the most job openings for Trainee Rn Utilization Review Nurse jobs include:
Trainee Rn Utilization Review Nurse jobs near you
Registered Nurse, Utilization Review

Registered Nurse, Utilization Review

MMC Group

Austin, TX • On-site

Other

Medical, Dental, Vision, Life

Posted 10 days ago

Job description

Registered Nurse, Utilization Review (Remote)
Local Candidates in the Austin, TX Area Only
Long Term Opportunity | High Potential for Extension
Use Your Clinical Expertise to Improve Healthcare Outcomes, Without Providing Direct Patient Care
Are you an experienced Registered Nurse looking to transition away from bedside care while continuing to make a meaningful impact on patients' healthcare journeys? If you have a strong clinical background and experience evaluating medical necessity, this is an excellent opportunity to utilize your nursing expertise in a remote, collaborative environment.
Join a team dedicated to ensuring members receive medically appropriate, high quality, and cost-effective healthcare services while working alongside physicians, healthcare providers, and interdisciplinary teams.
Why You'll Love This Opportunity
  • Remote position for candidates living in the Austin, Texas area
  • No direct patient care
  • Long term contract with a high likelihood of extension
  • Monday through Friday schedule with occasional approved overtime
  • Opportunity to use your clinical knowledge to improve healthcare quality and outcomes
  • Collaborative and supportive team environment
  • Work with leading healthcare professionals and providers across Texas
Schedule
  • Must be available to work any 8-hour shift between 7:00 AM and 7:00 PM
  • Required shift availability includes 10:00 AM to 7:00 PM
  • Occasional overtime may be required and approved based on business needs
What You'll Do
As a Utilization Review Registered Nurse, you will use your clinical judgment to evaluate medical services and ensure members receive appropriate, medically necessary care.
Your responsibilities will include:
  • Conduct pre-service, concurrent, and retrospective utilization reviews
  • Evaluate medical necessity for outpatient services and out-of-network care
  • Assess the appropriateness of treatment settings using evidence based clinical guidelines
  • Collaborate with physicians, healthcare providers, and interdisciplinary teams
  • Promote high-quality, cost-effective healthcare outcomes
  • Optimize member benefits while ensuring compliance with Medicaid requirements
  • Apply Texas Administrative Code (TAC) guidelines and medical necessity criteria
  • Document review decisions accurately and thoroughly
  • Maintain productivity, quality, and compliance standards
  • Participate in team meetings, training, and continuous improvement initiatives
Qualifications
We're looking for professionals who have:
  • Current Registered Nurse (RN) license in good standing
  • Experience performing Utilization Review, Case Management, Care Management, or Medical Necessity reviews
  • Knowledge of Medicaid programs and utilization management principles
  • Experience applying medical necessity criteria
  • Understanding of the Texas Administrative Code (TAC)
  • Strong clinical assessment and critical thinking skills
  • Excellent written and verbal communication abilities
  • Strong organizational and time management skills
  • Ability to work independently in a remote environment
Technical Skills
  • Microsoft Word
  • Microsoft Excel
  • Electronic documentation systems
  • Ability to navigate multiple computer applications simultaneously
Ideal Candidate
You'll thrive in this role if you:
  • Enjoy using clinical expertise to improve healthcare outcomes
  • Have exceptional analytical and critical thinking skills
  • Are detail oriented and able to make sound clinical decisions
  • Communicate professionally with providers and interdisciplinary teams
  • Can manage multiple priorities in a fast-paced environment
  • Work independently while remaining engaged with a collaborative remote team
Apply Today!
If you're ready to leverage your nursing experience in a rewarding remote role that supports quality healthcare delivery, we'd love to hear from you.
This is an outstanding opportunity for an experienced Registered Nurse seeking a professional, non-bedside position with long term potential and meaningful impact!
Job Requirements
Throughout the past 35+ years, MMC, one of the most trusted names in workforce management services, has successfully delivered strategic solutions to large and small businesses in numerous industries.
We have built our reputation on partnering with our clients and candidates to achieve the desired results. Our recruiting professionals have extensive experience matching the right candidate, to the right client, for the right position. We provide the best opportunities to the most talented candidates in a multitude of industries.
MMC is a privately owned business with corporate headquarters in Irving, Texas. With 2,000+ employees, working in 40+ states, MMC is able to support all United States locations, and some international locations.
We appreciate your interest in reviewing this particular position and we encourage you to visit our website where you can always search and apply for opportunities at www.mmcgrp.com
Benefits with MMC Group
MMC offers health insurance plans for our active candidates on assignment, including:
  • Medical, dental, and vision coverage
  • Life and disability insurance
  • Additional voluntary benefits

Join MMC and enjoy the support of a team that values your well-being, both on and off the job!
MMC strives to ensure all job postings confirm details of the position, the rate of pay, and acknowledge that medical benefits are offered.
Get started on your career journey today! Apply to become a part of the MMC Team!
We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status or any other characteristic protected by law. In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire.

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