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Utilization Management Pre Service Review Nurse Jobs

Intus, Inc

Utilization Management Nurse

$80K - $95K/yr

Role Overview The Utilization Management Nurse plays a critical role in ensuring high-quality, cost ... Coordination and review of all other services delivered by contracted providers and identified by ...

Sagility LLC

RN Utilization Management Reviewer

$35 - $40/hr

This role will be responsible in day-to-day timely clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ...

UofL Health

RN Utilization Review

Louisville, KY · On-site

Position Summary and Purpose The Utilization Review RN performs activities which support the ... manager/director of care coordination, CAO, or medical director when intensity of service or ...

Astrana Health

UM Review Nurse

Monterey Park, CA · Remote

$34 - $42/hr

Astrana Health is looking for a CA-licensed Utilization Review Nurse to assist our Health Services ... We are seeking nurses with at least one year of outpatient Utilization Management experience in a ...

UHS

MGR - UTILIZATION REVIEW / MGMT

Bloomington, IN · On-site

... oversees utilization management including, but not limited to: utilization review, case ... Must have Registered Nurse license or Master's Degree. Experience: 5-7 yrs acute inpatient ...

UHS

DIR - UTILIZATION REVIEW / MGMT

Springfield, IL · On-site

$37.55 - $56.33/hr

Collaborate with physicians, nursing leadership, therapists, and hospital administration ... Services One of the nation's largest and most respected providers of hospital and healthcare ...

University of Kentucky

Supervisor, Utilization Review Work Location: UK Chandler Hospital, Pavilion A Grade Level: 11 Type ... health services, compliance with payer requirements, and accuracy of admission status ...

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How much do utilization management pre service review nurse jobs pay per hour?

As of Sep 14, 2026, the average hourly pay for utilization management pre service 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.

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Infographic showing various Utilization Management Pre Service Review Nurse job openings in the United States as of June 2026, with employment types broken down into 3% As Needed, 82% Full Time, 12% Part Time, and 3% Contract. Highlights an 95% Physical, 1% Hybrid, and 4% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

Utilization Review Nurse (RN)

Madera, CA

Madera Community Hospital
501 - 1,000 employees
Learn more about Madera Community Hospitalexternal

$46 - $60/hr

Full-time

Re-posted 28 days ago

Job description

Madera Community Hospital

Located in the heart of Central California, Madera Community Hospital is a General Acute Care, private, not-for-profit hospital dedicated to improving and maintaining the health and wellness of residents throughout the Central Valley. We are committed to identifying and serving our community's needs with compassion, concern, care and safety for every patient. Madera Community Hospital is a growing acute care facility seeking talented individuals with a drive to provide quality care and dedicated to making a difference in our community.

Position Summary: The Utilization Review Nurse assesses, plans, implements and evaluates the needs of patients for discharge planning and utilization review. This includes those who may have Medicare, Medicaid, HMO or private insurance to cover their stay at various units. Discharge planning is coordinated with physicians, Nursing, patient and family who have an ongoing caring relationship with the patient. Utilization review procedures include those stated for discharge planning in addition to knowledge of criteria for Medicare, Medicaid coverage and that of HMO or private insurers.

Qualifications:

  • Minimum of 1-3 years of related acute care nursing experience and completion of an accredited nursing program required.
  • Experience with Meditech Electronic Health Record (EHR) system preferred.
  • Must have working knowledge of criteria for Medicare, Medicaid, HMO and private insurance coverage.
  • Ability to maintain collaborative working relationships to ensure a positive and productive work environment.
  • Ability to plan and prioritize work with frequent interruptions.
  • Ability to provide exceptional customer service.
  • Effective verbal and written communication skills.
  • Knowledge and proficiency of hospital information technology applications.
  • Requires Current California Board of Nursing Registered Nurse License.
  • Current American Heart Association BCLS certificate required; ACLS certificate preferred.
  • CCM in Case Management preferred.

Madera Community Hospital provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

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