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Utilization Review Epic Emr Jobs (NOW HIRING)

Southeast Health

Utilization Review Nurse

Dothan, AL · On-site

Summary The Utilization Review Nurse screens medical records in accordance with contractual ... Documents clear billing notes into the Electronic Medical Record (EMR) payer communications ...

Genesis HealthCare

The Utilization Review (UR) Analyst is responsible for assuring insurance notification ... EPIC. Works with insurance verification associates, billers, physicians, and patients to analyze ...

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Utilization Review Epic Emr information

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How much do utilization review epic emr jobs pay per hour?

As of Jun 10, 2026, the average hourly pay for utilization review epic emr 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.

How much do utilization review nurses make in the US?

Utilization review nurses in the US typically earn between $65,000 and $85,000 annually, depending on experience, location, and certifications such as CCM or CPHQ. They review medical records and determine the necessity of treatments using electronic health records like Epic EMR, often working full-time in healthcare settings.

What are the key skills and qualifications needed to thrive as a Utilization Review Epic EMR Specialist, and why are they important?

To thrive as a Utilization Review Epic EMR Specialist, you need expertise in medical record review, knowledge of healthcare regulations, and a background in nursing or a related clinical field, often supported by a valid RN or healthcare degree. Proficiency with Epic EMR software, clinical documentation tools, and utilization review systems is crucial. Strong analytical thinking, attention to detail, and effective communication skills enable professionals to interpret clinical data and collaborate across teams. These skills ensure accurate case reviews, regulatory compliance, and optimized patient care processes.

What is the difference between Utilization Review Epic Emr vs Utilization Review Nurse?

AspectUtilization Review Epic EmrUtilization Review Nurse
CredentialsTypically requires RN license, Epic EMR trainingRN license, often with utilization review certification
Work EnvironmentUtilizes Epic EMR software in healthcare settingsPerforms reviews in clinical or administrative settings
Employer & IndustryHospitals, health systems using Epic EMRInsurance companies, healthcare organizations
Primary FocusManaging utilization data within Epic EMR systemAssessing medical necessity and reviewing patient cases

Utilization Review Epic Emr professionals focus on managing utilization data within the Epic EMR system, often requiring Epic training and technical skills. In contrast, Utilization Review Nurses perform clinical assessments and review patient cases to determine medical necessity, leveraging their nursing expertise. Both roles are essential in healthcare but differ in their primary functions and work environments.

How does a Utilization Review professional use Epic EMR to facilitate interdisciplinary collaboration?

Utilization Review professionals leverage Epic EMR to efficiently communicate with physicians, nurses, case managers, and other healthcare team members. By documenting reviews, recommendations, and authorization statuses directly in the EMR, they ensure transparent and timely information sharing, which is essential for coordinated patient care and discharge planning. This digital workflow helps minimize delays, supports compliance, and enhances overall patient outcomes by keeping all stakeholders informed and aligned throughout the review process.

What is a Utilization Review Epic EMR specialist?

A Utilization Review Epic EMR specialist is a healthcare professional who uses the Epic electronic medical record (EMR) system to review patient care and ensure that medical services are necessary and appropriate. They work with clinical teams to monitor documentation, compliance, and insurance requirements. Their primary goal is to optimize the use of healthcare resources while maintaining quality patient care, often interacting with insurance companies and regulatory agencies.

Registered Nurse - Utilization Review - RNUR26-06087

NavitasPartners

Oakland, CA • Remote

$40/hr

Other

This job post has expired 2 days ago. Applications are no longer accepted.

Job description

Job Title: Registered Nurse - Utilization Review

Location: Santa Rosa, CA 

Shift Details: Day Shift | 5x8 Hours | 08:00 AM - 04:30 PM
Contract Duration: 13 Weeks
Orientation: 40 Hours (Non-Billable)

Required Qualifications
  • Active Registered Nurse (RN) License required
  • Minimum 1-2 years acute care nursing experience preferred
  • Experience in Utilization Review, Case Management, or similar role preferred
  • Strong understanding of medical necessity, payer guidelines, and clinical documentation
  • Knowledge of insurance authorization processes preferred
  • Strong analytical, communication, and decision-making skills
  • Ability to work independently in a remote environment
  • Proficiency with EMR systems preferred (Epic experience a plus)
Job Responsibilities
  • Perform utilization review of inpatient and outpatient cases
  • Evaluate medical necessity based on clinical guidelines and payer policies
  • Review patient records and documentation for appropriate level of care
  • Collaborate with physicians, case managers, and insurance providers
  • Process prior authorizations and continued stay reviews
  • Document all review decisions accurately in EMR systems
  • Identify cases requiring further clinical escalation
  • Ensure compliance with regulatory, hospital, and insurance standards
  • Support discharge planning and care coordination as needed
  • Maintain productivity and quality standards in a remote setting

For more details contact at sthakur@navitashealth.com 

About Navitas Healthcare, LLC certified WBENC and one of the fastest-growing healthcare staffing firms in the US providing Medical, Clinical and Non-Clinical services to numerous hospitals. We offer the most competitive pay for every position we cater. We understand this is a partnership. You will not be blindsided and your salary will be discussed upfront.

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