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Utilization Review Np Jobs in Delaware (NOW HIRING)

DOCS Health

Nurse Practitioner

Wilmington, DE · On-site

Review health history, service member medical records, and medical questionnaires. * Interview ... Active NP license in the state * CPR/BLS Certification * Experience with Primary Care, Urgent Care ...

DOCS Health

Nurse Practitioner

Wilmington, DE · On-site

Review health history, service member medical records, and medical questionnaires. * Interview ... Active NP license in the state * CPR/BLS Certification * Experience with Primary Care, Urgent Care ...

DOCS Health

Nurse Practitioner

Wilmington, DE · On-site

$550/day

Review health history, service member medical records, and medical questionnaires. * Interview ... Active NP license in the state * CPR/BLS Certification * Experience with Primary Care, Urgent Care ...

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Utilization Review Np information

What does a utilization review nurse practitioner do?

A Utilization Review Nurse Practitioner (NP) evaluates the medical necessity, appropriateness, and efficiency of healthcare services provided to patients. They review patient records, treatment plans, and insurance coverage to ensure that care meets established guidelines and regulatory requirements. Utilization Review NPs help coordinate care, prevent unnecessary procedures, and support cost-effective healthcare delivery while ensuring patient safety and quality outcomes.

What are some common challenges utilization review nurse practitioners face when collaborating with healthcare providers and insurance companies?

Utilization Review Nurse Practitioners often navigate the challenge of balancing patient advocacy with payer requirements. They must effectively communicate clinical justifications to both healthcare providers and insurance representatives, sometimes mediating disagreements over the necessity of certain treatments or hospital stays. Staying up-to-date with ever-changing insurance guidelines and ensuring timely documentation can also be demanding, but strong organizational and interpersonal skills help facilitate smooth collaboration and successful patient outcomes.

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

To thrive as a Utilization Review Nurse Practitioner (NP), you need expert clinical judgment, a strong understanding of healthcare regulations, and advanced assessment skills, typically supported by an active NP license and clinical experience. Familiarity with utilization management software, electronic health records (EHRs), and knowledge of insurance guidelines such as Medicare and Medicaid are commonly required. Excellent communication, attention to detail, and critical thinking are vital soft skills for effective case evaluations and collaboration with providers. These competencies ensure accurate, efficient reviews that support quality care, compliance, and cost-effective treatment decisions.

What is the difference between Utilization Review Np vs Utilization Review Nurse?

AspectUtilization Review NpUtilization Review Nurse
CredentialsMaster's degree in Nursing, Nurse Practitioner certification, state licensureRegistered Nurse (RN) license, possibly with certification in utilization review
Work EnvironmentHealthcare facilities, insurance companies, utilization review organizationsHospitals, insurance companies, outpatient clinics
Job ResponsibilitiesAssess medical necessity, authorize treatments, make clinical decisions, often with greater autonomyReview medical records, support authorization processes, follow established guidelines

Utilization Review NPs typically have advanced clinical training and greater decision-making authority compared to Utilization Review Nurses. Both roles focus on evaluating medical necessity, but NPs often perform more complex assessments and can make independent recommendations, whereas nurses support the review process under supervision or guidelines.

What are popular job titles related to Utilization Review Np jobs in Delaware?

For Utilization Review Np jobs in Delaware, the most frequently searched job titles are:

What job categories do people searching Utilization Review Np jobs in Delaware look for?

The top searched job categories for Utilization Review Np jobs in Delaware are:

What cities in Delaware are hiring for Utilization Review Np jobs?

Cities in Delaware with the most Utilization Review Np job openings:

Utilization Review Np jobs near you
Infographic showing various Utilization Review Np job openings in Delaware as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 15% Part Time, 3% Contract, and 1% Nights. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution.

Nurse Practitioner

DOCS Health

Wilmington, DE • On-site

Contractor

Re-posted 15 days ago

Job description

Description

Attention all Nurse Practitioners, we are calling you to partner with us as independent contractors providing services to our Military Service members. 

We primarily work weekends, with some occasional weekdays under the Reserve Health Readiness Program (RHRP) in the State of DE  on an "as needed basis". 

We provide health readiness services to meet the medical and dental requirements to maintain a deployable military force for the following:

  • U.S. Army Reserve (USAR)
  • Army National Guard (ARNG)
  • U.S. Navy Reserve (USNR)
  • U.S. Marine Forces Reserve (MARFORRES)
  • U.S. Coast Guard Reserve (USCGR)
  • Air National Guard (ANG)
  • U.S. Air Force Reserve (USAFR)


Responsibilities:

  • Support Physical Health Assessments of military personnel.   
  • Review health history, service member medical records, and medical questionnaires.  
  • Interview military personnel to determine current and prior medical concerns.
  • Identify any concerns that need to be addressed immediately, inclusive of Behavioral Health.  
  • Document interview results for readiness classification in the service member's medical record using the proprietary system.

Requirements

  • Supervising Physician may required depending on the state requirement
  • Active NP license in the state
  • CPR/BLS Certification
  • Experience with Primary Care, Urgent Care or Occupational Health - preferred
  • Experience with mobile medical services - preferred
  • Knowledge of Military systems, protocols, and terminology - preferred
  • Adaptable to fast paced environments, with large volumes of service members seen daily
  • Able to work extended hours
  • Able to work in various locations, including remote military installations
  • Able to travel, with weekend availability - preferred
  • Excellent oral and written communication skills
  • Basic computer knowledge and skills
  • Not Required - Diagnose, treat, or prescribe medications


With over three decades of experience, we are a trusted industry leader. Our experienced team of clinicians and logistics professionals are dedicated, and strive to do the right thing for our partners and their members every time. Because of this commitment, we've set a new standard of care delivery through our fixed-clinic, mobile treatment center, telemedicine, and portable deployment models. 

Join our team, and become a part of a bridge for better health. 

________________________________________

If you are made a conditional offer of employment, you will be required to undergo background check (including criminal record check) and drug screening. We use E-Verify in our hiring process.

DOCS Health is committed to ensuring equal employment opportunity. All employment decisions, policies, and practices are in accordance with applicable federal, state, and local anti-discrimination laws. DOCS Health will not engage in or tolerate unlawful discrimination (including any form of unlawful harassment) on account of a person's sex (including pregnancy), age, race, color, religion, national origin, ancestry, citizenship, physical or mental disability, sexual orientation, gender nonconformity, status as a transgender individual, gender identity, genetic information, marital status, family responsibility, armed services, or any other status protected by law.

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About DOCS Health

Sourced by ZipRecruiter

DOCS Health is a pioneering healthcare-based organization headquartered in Pipersville, PA, USA. Operating in the broad healthcare industry, DOCS Health prides itself on delivering state-of-the-art, tailored healthcare solutions to a diverse group of clients. The official website suggests that the company offers a wide range of services, including modern diagnostic solutions, innovative treatment options, and holistic healthcare services. DOCS Health was founded with the mission of revolutionizing healthcare services and seeking innovative solutions to healthcare challenges.

Industry

Hospitals

Company size

11 - 50 Employees

Headquarters location

Pipersville, PA, US

Year founded

1990

Social media

Facebook

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