They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You ...
Quick apply
They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You ...
Utilization Management CNA
Dubuque, IA · On-site
Medical
Dental
Vision
Life
Retirement
PTO
They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You ...
Utilization Management CNA
Dubuque, IA · On-site
Medical
Dental
Vision
Life
Retirement
PTO
They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You ...
Utilization Management CNA
Dubuque, IA · On-site
Medical
Dental
Vision
Life
Retirement
PTO
They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You ...
Utilization Management CNA
Dubuque, IA · On-site
Medical
Dental
Vision
Life
Retirement
PTO
They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You ...
Utilization Management CNA
Dubuque, IA · On-site
Medical
Dental
Vision
Life
Retirement
PTO
They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You ...
Utilization Management CNA
Dubuque, IA · On-site
Medical
Dental
Vision
Life
Retirement
PTO
They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You ...
Utilization Management CNA
Asbury, IA · On-site
Medical
Dental
Vision
Life
Retirement
PTO
They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You ...
Utilization Management CNA
Asbury, IA · On-site
Medical
Dental
Vision
Life
Retirement
PTO
They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You ...
Utilization Management Assistant
Dubuque, IA · On-site
$39K - $45K/yr
Medical
Dental
Vision
Life
Retirement
PTO
They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You ...
Utilization Management Assistant
Dubuque, IA · On-site
$39K - $45K/yr
Medical
Dental
Vision
Life
Retirement
PTO
They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You ...
Utilization Management Assistant
Dubuque, IA · On-site
$39K - $45K/yr
Medical
Dental
Vision
Life
Retirement
PTO
They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You ...
Utilization Management Assistant
Dubuque, IA · On-site
$39K - $45K/yr
Medical
Dental
Vision
Life
Retirement
PTO
They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You ...
Utilization Management Assistant
Dubuque, IA · On-site
$39K - $45K/yr
They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You ...
Quick apply
Utilization Management Assistant
Dubuque, IA · On-site
$39K - $45K/yr
They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You ...
Utilization Management CNA
Davenport, IA · On-site
Medical
Dental
Vision
Life
Retirement
PTO
They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You ...
Utilization Management CNA
Davenport, IA · On-site
Medical
Dental
Vision
Life
Retirement
PTO
They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You ...
Utilization Management CNA
Medical
Dental
Vision
Life
Retirement
PTO
They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You ...
Utilization Management CNA
Medical
Dental
Vision
Life
Retirement
PTO
They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You ...
Utilization Management CNA
Dubuque, IA · On-site
Medical
Dental
Vision
Life
Retirement
PTO
They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You ...
Utilization Management CNA
Dubuque, IA · On-site
Medical
Dental
Vision
Life
Retirement
PTO
They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You ...
Utilization Management CNA
Dubuque, IA · On-site
They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You ...
Quick apply
Utilization Management CNA
Dubuque, IA · On-site
They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You ...
Utilization Management CNA
Asbury, IA · On-site
$29K - $39K/yr
Medical
Dental
Vision
Life
Retirement
PTO
They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You ...
Utilization Management CNA
Asbury, IA · On-site
$29K - $39K/yr
Medical
Dental
Vision
Life
Retirement
PTO
They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You ...
Utilization Management CNA
Medical
Dental
Vision
Life
Retirement
PTO
They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You ...
Utilization Management CNA
Medical
Dental
Vision
Life
Retirement
PTO
They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You ...
They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You ...
Quick apply
They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You ...
Utilization Management CNA
Davenport, IA · On-site
Medical
Dental
Vision
Life
Retirement
PTO
They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You ...
Utilization Management CNA
Davenport, IA · On-site
Medical
Dental
Vision
Life
Retirement
PTO
They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You ...
Utilization Management CNA
Dubuque, IA · On-site
Medical
Dental
Vision
Life
Retirement
PTO
They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You ...
Utilization Management CNA
Dubuque, IA · On-site
Medical
Dental
Vision
Life
Retirement
PTO
They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You ...
Utilization Management Assistant
$41K - $47K/yr
Medical
Dental
Vision
Life
Retirement
PTO
They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You ...
Utilization Management Assistant
$41K - $47K/yr
Medical
Dental
Vision
Life
Retirement
PTO
They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You ...
Utilization Management Assistant
Dubuque, IA · On-site
$39K - $45K/yr
They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You ...
Quick apply
Utilization Management Assistant
Dubuque, IA · On-site
$39K - $45K/yr
They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You ...
Utilization Management Assistant
Dubuque, IA · On-site
$39K - $45K/yr
They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You ...
Quick apply
Utilization Management Assistant
Dubuque, IA · On-site
$39K - $45K/yr
They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You ...
Utilization Review Np information
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 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 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?
| Aspect | Utilization Review Np | Utilization Review Nurse |
|---|---|---|
| Credentials | Master's degree in Nursing, Nurse Practitioner certification, state licensure | Registered Nurse (RN) license, possibly with certification in utilization review |
| Work Environment | Healthcare facilities, insurance companies, utilization review organizations | Hospitals, insurance companies, outpatient clinics |
| Job Responsibilities | Assess medical necessity, authorize treatments, make clinical decisions, often with greater autonomy | Review 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 Iowa?
For Utilization Review Np jobs in Iowa, the most frequently searched job titles are:
- Telemedicine Nurse Practitioner
- Evening Addiction Nurse Practitioner
- Testosterone Replacement Physician Assistant
- Palliative Care Np
- Hormone Nurse Practitioner
- Internship Neurology Nurse Practitioner
- Mobile Nurse Practitioner
- Locum Tenens Rheumatology Nurse Practitioner
- Internal Medicine Nurse Practitioner
- Afternoon Labor Delivery Nurse Practitioner
What job categories do people searching Utilization Review Np jobs in Iowa look for?
The top searched job categories for Utilization Review Np jobs in Iowa are:
- Online Fnp
- Nurse Practitioner Relocation Package
- Internship Nurse Practitioner Medical Writer
- Physician Assistant Or Nurse Practitioner 1099 Contract
- Temporary Concierge Nurse Practitioner
- Temporary Infusion Nurse Practitioner
- Flex Time 1099 Nurse Practitioner
- Clinic Np
- Hourly Inova Nurse Practitioner
- Family Nurse Practitioner Bc
What cities in Iowa are hiring for Utilization Review Np jobs?
Cities in Iowa with the most Utilization Review Np job openings:
Job description
Utilization Management Assistant
Location: Onsite in Dubuque, IA. Also accepting remote applicants.
Are you passionate about patient care and thrive in a fast-paced, professional environment? We are seeking a dedicated Utilization Management Assistant to join our healthcare team. We are looking for individuals with experience in a medical setting, including but not limited to a receptionist, scheduler, insurance verification, LPN, CNA, Medical Assistants, or individuals with a background in customer service who are looking to make a meaningful impact behind the scenes. If you are looking to get into a professional office setting with daytime office hours and weekends/holidays off, this is the role for you!
The Utilization Management Assistant answers first level calls in Utilization Review for HealthCheck360 participants. They will evaluate certification requests by reviewing the group specific requirements and will also triage the call to determine if a Utilization Review Nurse is needed to complete the call. You will be responsible for reviewing medical records, coordinating with healthcare providers, and ensuring that patients receive appropriate, cost-effective care in accordance with clinical guidelines and insurance requirements.
Preferred Skills
- Communication - Strong interpersonal skills to be able to connect with patients, doctors, internal team members, and providers
- Customer Service - Friendly demeanor and understanding to be able to relay sensitive information to members
- Detail Oriented - Accuracy and attention to detail when reviewing pre-certifications and plans
Qualifications:
- CNA, LPN, or Medical Assistant preferred
- Background in patient health support or care
- 1+ years of experience within this field
Full-Time Benefits - Most benefits start day 1
- Medical, Dental, Vision Insurance
- Flex Spending or HSA
- 401(k) with company match
- Profit-Sharing/Defined Contribution (1-year waiting period)
- PTO/Paid Holidays
- Company-paid ST and LT Disability
- Maternity Leave/Parental Leave
- Subsidized Parking
- Company-paid Term Life/Accidental Death Insurance
About HealthCheck360
HealthCheck 360 was created with the employer's needs and the participant's experience in mind. We focus on reducing medical costs, while increasing employee engagement and productivity. This is accomplished by providing onsite biometric screenings, engaging participants through technology and programming, educating the participant with risk-specific targeted communications, and supporting positive behavior change through our Health Coaching and Condition Management programs.
About HealthCheck360
Sourced by ZipRecruiter
Industry
Fitness and sports centers
Company size
201 - 500 Employees
Headquarters location
Dubuque, IA, US
Year founded
2007