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Utilization Review Np Jobs in Appleton, WI (NOW HIRING)

DOCS Health

PRN-Nurse Practitioner

Green Bay, WI · 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

PRN-Nurse Practitioner

Green Bay, WI · 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

PRN-Nurse Practitioner

Green Bay, WI · 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 ...

GQR Global Markets

RN - Case Manager

Appleton, WI · On-site

$1.8K - $1.9K/wk

  • Medical

  • Dental

  • Vision

Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location: Appleton, Wisconsin Start Date: August 23, 2026 Profession: Registered Nurse (RN) Facility: Estimated Pay: $1847 ...

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Showing results 21-40

All JobsUtilization Review Np JobsUtilization Review Np Jobs in Appleton, WI

Utilization Review Np information

See Appleton, WI salary details

$20

$41

$67

How much do utilization review np jobs pay per hour?

As of Aug 19, 2026, the average hourly pay for utilization review np in Appleton, WI is $41.26, according to ZipRecruiter salary data. Most workers in this role earn between $32.60 and $47.36 per hour, depending on experience, location, and employer.

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 Appleton, WI?

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

What job categories do people searching Utilization Review Np jobs in Appleton, WI look for?

The top searched job categories for Utilization Review Np jobs in Appleton, WI are:

What cities near Appleton, WI are hiring for Utilization Review Np jobs?

Cities near Appleton, WI with the most Utilization Review Np job openings:

Utilization Review Np jobs near you
Infographic showing various Utilization Review Np job openings in Appleton, WI as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 14% Part Time, 3% Contract, and 1% Nights. Highlights an 90% Physical, 3% Hybrid, and 7% Remote job distribution, with an average salary of $85,812 per year, or $41.3 per hour.

Health Risk Assessments - Nurse Practitioner (NP) and Physician Assistants (PA)

National Recruiters

Appleton, WI

$106K - $137K/yr

Per diem

Posted 8 days ago

Job description

Flexible PRN Opportunity for Nurse Practitioners & Physician Assistants – Health Risk Assessments

We’re looking for Nurse Practitioners (NPs) and Physician Assistants (PAs) interested in a flexible PRN role conducting in-home Health Risk Assessments (HRAs) for Medicare Advantage members. This is a great way to supplement your income, work autonomously, and make a real difference in patient care, without the responsibilities of ongoing treatment.

What makes this role stand out:

  • Create your schedule with an 8-day monthly minimum
  • Competitive pay with added performance incentives
  • No prescribing, no on-call shifts, and no follow-ups
  • Simple, user-friendly documentation using a company-provided iPad
  • Malpractice insurance and collaborating physicians included

What you’ll do:

  • Complete comprehensive in-home HRAs for Medicare Advantage patients
  • Review each patient’s medical history, current medications, lifestyle, and key social factors
  • Conduct basic physical and mental health evaluations
  • Share preventive care education—no ongoing management required
  • Travel locally to patients in your county and nearby areas

What we’re looking for:

  • Active NP or PA license (excluding Pediatrics, PMHNP and Women’s Health specialties)
  • Minimum availability of eight (8) full 7.5-hour days per month
  • Willingness to travel within roughly 60 minutes of your home

Additional info:

  • As a 1099 contractor, you may deduct $0.725/mile in 2026 (check with your tax advisor)
  • Streamlined documentation with our proprietary EMR system
  • Quick onboarding—you could be up and running in 3 to 4 weeks

Interested?
Send your resume to apply. This is a great opportunity for independent, motivated clinicians who want to earn extra income while maintaining a flexible schedule.

#wyatt