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Utilization Review Np Jobs in Boca Raton, FL (NOW HIRING)

Guardian Recovery

UR COORDINATOR

Delray Beach, FL · On-site

The Utilization Review Coordinator (UR Coordinator) is responsible to perform the process of ... Master's degree from an accredited college or university in social work, mental health, nursing, or ...

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Utilization Review Np information

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How much do utilization review np jobs pay per hour?

As of Sep 7, 2026, the average hourly pay for utilization review np in Boca Raton, FL is $40.12, according to ZipRecruiter salary data. Most workers in this role earn between $31.73 and $46.06 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.

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The top searched job categories for Utilization Review Np jobs in Boca Raton, FL are:

What cities near Boca Raton, FL are hiring for Utilization Review Np jobs?

Cities near Boca Raton, FL with the most Utilization Review Np job openings:

Utilization Review Np jobs near you

Nurse Practitioner (NP)

Avante at Boca Raton

Boca Raton, FL • On-site

Other

Medical, Dental, Vision, Retirement, PTO

This job post has expired today. Applications are no longer accepted.

Job description

Job Description
Job Description

Nurse Practitioner Needed!!

KOPA, Inc. is looking for a Nurse Practitioner to diagnose and treat health conditions, as well as promote good health practices. This position will be at the Avante at Boca Raton.

As an advanced practice registered nurse, you’ll be our go-to person for ensuring the best patient care possible. The job description of a nurse practitioner includes conducting physical examinations, interpreting lab tests and overseeing patients’ health. You’ll be both a health practitioner and an educator, supporting disease prevention practices and helping people lead healthy lives.

As a Nurse Practitioner, you’ll have to work closely with other healthcare professionals, so you should have a team spirit and a positive attitude. Patience, problem-solving skills and communication ability are important. If you’re dedicated to advancing your knowledge and clinical expertise through research and professional discourse, we’d like to meet you.

We will be providing essential care to a very compromised group of individuals who do not require acute care, however, due to specialized infection control needs of these residents, many other skilled nursing facilities are unable to provide this level of care and therefore these residents are in need of temporary placement.

Responsibilities:

  • Examine patients and their medical records

  • Order and study diagnostic tests (blood tests, X-rays etc.)

  • Diagnose health conditions and illnesses

  • Propose treatments for chronic and infectious diseases

  • Prescribe medications

  • Maintain accurate records and schedules

  • Inform patients about their health conditions and prescribed medications

  • Educate patients and their family members on diseases, epidemics and prevention

  • Oversee patients’ overall health

  • Promote good health practices

  • Advance professional knowledge and conduct research

  • Supervise and mentor a team of nurse practitioners

  • Review documentation and provide clinical feedback

  • Lead team meetings

  • Assist with onboarding and training of new NPs

  • Help monitor performance and support ongoing development

  • Act as a liaison between the NP team and facility leadership

  • Assist in creating and refining workflows, protocols, and best practices

  • Provide coverage at other Florida facilities when needed (e.g., vacation, sick leave, or coverage gaps), which may involve occasional in-state travel

Skills:

  • Proven experience as Nurse Practitioner in a skilled nursing facility, minimum 1 year of supervisory experience

  • Expertise in primary care, acute care and chronic care practices

  • Knowledge of health and patient care regulations

  • Excellent communication skills

  • Strong ethics

  • Team spirit with a positive attitude

  • Patience and cool-headedness

  • Willingness to continue gaining knowledge and clinical experience

  • Valid nurse practitioner license


Benefits:

  • Competitive Compensation

  • Comprehensive Insurance Coverage (Medical, Dental, Vision, and more!)

  • Health and Wellness Programs to Keep you Feeling Your Best

  • Retirement plan with employer match.

  • Paid Time Off & Holidays to Recharge

  • Continuing education and professional development opportunities.

  • Supportive and Collaborative work environment.


Background Screening Requirement:

This position requires background screening through the Agency for Health Care Administration (AHCA) Care Provider Background Screening Clearinghouse.

Learn more: https://info.flclearinghouse.com


If you are passionate about patient care and a rewarding work environment, Don’t Hesitate- Apply Today!

KOPA provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, Veterans' status, national origin, gender identity or expression, age, sexual orientation, disability, gender, genetic information or any other category protected by law. In addition to federal requirements, Avante complies with applicable state and local laws governing non-discrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.KOPA expressly prohibits any form of workplace harassment based on race, color, religion, sex, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, Veterans' status or any other category protected by law. Improper interference with the ability of KOPA employees to perform their job duties may result in discipline, up to and including, discharge.

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