This role requires strong collaboration with surgeons, physician assistants, nurse practitioners ... Utilization Review or Case Management experience Required License/Registration/Certification:
This role requires strong collaboration with surgeons, physician assistants, nurse practitioners ... Utilization Review or Case Management experience Required License/Registration/Certification:
This role requires strong collaboration with surgeons, physician assistants, nurse practitioners ... Utilization Review or Case Management experience Required License/Registration/Certification:
This role requires strong collaboration with surgeons, physician assistants, nurse practitioners ... Utilization Review or Case Management experience Required License/Registration/Certification:
This role requires strong collaboration with surgeons, physician assistants, nurse practitioners ... Utilization Review or Case Management experience Required License/Registration/Certification:
This role requires strong collaboration with surgeons, physician assistants, nurse practitioners ... Utilization Review or Case Management experience Required License/Registration/Certification:
This role requires strong collaboration with surgeons, physician assistants, nurse practitioners ... Utilization Review or Case Management experience Required License/Registration/Certification:
This role requires strong collaboration with surgeons, physician assistants, nurse practitioners ... Utilization Review or Case Management experience Required License/Registration/Certification:
This role requires strong collaboration with surgeons, physician assistants, nurse practitioners ... Utilization Review or Case Management experience Required License/Registration/Certification:
This role requires strong collaboration with surgeons, physician assistants, nurse practitioners ... Utilization Review or Case Management experience Required License/Registration/Certification:
Nurse Practitioner
Huntsville, AL · On-site
Orthopaedic Center Nurse Practitioner Opportunity The Orthopaedic Center is seeking a highly ... reviewing lab results, evaluating X-Ray, CT scan, and MRI results. Providing clear, concise, and ...
Nurse Practitioner
Huntsville, AL · On-site
Orthopaedic Center Nurse Practitioner Opportunity The Orthopaedic Center is seeking a highly ... reviewing lab results, evaluating X-Ray, CT scan, and MRI results. Providing clear, concise, and ...
Current NP board certification by ANCC/AANP * CPR certification Preferred Qualifications * 1-2 ... Chart review and document all patient encounters efficiently and according to organization policy ...
Current NP board certification by ANCC/AANP * CPR certification Preferred Qualifications * 1-2 ... Chart review and document all patient encounters efficiently and according to organization policy ...
Nurse Practitioner
Huntsville, AL · On-site
... reviewing lab results, evaluating X-Ray, CT scan, and MRI results. Providing clear, concise, and ... Certified Registered Nurse Practitioner with First Assist, licensed to practice in Alabama.
Nurse Practitioner
Huntsville, AL · On-site
... reviewing lab results, evaluating X-Ray, CT scan, and MRI results. Providing clear, concise, and ... Certified Registered Nurse Practitioner with First Assist, licensed to practice in Alabama.
FT Family Nurse Practitioner - Huntsville, AL Join a fun, supportive team delivering compassionate ... Perform minor office procedures and EKG reviews as per privileges & collaborate with physicians on ...
Quick apply
FT Family Nurse Practitioner - Huntsville, AL Join a fun, supportive team delivering compassionate ... Perform minor office procedures and EKG reviews as per privileges & collaborate with physicians on ...
Nurse Practitioner PRN
Huntsville, AL · On-site
As a Hospice Nurse Practitioner with us, you'll play a vital role in providing comprehensive ... Review clinical information and seamlessly coordinate and oversee patient care in collaboration ...
Nurse Practitioner PRN
Huntsville, AL · On-site
As a Hospice Nurse Practitioner with us, you'll play a vital role in providing comprehensive ... Review clinical information and seamlessly coordinate and oversee patient care in collaboration ...
Nurse Practitioner PRN
Huntsville, AL · On-site
As a Hospice Nurse Practitioner with us, you'll play a vital role in providing comprehensive ... Review clinical information and seamlessly coordinate and oversee patient care in collaboration ...
Nurse Practitioner PRN
Huntsville, AL · On-site
As a Hospice Nurse Practitioner with us, you'll play a vital role in providing comprehensive ... Review clinical information and seamlessly coordinate and oversee patient care in collaboration ...
Nurse Practitioner PRN
Huntsville, AL · On-site
As a Hospice Nurse Practitioner with us, you'll play a vital role in providing comprehensive ... Review clinical information and seamlessly coordinate and oversee patient care in collaboration ...
New
Nurse Practitioner PRN
Huntsville, AL · On-site
As a Hospice Nurse Practitioner with us, you'll play a vital role in providing comprehensive ... Review clinical information and seamlessly coordinate and oversee patient care in collaboration ...
New
Nurse Practitioner PRN
Huntsville, AL · On-site
As a Hospice Nurse Practitioner with us, you'll play a vital role in providing comprehensive ... Review clinical information and seamlessly coordinate and oversee patient care in collaboration ...
Nurse Practitioner PRN
Huntsville, AL · On-site
As a Hospice Nurse Practitioner with us, you'll play a vital role in providing comprehensive ... Review clinical information and seamlessly coordinate and oversee patient care in collaboration ...
Nurse Practitioner
Huntsville, AL · On-site
... reviewing lab results, evaluating X-Ray, CT scan, and MRI results. Providing clear, concise, and ... Certified Registered Nurse Practitioner with First Assist, licensed to practice in Alabama.
Nurse Practitioner
Huntsville, AL · On-site
... reviewing lab results, evaluating X-Ray, CT scan, and MRI results. Providing clear, concise, and ... Certified Registered Nurse Practitioner with First Assist, licensed to practice in Alabama.
Nurse Practitioner
Huntsville, AL · On-site
... reviewing lab results, evaluating X-Ray, CT scan, and MRI results. Providing clear, concise, and ... Certified Registered Nurse Practitioner with First Assist, licensed to practice in Alabama.
New
Nurse Practitioner
Huntsville, AL · On-site
... reviewing lab results, evaluating X-Ray, CT scan, and MRI results. Providing clear, concise, and ... Certified Registered Nurse Practitioner with First Assist, licensed to practice in Alabama.
New
Nurse Practitioner
Huntsville, AL · On-site
... reviewing lab results, evaluating X-Ray, CT scan, and MRI results. Providing clear, concise, and ... Certified Registered Nurse Practitioner with First Assist, licensed to practice in Alabama.
Nurse Practitioner
Huntsville, AL · On-site
... reviewing lab results, evaluating X-Ray, CT scan, and MRI results. Providing clear, concise, and ... Certified Registered Nurse Practitioner with First Assist, licensed to practice in Alabama.
Nurse Practitioner PRN
Huntsville, AL · On-site
As a Hospice Nurse Practitioner with us, you'll play a vital role in providing comprehensive ... Review clinical information and seamlessly coordinate and oversee patient care in collaboration ...
Nurse Practitioner PRN
Huntsville, AL · On-site
As a Hospice Nurse Practitioner with us, you'll play a vital role in providing comprehensive ... Review clinical information and seamlessly coordinate and oversee patient care in collaboration ...
Nurse Practitioner
Huntsville, AL · On-site
... reviewing lab results, evaluating X-Ray, CT scan, and MRI results. Providing clear, concise, and ... Certified Registered Nurse Practitioner with First Assist, licensed to practice in Alabama.
Nurse Practitioner
Huntsville, AL · On-site
... reviewing lab results, evaluating X-Ray, CT scan, and MRI results. Providing clear, concise, and ... Certified Registered Nurse Practitioner with First Assist, licensed to practice in Alabama.
ANCC - Family Nurse Practitioner Certification (FNP) Tutor
Huntsville, AL · Remote
$30 - $40/hr
Adapts instruction using board review materials, clinical case analysis, and practice examinations to support MSN and DNP graduates preparing for ANCC Family Nurse Practitioner certification.
ANCC - Family Nurse Practitioner Certification (FNP) Tutor
Huntsville, AL · Remote
$30 - $40/hr
Adapts instruction using board review materials, clinical case analysis, and practice examinations to support MSN and DNP graduates preparing for ANCC Family Nurse Practitioner certification.
Nurse Practitioner
Huntsville, AL · On-site
Nurse Practitioner Behavioral Health Group (BHG) is the largest network of Joint Commission ... For further information, please review the Know Your Rights notice from the Department of Labor.
Nurse Practitioner
Huntsville, AL · On-site
Nurse Practitioner Behavioral Health Group (BHG) is the largest network of Joint Commission ... For further information, please review the Know Your Rights notice from the Department of Labor.
Utilization Review Np information
See Decatur, AL salary details
$20.06 - $24.11
2% of jobs
$24.11 - $28.17
9% of jobs
$30.94 is the 25th percentile. Wages below this are outliers.
$28.17 - $32.22
21% of jobs
The median wage is $35.51 / hr.
$32.22 - $36.28
23% of jobs
$36.28 - $40.34
13% of jobs
$43.49 is the 75th percentile. Wages above this are outliers.
$40.34 - $44.39
10% of jobs
$44.39 - $48.45
8% of jobs
$48.45 - $52.51
5% of jobs
$52.51 - $56.56
5% of jobs
$56.56 - $60.62
2% of jobs
$60.62 - $64.67
2% of jobs
$20
$39
$64
How much do utilization review np jobs pay per hour?
As of Jul 14, 2026, the average hourly pay for utilization review np in Decatur, AL is $39.64, according to ZipRecruiter salary data. Most workers in this role earn between $31.35 and $45.53 per hour, depending on experience, location, and employer.
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 NP 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 Decatur, AL? For Utilization Review Np jobs in Decatur, AL, the most frequently searched job titles are:
- Nurse Practitioner
- Part Time Psychiatric Nurse Practitioner
- Work From Home Womens Health Nurse Practitioner
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- Nights Corporate Nurse Practitioner
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- Day Shift Psych Np
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What job categories do people searching Utilization Review Np jobs in Decatur, AL look for? The top searched job categories for Utilization Review Np jobs in Decatur, AL are:
- Internship Nurse Practitioner Veteran Exams
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What cities near Decatur, AL are hiring for Utilization Review Np jobs? Cities near Decatur, AL with the most Utilization Review Np job openings:
Other
Posted 8 days ago
Job description
Surgical Utilization Review Registered Nurse
The Surgical Utilization Review Registered Nurse is responsible for conducting concurrent medical necessity reviews to ensure appropriate level-of-care determinations, regulatory compliance, and reimbursement integrity. This position serves as a liaison between physicians, advanced practice providers, nursing, case management, revenue cycle, and payer organizations to facilitate accurate patient status assignment, timely authorization management, and denial prevention. The primary focus of this role is surgical utilization review, including pre-operative, post-operative, and procedural patient populations. Responsibilities include validating compliance with Medicare, commercial payer, and organizational requirements, including Inpatient Only (IPO) procedures, Two-Midnight Rule criteria, observation services, and medical necessity requirements. This role requires strong collaboration with surgeons, physician assistants, nurse practitioners, hospitalists, and clinical staff to obtain clarifying documentation, facilitate timely order placement, and support appropriate status determinations. The Surgical UR RN is expected to serve as a resource for utilization management best practices and support broader utilization review functions as operational needs dictate.
QualificationsRequired Education: Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN) or Licensed Registered Nurse
Preferred Education: Bachelors Science Nursing or higher
Required Experience: 2 years previous nursing experience
Preferred Experience: Utilization Review or Case Management experience
Required License/Registration/Certification: Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN) or Licensed Registered Nurse
Preferred License/Registration/Certification: ACM or CCM Certification
Computer Skills Required: Data entry skills; Demonstrable skills with Google Docs, Google Sheets, Microsoft Suite and email applications.
About Huntsville Hospital
Sourced by ZipRecruiter
Huntsville Hospital, located in Huntsville, Alabama, USA, operates in the healthcare industry. The organization's official website can be visited at huntsvillehospital.org. The hospital is a community-owned, not-for-profit healthcare system that was first established in 1895. This institution of paramount importance currently offers comprehensive health services dedicated to meeting the diverse needs of its community. The institution provides its services across a broad spectrum; this includes a children's hospital, women and infants’ hospital, a senior-orientated network, surgical services, orthopedic services, and more. Above all, Huntsville Hospital's core values emphasize patient safety, dignity, and care. Their mission is to deliver high-quality care and create a healthier community.
Industry
Hospitals
Company size
10,000+ Employees
Headquarters location
Huntsville, AL, US