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Utilization Review Np Jobs in Ripley, TN (NOW HIRING)

DOCS Health

Nurse Practitioner

Trenton, TN · On-site

Nurse Practitioner Opportunity Attention all Nurse Practitioners, we are calling you to partner ... Review health history, service member medical records, and medical questionnaires. * Interview ...

DOCS Health

Nurse Practitioner

Trenton, TN · 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

Trenton, TN · 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

Trenton, TN · 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 ...

Fast Pace Health

Family Nurse Practitioner

Millington, TN · On-site

$102K - $129K/yr

Discuss and review patients' medical history, symptoms, allergies, and current medications ... Ability to perform responsibilities within standard NP protocols. * Responsible for learning the ...

Fast Pace Health

Family Nurse Practitioner

Covington, TN · On-site

$98K - $125K/yr

Discuss and review patients' medical history, symptoms, allergies, and current medications ... Ability to perform responsibilities within standard NP protocols. * Responsible for learning the ...

Fast Pace Health

Family Nurse Practitioner

Millington, TN · On-site

$102K - $129K/yr

Discuss and review patients' medical history, symptoms, allergies, and current medications ... Ability to perform responsibilities within standard NP protocols. * Responsible for learning the ...

Fast Pace Health

Family Nurse Practitioner

Covington, TN · On-site

$98K - $125K/yr

Discuss and review patients' medical history, symptoms, allergies, and current medications ... Ability to perform responsibilities within standard NP protocols. * Responsible for learning the ...

Fast Pace Health

Family Nurse Practitioner

Covington, TN · On-site

$98K - $125K/yr

Discuss and review patients' medical history, symptoms, allergies, and current medications ... Ability to perform responsibilities within standard NP protocols. * Responsible for learning the ...

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All JobsUtilization Review Np JobsUtilization Review Np Jobs in Ripley, TN

Utilization Review Np information

See Ripley, TN salary details

$18

$37

$60

How much do utilization review np jobs pay per hour?

As of Aug 29, 2026, the average hourly pay for utilization review np in Ripley, TN is $37.17, according to ZipRecruiter salary data. Most workers in this role earn between $29.38 and $42.69 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 Ripley, TN?

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

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The top searched job categories for Utilization Review Np jobs in Ripley, TN are:

What cities near Ripley, TN are hiring for Utilization Review Np jobs?

Cities near Ripley, TN with the most Utilization Review Np job openings:

Utilization Review Np jobs near you

NURSE PRACTITIONER

Jackson, TN • On-site

Christ Community Health Services
51 - 200 employees
Learn more about Christ Community Health Servicesexternal

Other

Re-posted 3 days ago

Job description

 

POSITION SUMMARY

The Nurse Practitioner/Physician Assistant (Women's Health) will provide professional comprehensive primary medical services for ambulatory CCHS patients in collaboration with health center staff physicians.

DUTIES AND RESPONSIBILITIES

  1. The Nurse Practitioner/Physician Assistant will provide care for outpatients within their scope of training in collaboration with CCHS physicians.  Medical care will consist of assessment, ordering and interpretation of data, development and implementation of a therapeutic plan including prescription writing, referrals and procedures within their capacity of expertise, protocols and available equipment and appropriate follow up.
  2. The Nurse Practitioner/Physician Assistant will attend staff meetings and provider meetings and maintain a level of involvement with the health center committees as needed to ensure quality of care of patients.
  3. The Nurse Practitioner/Physician Assistant is to participate in peer review, performance evaluations and improvement data, and other activities to assess and advance quality improvement measures.
  4. Provider expectations regarding productivity are roughly 20 patients per day.  Providers may be rewarded at greater than a specified average on a monthly basis, and salary penalties may be initiated if the provider falls below a specified average on a quarterly basis.
  5. The Nurse Practitioner/Physician Assistant will collaborate with CCHS health center staff physicians as appropriate, and may be asked to assist in the educational training of Students.
  6. The Nurse Practitioner/Physician Assistants are expected to participate in Continuing Medical Education, including Life Support Training, etc., to maintain the skills necessary to perform their duties and as required by their boards and the state.
  7. The Nurse Practitioner/Physician Assistants are expected to sustain the health necessary to perform their duties and maintain current Immunization and PPD status.
  8. The Nurse Practitioner/Physician Assistant is expected to notify CCHS about any problems that occur regarding Drugs, Felonies, Discipline, Loss of License or Privileges, or other serious issues.
  9. The Nurse Practitioner/Physician Assistant will perform other duties as assigned by the Medical Director.


QUALIFICATIONS


  1. RN, Masters or Nurse Doctorate (ND) Certification by American Nurses Credentialing Center (ANCC); or Masters degree in Physician Assistant Studies, Health or Medical Sciences by Accreditation Review Commission on Education for the Physician Assistant (ARC-PA).
  1. Certification of American Academy of Nurse Practitioners, National Board of Pediatric Nurse Practitioners, or equivalent certifying body; or National Commission on Certification of Physician Assistants.
  1. State licensure to practice medicine in the State of Tennessee.

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