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Utilization Review Np Jobs in Rochester, MN (NOW HIRING)

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Utilization Review Np information

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How much do utilization review np jobs pay per hour?

As of Aug 6, 2026, the average hourly pay for utilization review np in Rochester, MN is $42.98, according to ZipRecruiter salary data. Most workers in this role earn between $33.94 and $49.38 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 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?

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 cities near Rochester, MN are hiring for Utilization Review Np jobs? Cities near Rochester, MN with the most Utilization Review Np job openings:
Infographic showing various Utilization Review Np job openings in Rochester, MN as of August 2026, with employment types broken down into 100% Full Time. Highlights an 83% In-person, and 17% Remote job distribution, with an average salary of $89,397 per year, or $43 per hour.

Nurse Practitioner (NP) or Physician Assistant (PA) - Pediatrics

Olmsted Medical Center

Rochester, MN โ€ข On-site

$61.78 - $84.25/hr

Other

Medical, Dental, Vision, Life, Retirement, PTO

This job post hasย expired today.ย Applications are no longer accepted.


Job description

Description
0.8 FTE - Pediatrics - Outpatient and Inpatient - Call rotation 1:8

Salary range: $61.78-$84.25 per hour.

Offers for external candidates are generally made between the minimum and midpoint of the range, based on experience.

Incentive Plan: Eligible for a variable, or non-guaranteed, portion of compensation based on achievement of specific citizenship, quality, or other goals. This is currently 7.5% of base income.

At Olmsted Medical Center, we value our clinicians and are committed to providing a comprehensive and competitive benefits package. To keep up with the evolving trends, Olmsted Medical Center offers the following for clinicians who are employed at a 0.5 FTE or higher.

  • Medical Insurance
  • Dental Insurance
  • Vision Insurance
  • Basic Life Insurance
  • Employer Paid Short-Term Disability and Long-Term Disability
  • Adoption Assistance Plan
  • PTO
  • CME
  • 401K
  • Malpractice

Advanced Practice Registered Nurses - APRNs:

  • Graduate of an accredited school of nursing with a Masters or Doctorate degree
  • Licensed as a registered nurse and as an APRN by the Minnesota Board of Nursing
  • Certified by a national credentialing board
  • Certified by specialty
  • Must complete continuing education and professional development beyond formal education as outlined by certifying body

Physician Assistant - PAs:

  • Graduate of an accredited physician assistant program
  • Licensed by Minnesota Board of Medicine
  • Certified through National Commission on Certification of Physician Assistants
  • Certification by specialty is also available
  • Must complete continuing education and professional development beyond formal education as outlined by certifying body

Both APC positions will also have:

  • Basic Life Support (Advanced Life Support as required by your area of practice)
  • DEA registration
  • Pass background check
  • Register with the Minnesota Prescriptive Monitoring Program (PMP).
  • Two years experience as a Pediatric NP/PA
  • PNP with nursery experience or NNP
  • NICU Experience

Expectations include:

  • Professional and ethical code of conduct
  • Culturally sensitive advocate for diverse populations
  • Ability to work autonomously and in partnership with healthcare team
  • Excellent written and verbal communication skills
  • Commitment to community service area
  • Ability to manage time and stress effectively and adapt to unpredictable situations within the patient care setting
  • Flexibility
  • Demonstrates proficiency in electronic medical record use
  • Works where job is physically demanding
  • Ability to teach and counsel individuals, families, and groups
  • Shares knowledge that promotes quality healthcare and improves clinical outcomes
  • Acts as leader, mentor, educator, researcher, and/or administrator as indicated
  • Participates in health policy activities at the local, state, national, and international levels as indicated
  • Maintains patient confidentiality and privacy at all times
  • Obtains and documents accurate patient(s) health history including medical, social, and psychological needs
  • Diagnoses and manages preventive, acute, and chronic healthcare conditions as indicated specific to your area of practice
  • Provides appropriate patient education
  • Emphasizes health promotion and disease prevention
  • Performs procedures as indicated specific to your area of practice
  • Orders and interprets laboratory and diagnostic tests and procedures; communicates results to patient(s) in a timely manner
  • Discusses assessments, prognosis, and treatment options with patient(s) to develop acceptable, affordable, and culturally sensitive treatment plans
  • Prescribes medications, treatment modalities, and durable medical equipment as indicated by health condition
  • Consults with and refers to other healthcare clinicians when indicated
  • Committee participation and meeting attendance
  • Participates in both professional and lay healthcare forums, conducts research, and applies findings to clinical practice as indicated
  • Other duties as assigned

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.