ZipRecruiter

Log In

1

Utilization Review Np Jobs in Santa Rosa, CA (NOW HIRING)

Petaluma Health Center

Nurse Practitioner

Bolinas, CA · On-site

Nurse Practitioner Petaluma Health Center is recruiting for a Nurse Practitioner to join our award ... Demonstrate competent knowledge in delivering health care to patients through the peer review ...

Petaluma Health Center

Nurse Practitioner

Petaluma, CA · On-site

$127K - $173K/yr

Summary: The Nurse Practitioner will work at the top of their licensure and as part of a team of ... Demonstrate competent knowledge in delivering health care to patients through the peer review ...

Petaluma Health Center

Nurse Practitioner

Rohnert Park, CA · On-site

$127K - $173K/yr

Summary: The Nurse Practitioner will work at the top of their licensure and as part of a team of ... Demonstrate competent knowledge in delivering health care to patients through the peer review ...

Petaluma Health Center

Nurse Practitioner

Bolinas, CA · On-site

$127K - $173K/yr

Summary: The Nurse Practitioner will work at the top of their licensure and as part of a team of ... Demonstrate competent knowledge in delivering health care to patients through the peer review ...

Petaluma Health Center

Nurse Practitioner

Bolinas, CA · On-site

$127K - $173K/yr

Summary: The Nurse Practitioner will work at the top of their licensure and as part of a team of ... Demonstrate competent knowledge in delivering health care to patients through the peer review ...

Petaluma Health Center

Nurse Practitioner

Rohnert Park, CA · On-site

$127K - $173K/yr

Summary: The Nurse Practitioner will work at the top of their licensure and as part of a team of ... Demonstrate competent knowledge in delivering health care to patients through the peer review ...

Petaluma Health Center

Nurse Practitioner

Petaluma, CA · On-site

$127K - $173K/yr

Summary: The Nurse Practitioner will work at the top of their licensure and as part of a team of ... Demonstrate competent knowledge in delivering health care to patients through the peer review ...

Petaluma Health Center

Nurse Practitioner

Rohnert Park, CA · On-site

$127K - $173K/yr

Summary: The Nurse Practitioner will work at the top of their licensure and as part of a team of ... Demonstrate competent knowledge in delivering health care to patients through the peer review ...

Petaluma Health Center

Nurse Practitioner

Petaluma, CA · On-site

Summary: The Nurse Practitioner will work at the top of their licensure and as part of a team of ... Demonstrate competent knowledge in delivering health care to patients through the peer review ...

Petaluma Health Center

Nurse Practitioner

Petaluma, CA · On-site

$127K - $173K/yr

Summary: The Nurse Practitioner will work at the top of their licensure and as part of a team of ... Demonstrate competent knowledge in delivering health care to patients through the peer review ...

Petaluma Health Center

Nurse Practitioner

Bolinas, CA

$127K - $173K/yr

Summary: The Nurse Practitioner will work at the top of their licensure and as part of a team of ... Demonstrate competent knowledge in delivering health care to patients through the peer review ...

Petaluma Health Center

Nurse Practitioner

Petaluma, CA · On-site

$127K - $173K/yr

Summary: The Nurse Practitioner will work at the top of their licensure and as part of a team of ... Demonstrate competent knowledge in delivering health care to patients through the peer review ...

Petaluma Health Center

Nurse Practitioner

Rohnert Park, CA · On-site

$127K - $173K/yr

Summary: The Nurse Practitioner will work at the top of their licensure and as part of a team of ... Demonstrate competent knowledge in delivering health care to patients through the peer review ...

next page

Showing results 1-20

All JobsUtilization Review Np JobsUtilization Review Np Jobs in Santa Rosa, CA

Utilization Review Np information

See Santa Rosa, CA salary details

$23

$46

$75

How much do utilization review np jobs pay per hour?

As of Aug 20, 2026, the average hourly pay for utilization review np in Santa Rosa, CA is $46.23, according to ZipRecruiter salary data. Most workers in this role earn between $36.54 and $53.08 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 Santa Rosa, CA?

For Utilization Review Np jobs in Santa Rosa, CA, the most frequently searched job titles are:

What job categories do people searching Utilization Review Np jobs in Santa Rosa, CA look for?

The top searched job categories for Utilization Review Np jobs in Santa Rosa, CA are:

What cities near Santa Rosa, CA are hiring for Utilization Review Np jobs?

Cities near Santa Rosa, CA with the most Utilization Review Np job openings:

Utilization Review Np jobs near you
Infographic showing various Utilization Review Np job openings in Santa Rosa, CA as of August 2026, with employment types broken down into 1% As Needed, 79% Full Time, 14% Part Time, 5% Contract, and 1% Nights. Highlights an 90% Physical, 3% Hybrid, and 7% Remote job distribution, with an average salary of $96,155 per year, or $46.2 per hour.

Registered Nurse Utilization Review

vTech Solution

Santa Rosa, CA • On-site

Other

Re-posted 22 days ago

Job description

Job Summary:
We seek a highly skilled and experienced Registered Nurse with specialties in Medical/Surgical, ICU, ER, Psychiatric, Labor & Delivery, PACU, Operating Room. The Registered Nurse will be responsible for providing skilled nursing care, case management, and hospice care to individuals facing advancing age, frailty, and serious illness. Daily tasks include patient assessments, medication administration, treatment planning, and collaborating with the interdisciplinary team. Critical to this role is strong communication and strong collaboration with patients, providers, and other members of our team. At least 2 years of experience and exceptional skill is required.
Responsibilities:
  • Conduct patient assessments and monitor patient conditions.
  • Administer medications and treatments as prescribed.
  • Develop and implement individualized treatment plans.
  • Collaborate with interdisciplinary teams including physicians, therapists, and social workers.
  • Provide case management and hospice care for patients with advancing age, frailty, and serious illness.
  • Document patient care activities and maintain accurate medical records.
  • Communicate effectively with patients, families, and healthcare providers.
Required Skills & Certifications:
  • Active Registered Nurse license in the state of employment.
  • Bachelor's degree in Nursing or related field.
  • Minimum of 2 years' experience in hospital, home health, or hospice care.
  • Clinical assessment, medication administration, and treatment planning skills.
  • Interdisciplinary team collaboration skills.
  • Excellent communication and interpersonal skills.
  • Driver's license, car insurance, and automobile for field work.
Preferred Skills & Certifications:
  • Experience in Utilization Review or case management roles.
  • Specialty certifications relevant to Medical/Surgical, ICU, ER, Psychiatric, Labor & Delivery, PACU, or Operating Room nursing.
  • Advanced certifications such as CCRN, CMC, or CHPN.
Special Considerations:
  • May require occasional field visits necessitating reliable transportation.
  • Strong ability to work independently in remote settings.
  • Must be able to handle fast-paced and complex clinical situations.
Scheduling:
  • Remote work with flexible scheduling based on utilization review caseload.
  • Standard business hours with potential for occasional extended hours as needed.
vTech Solution logo

About vTech Solution

Sourced by ZipRecruiter

vTech is a Managed IT Services firm based out of Washington DC with a primary focus on Cloud Computing and Managed Network Security.

Industry

It services

Company size

51 - 200 Employees

Headquarters location

Washington, DC, US

Year founded

2006

Social media

FacebookTwitter

View All vTech Solution Jobs

Apply