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Utilization Review Np Jobs in Silver Spring, MD (NOW HIRING)

Prime Time Healthcare

Utilization Review

Baltimore, MD · On-site

  • Medical

  • Dental

  • Vision

  • Retirement

Now Hiring: RN Utilization Review - Baltimore, MD Are you a passionate RN professional looking for a new adventure? Prime Time Healthcare is seeking dynamic individuals like you to join our team in ...

Prime Time Healthcare

Utilization Review

Washington, DC · On-site

  • Medical

  • Dental

  • Vision

  • Retirement

Now Hiring: RN Utilization Review - Washington, DC Are you a passionate RN professional looking for a new adventure? Prime Time Healthcare is seeking dynamic individuals like you to join our team in ...

Ascension

Registered Nurse Utilization Review

Baltimore, MD · On-site

$84K - $120K/yr

  • Medical

  • PTO

Utilization Management Schedule: Day-Shift | Full-Time | Monday-Friday 8:00AM-4:30PM | Weekend ... Advocate for appropriate care by reviewing admissions and service requests to ensure every patient ...

MedStar Health

RN Team Lead Utilization Review

Clinton, MD · On-site

$89K - $162K/yr

... Utilization Review Team. Manages daily assignment ensuring all UM tasks are completed each day. Collaborates with the physician nurse case manager social worker and other members of the health care ...

MedStar Health

RN Team Lead Utilization Review

Clinton, MD · On-site

$89K - $162K/yr

... Utilization Review Team. Manages daily assignment ensuring all UM tasks are completed each day. Collaborates with the physician nurse case manager social worker and other members of the health care ...

System One

Utilization Management Specialist

Baltimore, MD · Remote

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote (U.S.) -- Maryland compact/eligibility required Type: Contract (approx. 3 months; potential extension ...

System One

Utilization Management Specialist

Baltimore, MD · Remote

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote (U.S.) -- Maryland compact/eligibility required Type: Contract (approx. 3 months; potential extension ...

System One

Utilization Management Specialist

Baltimore, MD · Remote

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote (U.S.) -- Maryland compact/eligibility required Type: Contract (approx. 3 months; potential extension ...

System One

Utilization Management Specialist

Baltimore, MD · Remote

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote (U.S.) -- Maryland compact/eligibility required Type: Contract (approx. 3 months; potential extension ...

System One

Utilization Management Specialist

Baltimore, MD · Remote

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote (U.S.) -- Maryland compact/eligibility required Type: Contract (approx. 3 months; potential extension ...

System One

Utilization Management Specialist

Baltimore, MD · Remote

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote (U.S.) -- Maryland compact/eligibility required Type: Contract (approx. 3 months; potential extension ...

System One

Utilization Management Specialist

Baltimore, MD · Remote

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote (U.S.) -- Maryland compact/eligibility required Type: Contract (approx. 3 months; potential extension ...

System One

Utilization Management Specialist

Baltimore, MD · Remote

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote (U.S.) -- Maryland compact/eligibility required Type: Contract (approx. 3 months; potential extension ...

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All JobsUtilization Review Np JobsUtilization Review Np Jobs in Silver Spring, MD

Utilization Review Np information

See Silver Spring, MD salary details

$22

$43

$71

How much do utilization review np jobs pay per hour?

As of Aug 20, 2026, the average hourly pay for utilization review np in Silver Spring, MD is $43.71, according to ZipRecruiter salary data. Most workers in this role earn between $34.52 and $50.19 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 Silver Spring, MD?

For Utilization Review Np jobs in Silver Spring, MD, the most frequently searched job titles are:

What job categories do people searching Utilization Review Np jobs in Silver Spring, MD look for?

The top searched job categories for Utilization Review Np jobs in Silver Spring, MD are:

What cities near Silver Spring, MD are hiring for Utilization Review Np jobs?

Cities near Silver Spring, MD with the most Utilization Review Np job openings:

Utilization Review Np jobs near you
Infographic showing various Utilization Review Np job openings in Silver Spring, MD as of August 2026, with employment types broken down into 1% As Needed, 86% Full Time, 10% Part Time, 2% Contract, and 1% Nights. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $90,917 per year, or $43.7 per hour.

UTILIZATION REVIEW NURSE THP

Korak Healthsource Group

Washington, DC

Full-time

Re-posted 28 days ago

Job description

Additional Information

All your information will be kept confidential according to EEO guidelines.

Korak Healthsource Group logo

About Korak Healthsource Group

Sourced by ZipRecruiter

Korak Healthsource Group Inc., looks beyond today’s challenges and creates values for the future. Today’s Claims Management clients need the organizational flexibility for all staffing solutions to drive cost savings, efficiencies improvements and enhancement to process effectiveness. Korak Healthsource is dedicated to developing innovative partnerships, creating customized staffing solutions, cost-effective and efficient health care claims administration outsourcing and support services to meet your business goals. Our focus is on your business goals to drive business process improvement, solution effectiveness and technology enhancements to accelerate results.

Industry

Recruiting and staffing services

Company size

11 - 50 Employees

Headquarters location

Forest Hill, MD, US

Year founded

1996

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