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Utilization Review Np Jobs in Springfield, MA (NOW HIRING)

Milan Laser

Flyer Travel Nurse Practitioner

Hartford, CT · On-site

$141K/yr

Personalize treatments, anticipate client needs, and encourage rebooking and reviews. * Clinic ... Current applicable Nurse Practitioner (NP) license in good standing, along with active national ...

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All JobsUtilization Review Np JobsUtilization Review Np Jobs in Springfield, MA

Utilization Review Np information

See Springfield, MA salary details

$21

$42

$68

How much do utilization review np jobs pay per hour?

As of Aug 7, 2026, the average hourly pay for utilization review np in Springfield, MA is $42.13, according to ZipRecruiter salary data. Most workers in this role earn between $33.32 and $48.37 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 are popular job titles related to Utilization Review Np jobs in Springfield, MA? For Utilization Review Np jobs in Springfield, MA, the most frequently searched job titles are:
What job categories do people searching Utilization Review Np jobs in Springfield, MA look for? The top searched job categories for Utilization Review Np jobs in Springfield, MA are:
What cities near Springfield, MA are hiring for Utilization Review Np jobs? Cities near Springfield, MA with the most Utilization Review Np job openings:
Utilization Review Np jobs near you
Infographic showing various Utilization Review Np job openings in Springfield, MA as of August 2026, with employment types broken down into 12% As Needed, 58% Full Time, 24% Part Time, and 6% Contract. Highlights an 94% In-person, and 6% Remote job distribution, with an average salary of $87,639 per year, or $42.1 per hour.

Nurse Practitioner (PRN) - Health Risk Assessments

Hueman Risk Adjustment Solutions

Agawam, MA • On-site

Other

Re-posted 9 days ago

Job description

Description
Hueman is actively hiring Nurse Practitioners to complete in-home Health Risk Assessments (HRAs) for Medicare and Medicaid members in and around Agawam, MA.
This unique opportunity adapts to your lifestyle, giving you the freedom to achieve your professional goals on your terms, all while enjoying a schedule designed with your preferences in mind. Whether it be for supplemental income or the desire for community connection, this position invites you to become an integral part of the thriving HRA landscape, fostering connections that go beyond the clinic.
Benefits include:
  • Competitive compensation and travel reimbursement
  • Flexible schedule
  • Comprehensive home assessment training
  • Dedicated patient scheduling assistance
  • Liability insurance options
Position Summary
Qualified Nurse Practitioners interested in this position will have the opportunity to interact with members in a more intimate setting. Unlike a typical clinic visit, this role allows NPs to connect with patients on a more personal and effective level. Nurse Practitioners performing HRAs are not required to treat or prescribe in the home.
Nurse Practitioner Responsibilities
  • Travel to and from patients' homes.
  • Perform comprehensive, non-invasive physical assessments.
  • Review medical history and ensure accurate and timely documentation.
  • Conduct medical reconciliation to ensure patient safety and compliance.
  • Provide basic patient education on wellness and preventative healthcare measures.
Nurse Practitioner Qualifications and Experience Requirements:
  • Master's Degree OR commensurate experience and satisfactory completion of NP license
  • Active State NP license
  • Active National board certification
  • Current BLS certification
  • 12 months of experience as a paid advanced clinical provider is preferred but not required

To learn more about this position, please use this link to schedule a call with a member of our recruitment team.
About Hueman
At Hueman, we're dedicated to guiding you toward fulfilling career opportunities.
We believe that happiness should be a fundamental part of every role in risk assessment. Our opportunities provide flexibility, extra income, and integration into your local healthcare network. If this resonates with your idea of career satisfaction, allow us to assist you in discovering your next healthcare position!
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