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

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Utilization Review Np information

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$42

$68

How much do utilization review np jobs pay per hour?

As of Aug 16, 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.

Advanced Practice Registered Nurse - Part-Time

Boca Recovery Center

Springfield, MA • On-site

$86K - $119K/yr

Part-time

Medical, Retirement, PTO

Re-posted 18 days ago

Job description

Advanced Practice Registered Nurse (APRN) PMHNP or FNP - Dual Preferred.
Boca Recovery Center Website
Location: On Site - Springfield, Massachusetts - Part Time M, W , F.
Department: Medical Services
Reports to: Medical Director
Salary: Competitive, based on licensure and experience
About Boca Recovery Center
Founded in 2016, Boca Recovery Center is a nationally recognized addiction treatment provider specializing in substance use disorders and co-occurring mental health conditions. With locations in Florida, New Jersey, Indiana, and Massachusetts, we deliver evidence-based clinical care in a supportive, structured environment. Our team is committed to providing trauma-informed, client-centered services that promote lasting recovery.
Position Overview
We are seeking an experienced and dedicated Advanced Practice Registered Nurse (APRN) to join our multidisciplinary medical team in Springfield, Massachusetts. The APRN plays a key clinical role in delivering psychiatric and medical services to individuals in detox and residential treatment. This role requires clinical expertise in psychiatric evaluations, medication management, and a collaborative approach to patient care.
Requirements
Key Responsibilities
  • Provide advanced nursing expertise for the design and execution of medical and clinical activities in accordance with each patient's treatment plan.
  • Conduct psychiatric and physical assessments, medication management, and consultations within scope of APRN practice.
  • Assess and assure the appropriateness of patient admissions and ongoing care.
  • Provide after-hours on-call coverage for emergency psychiatric or medical needs.
  • Attend and contribute to interdisciplinary team meetings to coordinate patient care.
  • Deliver in-service training to staff as needed.
  • Participate in facility performance improvement and utilization review activities.
  • Conduct peer reviews and contribute to the development and evaluation of policies and procedures.
  • Assist in developing a network of community resources for post-discharge continuity of care.
  • Collaborate with executive and clinical leadership on policies related to patient care.
  • Ensure timely and accurate documentation of assessments, orders, progress notes, and discharge summaries.
  • Provide consultation to patients and their families as appropriate.
  • Maintain a current collaborative agreement and prescriptive authority with the Medical Director.
  • Provide on-site services according to facility schedule and agreement.
  • Support and comply with infection control standards and collaborate with the Infection Control Nurse.
  • Ensure compliance with state and federal regulations and Joint Commission standards.
  • Uphold all safety, risk management, and workplace policies.
  • Coordinate clinical services under the guidance of the Medical Director, Clinical Director, and Director of Nursing.

Qualifications / Required Experience
  • Licensed to practice as an APRN in the state of Massachusetts.
  • Dual certified preferred, FNP and PMHNP.
  • On-call phone consultations required, when needed. Split between staff.
  • Active NPI and DEA registration (X-Waiver preferred but not required).
  • Current CPR certification.
  • Maintains all state-required certifications and licenses.
  • Minimum of 2 years' experience in psychiatric or addiction treatment settings preferred.
  • Essential Knowledge, Skills & Attributes
  • Proficiency in verbal and written communication.
  • Strong knowledge of addiction, dual-diagnosis treatment, and trauma-informed care.
  • Adherence to state Board of Nursing Scope of Practice and professional Code of Ethics.
  • Understanding of Infection Control protocols and Joint Commission standards.
  • Familiarity with HIPAA, Drug-Free Workplace, Workplace Violence Prevention, and Corporate Compliance.
  • High competency in electronic health records (EHR) systems.
  • Cultural sensitivity and ethical approach to diverse patient populations.
  • Ability to respond to psychiatric crises, including suicidality and homicidality.

Benefits
Boca Recovery Center offers a comprehensive benefits package, including:
  • Health Insurance
  • Retirement Plans
  • Disability Coverage
  • Paid Time Off
  • Continuing Education & Professional Development Opportunities

Join Boca Recovery Center and make a meaningful impact through expert, compassionate care in a mission-driven environment focused on recovery and wellness.

Apply