ZipRecruiter

Log In

1

Utilization Review Np Jobs (NOW HIRING)

Houston Healthcare

$80 - $100/hr

The Utilization Reviewer has the unique ability to follow the patient from admission to discharge and provide the physician and nursing staff with the best possible options for post hospital care for ...

Pride Health

Utilization Review Nurse

Manhattan, NY · On-site

$60 - $61/hr

Minimum 5 years of clinical nursing experience * Experience in Care Coordination, Utilization Review, and Discharge Planning * MLTC experience required * Computer proficiency required * PRI and ...

Pride Health

Utilization Review Nurse

Queens, NY · On-site

$2.8K/wk

Job title: RN - Utilization Review Job location : East Elmhurst, NY 11370-1381 Shift : 8:30 AM-5:00 PM Length : 8 weeks, Possible extension Local Hourly pay: $60 - $63/hr Travel Weekly Pay upto ...

Bracane Co

Utilization Review Nurse

Plano, TX · Remote

Austin area - Travis/Williamson Counties or Richardson area - Dallas/Collin Counties*** RN working ... This position is responsible for performing initial, concurrent review activities; discharge care ...

Albany Medical College

$80 - $100/hr

## Utilization Review NurseApplylocations: 43 New Scotland Avenue Albany, NY 12208time type: Full ... Minimum Qualifications:** • Registered nurse with a New York State current license. • Associate ...

Merrimack Health

Utilization Review Nurse

Methuen, MA · On-site

... they relate to utilization review and discharge planning and payer regulations. MINIMUM EDUCATION AND EXPERIENCE: Required: * Graduate of an accredited professional nursing school * Current ...

silvercross

Utilization Review Nurse

$34.73 - $45.15/hr

Nurse, Registered (RN) licensure * BSN preferred. 2-5 years previous Utilization Review experience preferred. * Current CPR * Relevant hospital nursing; hospital case management; insurance case ...

Albanymed

Utilization Review Nurse

Albany, NY · On-site

$77K - $119K/yr

While performing utilization review identifies areas for clinical documentation improvement and ... Registered nurse with a New York State current license. Associate's degree required. Bachelor ...

Albany Medical College

Utilization Review Nurse

Albany, NY · On-site

$80 - $100/hr

## Utilization Review NurseApplylocations: 43 New Scotland Avenue Albany, NY 12208time type: Full ... Minimum Qualifications:** • Registered nurse with a New York State current license. • Associate ...

previous page

Showing results 41-60

All JobsHealthcare JobsNursing JobsNurse Case Manager JobsUtilization Review Np Jobs

Utilization Review Np information

See salary details

$21

$42

$68

How much do utilization review np jobs pay per hour?

As of Sep 7, 2026, the average hourly pay for utilization review np in the United States is $42.28, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 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.

More about Utilization Review Np jobs

What cities are hiring for Utilization Review Np jobs?

Cities with the most Utilization Review Np job openings:

What states have the most Utilization Review Np jobs?

States with the most job openings for Utilization Review Np jobs include:

What job categories do people searching Utilization Review Np jobs look for?

The top searched job categories for Utilization Review Np jobs are:

Utilization Review Np jobs near you
Infographic showing various Utilization Review Np job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 14% Part Time, 1% Temporary, and 3% Contract. Highlights an 88% Physical, 3% Hybrid, and 9% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

Utilization Review Nurse

Houston Healthcare

On-site

$80 - $100/hr

Other

Posted 6 days ago

Job description

Work Shift

The Utilization Reviewer performs concurrent, extended stay and retrospective reviews of admissions using established criteria to determine appropriateness of admission and extended stay. The Utilization Reviewer serves as a resource to medical and hospital staff on utilization and regulatory issues and participates in coordination of individualized patient care services. The Utilization Reviewer plays an integral role in discharge planning and maximizing the continuum of care for patients assigned to his/her assigned unit. The Utilization Reviewer has the unique ability to follow the patient from admission to discharge and provide the physician and nursing staff with the best possible options for post hospital care for the patient.

Qualifications
  • Education & Training: Graduate of an accredited School of Nursing.
  • Experience: Three (3) years in an acute care setting.
  • Required Certification/Registration/Licensure: Current US state RN license with authorization to practice in the state of GA.

Knowledge, Skills & Abilities: Utilizes a variety of standard office equipment to include computer, printer, fax machine, copier, telephone etc. Basic knowledge of statistics encouraged.

Emory is an equal opportunity employer, and qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by state or federal law.

Emory Healthcare is committed to providing reasonable accommodations to qualified individuals with disabilities upon request.

Scheduled Weekly Hours: 40 FTE: 1 Expanded Work Shift: On Call:

Please note that one week's advance notice is preferred.

#J-18808-Ljbffr

Apply