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Utilization Review Nurse Compact License Jobs (NOW HIRING)

Acrisure

Utilization Review Nurse

Bradenton, FL

Active multistate/compact nursing license required * Strong clinical nursing experience with the ... Utilization review or case management experience highly beneficial * Clinical experience involving ...

Acrisure

Utilization Review Nurse

Bradenton, FL · On-site

Active multistate/compact nursing license required * Strong clinical nursing experience with the ... Utilization review or case management experience highly beneficial * Clinical experience involving ...

Acrisure LLC

Utilization Review Nurse

Bradenton, FL · On-site

Active multistate/compact nursing license required * Strong clinical nursing experience with the ... Utilization review or case management experience highly beneficial * Clinical experience involving ...

Oscar Health

Utilization Review Nurse

Miami, FL · Remote

$35 - $45.94/hr

We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... Active, unrestricted RN licensure from the United States in [state], OR, active compact multistate ...

Oscar Health

Utilization Review Nurse

Dallas, TX · Remote

$35 - $45.94/hr

We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... Active, unrestricted RN licensure from the United States in [state], OR, active compact multistate ...

Oscar Health

Utilization Review Nurse

Tempe, AZ · Remote

$35 - $45.94/hr

We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... Active, unrestricted RN licensure from the United States in [state], OR, active compact multistate ...

Oscar Health

Utilization Review Nurse

Atlanta, GA · Remote

$35 - $45.94/hr

We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... Active, unrestricted RN licensure from the United States in [state], OR, active compact multistate ...

Fusion HCR

Utilization Review Nurse

Las Vegas, NV · On-site

Active RN license (Nevada) * 5+ years acute care nursing experience * 3+ years Utilization Review experience * 3+ years discharge planning experience (acute care) * Experience with InterQual (must be ...

University of Utah

Utilization Review Nurse

... utilization of resources. * Performs verbal/fax clinical review with payer as determined by nursing ... Must maintain current Interstate Compact (multi-state) license if residency is not being changed to ...

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Utilization Review Nurse Compact License information

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How much do utilization review nurse compact license jobs pay per hour?

As of Aug 26, 2026, the average hourly pay for utilization review nurse compact license 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 is a utilization review nurse with a compact license?

A Utilization Review Nurse with a Compact License is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services provided to patients, ensuring they meet established criteria and guidelines. Holding a Compact License means the nurse is authorized to practice in multiple states that are part of the Nurse Licensure Compact (NLC), making them eligible for remote or multi-state utilization review positions. This role involves reviewing medical records, collaborating with healthcare providers, and helping ensure patients receive appropriate care while controlling healthcare costs.

What are the key skills and qualifications needed to thrive as a utilization review nurse with a compact license?

To thrive as a Utilization Review Nurse with a Compact License, you need a current RN license (valid under the Nurse Licensure Compact), strong clinical judgment, and in-depth knowledge of medical necessity criteria and healthcare regulations. Familiarity with utilization management software, electronic health records (EHRs), and standardized review tools like InterQual or Milliman is typically required. Excellent communication, critical thinking, and attention to detail are essential soft skills for collaborating with healthcare providers and ensuring accurate documentation. These skills and qualifications are vital to ensure cost-effective, quality patient care while maintaining compliance with regulatory standards across multiple states.

What are the typical challenges utilization review nurses with a compact license face when managing cases across multiple states?

Utilization Review Nurses with a Compact License often manage cases for patients located in various states, which can present challenges such as staying updated on differing state-specific regulations, payer policies, and healthcare guidelines. Navigating multiple systems and ensuring compliance with each state’s requirements can be complex and requires strong organizational skills. Collaboration with multidisciplinary teams and timely communication with providers in different locations are essential for effectively coordinating care and maintaining efficiency. Many employers offer robust onboarding and ongoing training to help UR nurses stay current and confident in managing cross-state cases.

What is the difference between Utilization Review Nurse Compact License vs Utilization Review Nurse State License?

AspectUtilization Review Nurse Compact LicenseUtilization Review Nurse State License
CredentialsMulti-state license valid in participating statesLicense specific to one state
Work EnvironmentAllows practice across multiple states without multiple licensesLimited to practicing within the issuing state
Employer & Industry UsagePreferred for telehealth and multi-state employersRequired for in-state employment or non-participating states
Search & Comparison IntentCommonly compared for flexibility in multi-state rolesStandard license for local practice

The Utilization Review Nurse Compact License enables nurses to work across multiple states with a single license, increasing flexibility for telehealth and multi-state employers. In contrast, a Utilization Review Nurse State License restricts practice to one state, suitable for local or in-state roles. Choosing between them depends on your work location and employer needs.

More about Utilization Review Nurse Compact License jobs

What cities are hiring for Utilization Review Nurse Compact License jobs?

Cities with the most Utilization Review Nurse Compact License job openings:

What states have the most Utilization Review Nurse Compact License jobs?

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Utilization Review Nurse Compact License jobs near you
Infographic showing various Utilization Review Nurse Compact License job openings in the United States as of August 2026, with employment types broken down into 2% As Needed, 68% Full Time, 24% Part Time, and 6% Contract. Highlights an 87% Physical, 1% Hybrid, and 12% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

Utilization Review Nurse

Cooper City, FL

Health Business Solutions LLC
Health Care and Social Assistance • 51 - 200 employees
Learn more about Health Business Solutions LLCexternal

Full-time

Re-posted 19 days ago

Job description

Job Summary: We are seeking a highly motivated and experienced Utilization Review Nurse to join our team. The Utilization Review Nurse will play a crucial role in supporting our clients in the healthcare industry by providing expert clinical guidance, facilitating effective utilization management, and ensuring revenue cycle efficiency. This position offers a unique opportunity to combine clinical expertise with revenue cycle management knowledge.

Key Responsibilities:

·       Clinical Assessment: Conduct comprehensive clinical assessments of medical records to ensure patients are receiving appropriate care at the correct level of service.

  • Care Coordination: Collaborate with interdisciplinary healthcare teams to coordinate patient care and treatment plans, ensuring the most cost-effective and clinically appropriate care is provided.
  • Revenue Cycle Management: Utilize clinical expertise to support revenue cycle processes, including accurate coding, documentation improvement, and compliance with healthcare regulations.
  • Utilization Review:

a) Apply medical necessity screening criteria and clinical knowledge to ensure appropriateness of admissions and length of stays

b) Conduct initial admission, continuing stay, and 23-hour observations reviews for all patients

c) Support Utilization Review Coordinator team members on cases escalated for level of care determinations

d) Screen cases for Physician Advisor review

e) Collaborate with insurance companies on concurrently denied and high risk for denial cases

  •  Documentation Improvement: Identify opportunities for improving clinical documentation to support accurate coding and billing processes, ultimately improving reimbursement.


  • Data Analysis: Analyze clinical and financial data to identify trends, opportunities for improvement, and areas of potential cost savings for clients.


  • Compliance: Stay up-to-date with healthcare regulations, guidelines, and policies to ensure all patient care and revenue cycle processes are in compliance with industry standards and regulatory requirements to ensure appropriate reimbursement.

Qualifications:

·       Registered Nurse (RN) licensure required; must hold a USRN multi-state/compact nursing license.

·       Bachelor of Science in Nursing (BSN) preferred.

·       Case Management Certification (e.g., CCM) is a plus.

·       Minimum of 3 years of clinical nursing experience, preferably in a hospital or acute care setting.

·       Minimum 2 years of work experience in Utilization Review

·       Strong understanding of revenue cycle management and healthcare reimbursement.

·       Proficiency in medical coding and clinical documentation improvement.

·       Excellent communication, interpersonal, and teamwork skills.

·       Ability to work independently and make sound clinical and financial decisions.

·       Strong analytical and problem-solving skills.

·       Proficient in using healthcare information systems and technology.

·       Commitment to maintaining patient confidentiality and ethical standards.

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