Utilization Review Nurse
Cooper City, FL · On-site
Qualifications: · Registered Nurse (RN) licensure required; must hold a USRN multi-state/compact ... in Utilization Review · Strong understanding of revenue cycle management and healthcare ...
Cooper City, FL · On-site
Qualifications: · Registered Nurse (RN) licensure required; must hold a USRN multi-state/compact ... in Utilization Review · Strong understanding of revenue cycle management and healthcare ...
Cooper City, FL · On-site
Qualifications: · Registered Nurse (RN) licensure required; must hold a USRN multi-state/compact ... in Utilization Review · Strong understanding of revenue cycle management and healthcare ...
Cooper City, FL · On-site
Qualifications: · Registered Nurse (RN) licensure required; must hold a USRN multi-state/compact ... in Utilization Review · Strong understanding of revenue cycle management and healthcare ...
Cooper City, FL · On-site
Qualifications: · Registered Nurse (RN) licensure required; must hold a USRN multi-state/compact ... in Utilization Review · Strong understanding of revenue cycle management and healthcare ...
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 ...
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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 ...
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 ...
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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 ...
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 ...
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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 ...
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 ...
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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 ...
Hours: 8:30-5:30, Monday - Friday At Houston Methodist, the Utilization Review Nurse (URN) position ... of Nursing_PSV Compact Licensure - Must obtain permanent Texas license within 60 days (if ...
Hours: 8:30-5:30, Monday - Friday At Houston Methodist, the Utilization Review Nurse (URN) position ... of Nursing_PSV Compact Licensure - Must obtain permanent Texas license within 60 days (if ...
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 ...
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 ...
Alpharetta, GA · On-site
The ideal candidate is a licensed Registered Nurse (RN) with experience in utilization management ... Review medical records, physician documentation, treatment plans, and diagnostic results to ...
New
Alpharetta, GA · On-site
The ideal candidate is a licensed Registered Nurse (RN) with experience in utilization management ... Review medical records, physician documentation, treatment plans, and diagnostic results to ...
New
Las Vegas, NV · On-site
$40 - $63/hr
Active Nevada RN license Additional Requirements: * Experience with InterQual (must be able to pass exam) * Experience with Milliman criteria Key Skills & Knowledge * Utilization review criteria ...
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Las Vegas, NV · On-site
$40 - $63/hr
Active Nevada RN license Additional Requirements: * Experience with InterQual (must be able to pass exam) * Experience with Milliman criteria Key Skills & Knowledge * Utilization review criteria ...
... 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 ...
... 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 ...
Las Vegas, NV · On-site
Active Nevada RN license Additional Requirements: * Experience with InterQual (must be able to pass exam) * Experience with Milliman criteria Key Skills & Knowledge * Utilization review criteria ...
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Las Vegas, NV · On-site
Active Nevada RN license Additional Requirements: * Experience with InterQual (must be able to pass exam) * Experience with Milliman criteria Key Skills & Knowledge * Utilization review criteria ...
... 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 ...
... 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 ...
Must maintain current Interstate Compact (multi-state) license if residency is not being changed to ... Utilization Review Category Nursing Workplace Set Up Hybrid
Must maintain current Interstate Compact (multi-state) license if residency is not being changed to ... Utilization Review Category Nursing Workplace Set Up Hybrid
... 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 ...
... 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 ...
Murray, UT · On-site +1
... 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 ...
Murray, UT · On-site +1
... 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 ...
Murray, UT · On-site +1
... 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 ...
Murray, UT · On-site +1
... 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 ...
Omaha, NE · On-site
Utilization Review Nurse We have openings in our Omaha, Nebraska office for Utilization Review ... Licenses/Experience: A current RN license as well as 5+ years of recent, hands-on clinical ...
Omaha, NE · On-site
Utilization Review Nurse We have openings in our Omaha, Nebraska office for Utilization Review ... Licenses/Experience: A current RN license as well as 5+ years of recent, hands-on clinical ...
Active Washington State Registered Nurse License. * Experience in utilization review. * Demonstrated ability to work collaboratively with all members of the care team (CNLs, MSWs, MDs) in conveyance ...
Active Washington State Registered Nurse License. * Experience in utilization review. * Demonstrated ability to work collaboratively with all members of the care team (CNLs, MSWs, MDs) in conveyance ...
$85K - $105K/yr
UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR ... Active, unrestricted RN license (BSN or MSN) in Oregon or a compact state * Graduation from an ...
$85K - $105K/yr
UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR ... Active, unrestricted RN license (BSN or MSN) in Oregon or a compact state * Graduation from an ...
$21.39 - $25.72
2% of jobs
$25.72 - $30.05
9% of jobs
$33.01 is the 25th percentile. Wages below this are outliers.
$30.05 - $34.38
21% of jobs
The median wage is $37.88 / hr.
$34.38 - $38.70
23% of jobs
$38.70 - $43.03
13% of jobs
$46.39 is the 75th percentile. Wages above this are outliers.
$43.03 - $47.36
10% of jobs
$47.36 - $51.68
8% of jobs
$51.68 - $56.01
5% of jobs
$56.01 - $60.34
5% of jobs
$60.34 - $64.66
2% of jobs
$64.66 - $68.99
2% of jobs
$21
$42
$68
| Aspect | Utilization Review Nurse Compact License | Utilization Review Nurse State License |
|---|---|---|
| Credentials | Multi-state license valid in participating states | License specific to one state |
| Work Environment | Allows practice across multiple states without multiple licenses | Limited to practicing within the issuing state |
| Employer & Industry Usage | Preferred for telehealth and multi-state employers | Required for in-state employment or non-participating states |
| Search & Comparison Intent | Commonly compared for flexibility in multi-state roles | Standard 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.

Full-time
Re-posted 21 hours ago
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.
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
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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Health care and social assistance
51 - 200 Employees
Cooper City, FL, US
2002