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Utilization Review Nurse Jobs in Ridgeland, MS (NOW HIRING)

Responsibilities We are looking for looking for a dynamic Utilization Review Coordinator to join ... A Bachelor of Science in Nursing with 3 - 5 years experience in psychiatric setting. About ...

Responsibilities We are looking for looking for a dynamic Utilization Review Coordinator to join ... A Bachelor of Science in Nursing with 3 - 5 years experience in psychiatric setting. About ...

The Case Manager directs the utilization review of patient charts, treatment plans, and discharge ... Graduate from an accredited school of nursing, RN.Minimum of two years' clinical experience ...

Care Management Director

Flowood, MS · On-site

$80 - $100/hr

... physicians, nurse practitioners, and therapists dedicated to delivering high‑quality ... Strong knowledge of healthcare regulations, utilization review, discharge planning, and quality ...

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Utilization Review Nurse information

See Ridgeland, MS salary details

$17

$35

$57

How much do utilization review nurse jobs pay per hour?

As of Sep 4, 2026, the average hourly pay for utilization review nurse in Ridgeland, MS is $35.23, according to ZipRecruiter salary data. Most workers in this role earn between $27.84 and $40.48 per hour, depending on experience, location, and employer.

What does a utilization review nurse do?

A Utilization Review Nurse is responsible for evaluating the necessity, appropriateness, and efficiency of healthcare services and treatments provided to patients. They review medical records, coordinate with healthcare providers, and ensure that care meets established guidelines and insurance requirements. Their primary goal is to ensure patients receive appropriate care while helping to manage healthcare costs and prevent unnecessary procedures.

What does a utilization review nurse do?

A utilization review nurse determines the best course of treatment for a patient using preapproved policy criteria. Utilization review nurses collect and review patient records, clinical documentation, and billing information to recommend the best use of patient care resources. Their assessments help determine the length of hospital stays, the effectiveness of the care plan, and the necessity of the services administered. Utilization review nurses inform and educate patients about their options based on their insurance benefits and limitations. Utilization review nurses also assess patient care services in clinical appeals for approval or denial.

What are some typical challenges utilization review nurses face when communicating with healthcare providers and insurance companies?

Utilization Review Nurses often need to balance clinical judgment with insurance guidelines, which can lead to challenging conversations with providers who may disagree with coverage decisions. They must clearly explain the rationale behind approvals or denials and ensure all documentation is thorough and compliant. Navigating differing priorities while maintaining positive, professional relationships is key, and strong communication skills help facilitate collaboration and resolve conflicts efficiently.

What are the key skills and qualifications needed to thrive as a utilization review nurse, and why are they important?

To thrive as a Utilization Review Nurse, you need a strong background in clinical nursing, critical thinking, and knowledge of healthcare regulations, usually supported by an RN license and nursing degree. Familiarity with utilization management software, medical coding systems (like ICD-10 and CPT), and case management certifications (such as CCM or URAC) is typically required. Excellent communication, negotiation, and organizational skills help you collaborate with providers and advocate for patient care while managing complex cases. These skills ensure appropriate resource use, regulatory compliance, and high-quality patient outcomes in healthcare settings.

What is the difference between Utilization Review Nurse vs Case Manager?

AspectUtilization Review NurseCase Manager
CredentialsRN license, certification in utilization review (e.g., URAC)RN license, case management certification (e.g., CCM)
Work EnvironmentHospitals, insurance companies, healthcare facilitiesHospitals, insurance companies, community health settings
Employer & Industry UsagePrimarily in insurance and healthcare organizations for reviewing medical necessityIn healthcare and insurance for coordinating patient care and discharge planning

Utilization Review Nurses focus on evaluating the necessity and appropriateness of medical services, often working in insurance or healthcare settings. Case Managers coordinate patient care, discharge planning, and resource management. While both roles require RN licensure and related certifications, their primary responsibilities differ: UR Nurses review medical necessity, whereas Case Managers facilitate patient care and services.

What are popular job titles related to Utilization Review Nurse jobs in Ridgeland, MS?

For Utilization Review Nurse jobs in Ridgeland, MS, the most frequently searched job titles are:

What job categories do people searching Utilization Review Nurse jobs in Ridgeland, MS look for?

The top searched job categories for Utilization Review Nurse jobs in Ridgeland, MS are:

What cities near Ridgeland, MS are hiring for Utilization Review Nurse jobs?

Cities near Ridgeland, MS with the most Utilization Review Nurse job openings:

Infographic showing various Utilization Review Nurse job openings in Ridgeland, MS as of August 2026, with employment types broken down into 2% As Needed, 64% Full Time, 6% Part Time, 2% Temporary, and 26% Contract. Highlights an 98% In-person, and 2% Remote job distribution, with an average salary of $73,275 per year, or $35.2 per hour.

Director of Utilization Review Management (Licensed)

UHS

Flowood, MS • On-site

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 14 days ago


Universal Health Services rating

6.9

Company rating: 6.9 out of 10

Based on 254 frontline employees who took The Breakroom Quiz

454th of 898 rated healthcare providers


Job description

Responsibilities

We are looking for looking for a dynamic Director of Utlization Review to join our team!

Brentwood Behavioral Healthcare is a provider of quality psychiatric treatment services for adults, children and adolescents. Our outpatient services are a convenient drive to areas in Hinds County, Madison County and Rankin County. We also provide inpatient services for those who need more structured treatment. As a leading provider of behavioral health services, our goal is to help individuals and families achieve optimal mental health, resulting in improved quality of life. Our dedicated team of professionals provides individualized treatment, meeting the personal needs of our customers in a secure and nurturing environment. Brentwood Behavioral Healthcare is a 133-bed acute psychiatric care facility located in Flowood, Mississippi. We are accredited by the Joint Commission of Accreditation of Healthcare Organizations and certified by Medicare, Medicaid and TRICARE®. We provide psychiatric treatment for depression, bipolar disorder, anxiety, schizophrenia, phobia and more. It is important these issues get treated so individuals are able to lead a healthy and happy life.

Website: Brentwoodjackson.com

Position Summary:The UR Director possesses knowledge of psychiatric clinical diagnosis and the ability to articulate those indicators professionally. The UR Director evaluates patient medical records to determine severity of patient’s illness and determining the appropriateness of level of care. Serves as liaison for patients and hospital with insurance companies. Negotiates and advocates for patient length of stay and level of care. Oversees utilization review activities with other departments to ensure reimbursement for services provided by the hospital. The UR Director leads physician weekly staffing meetings and coordinates with physician’s outpatient offices for the purposes of billing. The UR Director has a working knowledge of all levels of care offered and appropriately manages patient benefits.
 

WHAT DO OUR CURRENT EMPLOYEES VALUE AT BRENTWOOD AND UHS? 

An environment that puts patient care first.  One of the most rewarding aspects of this job is providing excellent care, comfort, and security to the patients and families you treat, at their most vulnerable times.  Supportive and responsive leadership.  You are never alone, as you are part of a large network of peer co-workers that routinely exchange ideas and review current topics within the industry.  Having the opportunity to grow, learn, and advance in your career.  There are very robust continuing education options and opportunities for skills diversification and career advancement with UHS.  

Benefit & Rewards Highlights 

  • Challenging and rewarding work environment
  • Competitive Compensation & Generous Paid Time Off
  • Excellent Medical, Dental, Vision and Prescription Drug Plans
  • 401(K) with company match and discounted stock plan
  • SoFi Student Loan Refinancing Program
  • Career development opportunities within UHS and its 300+ Subsidiaries!
  • Pet Insurance
  • More information is available on our Benefits Guest Website: uhsguest.com

Qualifications

Education: Degree in nursing, social work, mental health/behavioral sciences, or related field.  Combination of education and experience may be considered. 

Experience:  A minimum of five (5) years’ direct clinical experience in a psychiatric or mental health treatment setting. A minimum of one year of managing a related function is preferred.  Experience in patient assessment, family motivation, treatment planning and communication with external review organizations or comparable entities. 

Licensure:    LMSW, LPC, RN or LVN licensure is required.


About Universal Health Services

Headquartered in King of Prussia, PA, Universal Health Services, Inc. (NYSE: UHS) is one of the nation’s largest and most respected providers of hospital and healthcare services. Since our founding in 1979, UHS has grown steadily into a premier Fortune 500® corporation perennially recognized by multiple esteemed national rating entities. Through its subsidiaries, UHS operates inpatient acute care facilities, inpatient behavioral health facilities, outpatient and other facilities, nationwide virtual behavioral health services, an insurance offering, a physician network and various related services with physical locations in the U.S., Puerto Rico, Ireland and United Kingdom. www.uhs.com. 

From Fortune, ©2025, 2026 Fortune Media IP Limited. All rights reserved. Used under license.

EEO Statement 

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

 

Avoid and Report Recruitment Scams 

We are aware of a scam whereby imposters are posing as Recruiters from UHS, and our subsidiary hospitals and facilities. Beware of anyone requesting financial or personal information.

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc.

If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.

Qualifications:

Education: Degree in nursing, social work, mental health/behavioral sciences, or related field.  Combination of education and experience may be considered. 

Experience:  A minimum of five (5) years’ direct clinical experience in a psychiatric or mental health treatment setting. A minimum of one year of managing a related function is preferred.  Experience in patient assessment, family motivation, treatment planning and communication with external review organizations or comparable entities. 

Licensure:    LMSW, LPC, RN or LVN licensure is required.


About Universal Health Services

Headquartered in King of Prussia, PA, Universal Health Services, Inc. (NYSE: UHS) is one of the nation’s largest and most respected providers of hospital and healthcare services. Since our founding in 1979, UHS has grown steadily into a premier Fortune 500® corporation perennially recognized by multiple esteemed national rating entities. Through its subsidiaries, UHS operates inpatient acute care facilities, inpatient behavioral health facilities, outpatient and other facilities, nationwide virtual behavioral health services, an insurance offering, a physician network and various related services with physical locations in the U.S., Puerto Rico, Ireland and United Kingdom. www.uhs.com. 

From Fortune, ©2025, 2026 Fortune Media IP Limited. All rights reserved. Used under license.

EEO Statement 

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

 

Avoid and Report Recruitment Scams 

We are aware of a scam whereby imposters are posing as Recruiters from UHS, and our subsidiary hospitals and facilities. Beware of anyone requesting financial or personal information.

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc.

If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.

Education:UNAVAILABLEEmployment Type: FULL_TIME

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About Universal Health Services

Sourced by ZipRecruiter

Universal Health Services (UHS) is a major player in the healthcare industry, based in King of Prussia, Pennsylvania, U.S. Founded in 1978, UHS offers hospital and healthcare services. Their diverse services range from acute care hospitals, behavioral health facilities and ambulatory centers nationwide. The company's mission of enhancing the health and well-being of their patients is reflected in their commitment to 'Helping Individuals Live Longer, Healthier and Happier Lives'. Universal Health Services' consistent growth and success in their industry have been recognized on numerous occasions, including being ranked amongst the Fortune 500 list of largest companies.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

King of Prussia, PA, US