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Weekday Aetna Utilization Review Nurse Jobs (NOW HIRING)

US Tech Solutions

Utilization Review Nurse

Chicago, IL · On-site

Staff may be required to contact the providers of record, vendors, or internal Aetna departments to ... Do you have experience with Utilization Review? * Do you have an Active Registered Nurse License?

Fusion HCR

Utilization Review Nurse

Las Vegas, NV · On-site

Direct Hire - Utilization Review Nurse, this is an onsite position, working with our client in Acute Care. Overview Seeking an experienced Utilization Review Nurse (RN) to review patient admissions ...

Acrisure

Utilization Review Nurse

Bradenton, FL · On-site

Acrisure is seeking a Utilization Review Nurse, LPN to evaluate treatment requests and help ensure injured workers receive appropriate, timely care in accordance with applicable clinical guidelines ...

Acrisure

Utilization Review Nurse

Bradenton, FL · On-site

Acrisure is seeking a Utilization Review Nurse, LPN to evaluate treatment requests and help ensure injured workers receive appropriate, timely care in accordance with applicable clinical guidelines ...

Acrisure LLC

Utilization Review Nurse

Bradenton, FL · On-site

Acrisure is seeking a Utilization Review Nurse, LPN to evaluate treatment requests and help ensure injured workers receive appropriate, timely care in accordance with applicable clinical guidelines ...

Global Force

Utilization Review Nurse

Las Vegas, NV · On-site

About the job Utilization Review Nurse Sign on bonus may apply up to $15,000 Position Summary: Reviews patient admissions for appropriateness, efficiency of resource utilization and compliance with ...

US Tech Solutions

Utilization Review Nurse

Canton, MA · On-site

$55 - $60/hr

... Nurse to support outpatient utilization review and prior authorization activities for a leading healthcare organization. The ideal candidate will have a strong background in managed care, utilization ...

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 will perform frequent case reviews, check medical records and speak with care providers regarding ...

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 will perform frequent case reviews, check medical records and speak with care providers regarding ...

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Weekday Aetna Utilization Review Nurse information

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$68

How much do weekday aetna utilization review nurse jobs pay per hour?

As of Aug 24, 2026, the average hourly pay for weekday aetna utilization review nurse 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 the difference between Weekday Aetna Utilization Review Nurse vs Weekday Aetna Case Manager?

AspectWeekday Aetna Utilization Review NurseWeekday Aetna Case Manager
CredentialsRN license, certifications in utilization reviewRN license, case management certification preferred
Work EnvironmentHospitals, clinics, insurance companies during weekdaysInsurance companies, healthcare settings, often office-based
Primary ResponsibilitiesReview medical necessity, approve or deny servicesCoordinate care, develop treatment plans, advocate for patients

While both roles require nursing credentials and focus on patient care, the Weekday Aetna Utilization Review Nurse primarily evaluates medical necessity for insurance coverage, whereas the Weekday Aetna Case Manager actively manages patient care plans and coordinates services. Understanding these differences helps job seekers find the right fit in healthcare insurance roles.

What cities are hiring for Weekday Aetna Utilization Review Nurse jobs?

Cities with the most Weekday Aetna Utilization Review Nurse job openings:

What are the most commonly searched types of Aetna Utilization Review Nurse jobs?

The most popular types of Aetna Utilization Review Nurse jobs are:

What states have the most Weekday Aetna Utilization Review Nurse jobs?

States with the most job openings for Weekday Aetna Utilization Review Nurse jobs include:

Weekday Aetna Utilization Review Nurse jobs near you
Infographic showing various Weekday Aetna Utilization Review Nurse 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, 3% Contract, and 1% Nights. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

Utilization Review Nurse

US Tech Solutions

Chicago, IL • On-site

Other

Re-posted 18 hours ago

Job description

Chicago, IL

Contract

Job Description:

  • Participates in the development and ongoing implementation of QM Work Plan activities.

  • Improve quality products and services, by using measurement and analysis to process, evaluate and make recommendations to meet QM objectives

Responsibilities:

  • Reviews documentation and evaluates Potential Quality of Care issues based on clinical policies and benefit determinations.

  • Considers all documented system information as well as any additional records/data presented to develop a determination or recommendation.

  • Data gathering requires navigation through multiple system applications.

  • Staff may be required to contact the providers of record, vendors, or internal Aetna departments to obtain additional information.

  • Evaluates documentation/information to determine compliance with clinical policy, regulatory and accreditation guidelines.

  • Responsible for the review and evaluation of clinical information and documentation.

  • Reviews documentation and interprets data obtained form clinical records or systems to apply appropriate clinical criteria and policies in line with regulatory and accreditation requirements for member and/or provider issues.

  • Works Potential Quality of Care cases across all lines of business (Commercial and Medicare).

  • Independently coordinates the clinical resolution with internal/external clinician support as required.

  • Processes and evaluates complex data and information sets -Converts the results of data analysis into meaningful business information and reaches conclusions about the data

  • Prepares and completes QM documents based on interpretation and application of business requirements

  • Documents QM activities to demonstrate compliance with business, regulatory, and accreditation requirements

  • Assists in the development and implementation of QM projects and activities

  • Accountable for completing and implementation of QM Work Plan Activities

Experience:

  • 3+ years of experience as an RN

  • Registered Nurse in state of residence

  • Must have prior authorization utilization experience

  • Experience with Medcompass

Skills:

  • MUST HAVE MEDCOMPASS or ASSURECARE exp.

  • MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge.

  • MUST HAVE UM experience, inpatient utilization management review.

  • MUST HAVE 1 YEAR OF UTILIZATION MANAGEMENT EXP, pref. knowledge of Milliman/MCG.

  • MUST HAVE 6 months of Prior Authorization.

Education:

  • Active and unrestricted RN licensure in state of residence

Questionnaire:

  • Do you have experience with Medcompass?

  • Do you have experience with Prior Authorization?

  • Do you have experience with Utilization Review?

  • Do you have an Active Registered Nurse License?

About US Tech Solutions:

US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit www.ustechsolutions.com (http://www.ustechsolutionsinc.com) .

US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

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About US Tech Solutions

Sourced by ZipRecruiter

US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions.

Industry

It services

Company size

1,001 - 5,000 Employees

Headquarters location

Jersey City, NJ, US

Year founded

2000

Social media

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