Utilization Review Nurse Jobs in the United States
Providence Health and Services
$43.29 - $76.06
Chugiak, AK
Our not-for-profit network also provides a full spectrum of care with leading-edge diagnostics and treatment, outpatient health centers, physician groups and clinics, outreach programs, and hospice and home care. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington.
Williamson Health
Murfreesboro, TN
The flagship facility, Williamson Medical Center, which recently opened its new Boyer-Bryan West Tower, offers extensive women's services, state-of-the-art cardiology services, advanced surgical technologies, an award-winning obstetrics and NICU, leading-edge orthopaedics, outpatient imaging services, and distinct comprehensive emergency and inpatient services for both adult and pediatric patients. Timely reviews patients within 24 hours or next business day after admission and at a minimum of every 2 days thereafter for continued stay, applying appropriate criteria (Interqual®) and facilitating reimbursement for services with third payer parties, obtaining and entering authorization number/approval status and notes in Meditech.
Epitec, Inc
$39 - $41
Albuquerque, NM
We’re seeking an experienced Registered Nurse to support Utilization Management (UM) activities, focused on medical necessity review, regulatory compliance, and appropriate use of healthcare resources. Evaluate requests for admissions, procedures, drugs/biologics, DME, home health, and OON services.
Providence Health and Services
$80000 - $96000
Bryn Mawr-Skyway, WA
It is comprised of eight hospital campuses (Ballard, Edmonds, Everett, Centralia, Cherry Hill (Seattle), First Hill (Seattle), Issaquah and Olympia); emergency rooms and specialty centers in Redmond (East King County) and the Mill Creek area in Everett; and Providence Swedish Medical Group, a network of 190+ primary care and specialty care locations throughout the Puget Sound. See Providence Health and Services Terms & Conditions at https://www.providence.org/utility-pages/privacy-policy#terms-of-use and Privacy Policy at https://www.providence.org/utility-pages/privacy-policy#privacy-policy and SonicJobs Privacy Policy at https://www.sonicjobs.com/us/privacy-policy and Terms of Use at https://www.sonicjobs.com/us/terms-conditions.
Providence Health and Services
$44.16 - $77.58
Eagle River, AK
Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. The goal of the Inpatient Care Management RN is to ensure the use of appropriate healthcare resources throughout the continuum, so that the care provided is the right care, at the right time, in the right setting.
Spectraforce Technologies Inc
Atlanta, GA
Configuration support will be for both pharmacy and medical criteria and will require good creative problem solving skills to ensure appropriate setup to meet client needs and maximum operation efficiency. Responsible for clinical criteria prior authorization setup, which takes client clinical policy requirements and creates the prior authorization request sent to prescribers.
TRS Healthcare
$2426
Orange, CA
TRS give nurses the best of both worlds - the adventure of experiencing new locations with the comfort security of a company founded by nurses. TRS Healthcare is seeking a Registered Nurse who is licensed to work in CA, and has Utilization Review experience.
Lancesoft Inc
$2300 - $2500
Atlanta, GA
A Utilization Review (UR) RN job involves assessing patient medical records and treatment plans to ensure care is medically necessary, appropriate, efficient, and cost-effective, working with providers and insurers to approve services, manage length of stay, prevent unnecessary procedures, and facilitate smooth transitions, often involving prospective, concurrent, and retrospective reviews. Conduct utilization review of patient cases to ensure quality of care and appropriateness of services provided.
GQR Healthcare
$2500 - $2595
Falls Church, VA
As an award-winning talent partner, we support healthcare professionals through every step of that process, offering meaningful opportunities, clear guidance, and long-term partnership. *Estimated weekly pay includes projected hourly wages and weekly meal and lodging per diems for eligible clinicians based on nationally published GSA rates.
GQR Healthcare
$2432 - $2527
Waukesha, WI
As an award-winning talent partner, we support healthcare professionals through every step of that process, offering meaningful opportunities, clear guidance, and long-term partnership. *Estimated weekly pay includes projected hourly wages and weekly meal and lodging per diems for eligible clinicians based on nationally published GSA rates.
GQR Healthcare
$2065 - $2160
San Pedro, CA
As an award-winning talent partner, we support healthcare professionals through every step of that process, offering meaningful opportunities, clear guidance, and long-term partnership. *Estimated weekly pay includes projected hourly wages and weekly meal and lodging per diems for eligible clinicians based on nationally published GSA rates.
GQR Healthcare
$1948 - $2043
Mission Viejo, CA
As an award-winning talent partner, we support healthcare professionals through every step of that process, offering meaningful opportunities, clear guidance, and long-term partnership. *Estimated weekly pay includes projected hourly wages and weekly meal and lodging per diems for eligible clinicians based on nationally published GSA rates.
GQR Healthcare
$2065 - $2160
Everett, WA
As an award-winning talent partner, we support healthcare professionals through every step of that process, offering meaningful opportunities, clear guidance, and long-term partnership. *Estimated weekly pay includes projected hourly wages and weekly meal and lodging per diems for eligible clinicians based on nationally published GSA rates.
GQR Healthcare
$3132 - $3227
Carmichael, CA
As an award-winning talent partner, we support healthcare professionals through every step of that process, offering meaningful opportunities, clear guidance, and long-term partnership. *Estimated weekly pay includes projected hourly wages and weekly meal and lodging per diems for eligible clinicians based on nationally published GSA rates.
GQR Healthcare
$2007 - $2102
Detroit, MI
As an award-winning talent partner, we support healthcare professionals through every step of that process, offering meaningful opportunities, clear guidance, and long-term partnership. *Estimated weekly pay includes projected hourly wages and weekly meal and lodging per diems for eligible clinicians based on nationally published GSA rates.
GQR Healthcare
$2065 - $2160
Torrance, CA
As an award-winning talent partner, we support healthcare professionals through every step of that process, offering meaningful opportunities, clear guidance, and long-term partnership. *Estimated weekly pay includes projected hourly wages and weekly meal and lodging per diems for eligible clinicians based on nationally published GSA rates.
GQR Healthcare
$2352 - $2447
Anchorage, AK
As an award-winning talent partner, we support healthcare professionals through every step of that process, offering meaningful opportunities, clear guidance, and long-term partnership. *Estimated weekly pay includes projected hourly wages and weekly meal and lodging per diems for eligible clinicians based on nationally published GSA rates.
GQR Healthcare
$2059 - $2154
Milford, MA
As an award-winning talent partner, we support healthcare professionals through every step of that process, offering meaningful opportunities, clear guidance, and long-term partnership. *Estimated weekly pay includes projected hourly wages and weekly meal and lodging per diems for eligible clinicians based on nationally published GSA rates.
GQR Healthcare
$1315 - $1410
Windom, MN
As an award-winning talent partner, we support healthcare professionals through every step of that process, offering meaningful opportunities, clear guidance, and long-term partnership. *Estimated weekly pay includes projected hourly wages and weekly meal and lodging per diems for eligible clinicians based on nationally published GSA rates.
GQR Healthcare
$2065 - $2160
Santa Monica, CA
As an award-winning talent partner, we support healthcare professionals through every step of that process, offering meaningful opportunities, clear guidance, and long-term partnership. *Estimated weekly pay includes projected hourly wages and weekly meal and lodging per diems for eligible clinicians based on nationally published GSA rates.
GQR Healthcare
$1455 - $1550
Longview, TX
As an award-winning talent partner, we support healthcare professionals through every step of that process, offering meaningful opportunities, clear guidance, and long-term partnership. *Estimated weekly pay includes projected hourly wages and weekly meal and lodging per diems for eligible clinicians based on nationally published GSA rates.
GQR Healthcare
$1980 - $2075
Portland, OR
As an award-winning talent partner, we support healthcare professionals through every step of that process, offering meaningful opportunities, clear guidance, and long-term partnership. *Estimated weekly pay includes projected hourly wages and weekly meal and lodging per diems for eligible clinicians based on nationally published GSA rates.
GQR Healthcare
$2557 - $2652
Burlingame, CA
As an award-winning talent partner, we support healthcare professionals through every step of that process, offering meaningful opportunities, clear guidance, and long-term partnership. *Estimated weekly pay includes projected hourly wages and weekly meal and lodging per diems for eligible clinicians based on nationally published GSA rates.
GQR Healthcare
$2065 - $2160
Mission Viejo, CA
As an award-winning talent partner, we support healthcare professionals through every step of that process, offering meaningful opportunities, clear guidance, and long-term partnership. *Estimated weekly pay includes projected hourly wages and weekly meal and lodging per diems for eligible clinicians based on nationally published GSA rates.
GQR Healthcare
$2065 - $2160
Orange, CA
As an award-winning talent partner, we support healthcare professionals through every step of that process, offering meaningful opportunities, clear guidance, and long-term partnership. *Estimated weekly pay includes projected hourly wages and weekly meal and lodging per diems for eligible clinicians based on nationally published GSA rates.
GQR Healthcare
$2820 - $2915
Ashland, WI
As an award-winning talent partner, we support healthcare professionals through every step of that process, offering meaningful opportunities, clear guidance, and long-term partnership. *Estimated weekly pay includes projected hourly wages and weekly meal and lodging per diems for eligible clinicians based on nationally published GSA rates.
GQR Healthcare
$2065 - $2160
Santa Rosa, CA
As an award-winning talent partner, we support healthcare professionals through every step of that process, offering meaningful opportunities, clear guidance, and long-term partnership. *Estimated weekly pay includes projected hourly wages and weekly meal and lodging per diems for eligible clinicians based on nationally published GSA rates.
Adelphi Healthcare
$46
Glendale, CO
The RNs will assist in the coordination and review of healthcare services for veterans, including clinical consultations and community-based care referrals, as well as ensuring the quality and effectiveness of medical services provided. • Communicate with veterans, community providers, internal staff, and administrative teams to facilitate and process care authorizations.
Bluebix Health Inc
$55 - $60
Camden, ME
The RN Utilization Management (UM) Nurse is responsible for reviewing and evaluating the medical necessity, appropriateness, and efficiency of healthcare services. Collaborate with physicians, case managers, and care teams to optimize patient care plans.
GQR Healthcare
Sundance, WY
Role Overview - RN responsible for case management across acute care, swing bed, and outpatient services. Focus on discharge planning, utilization review, care coordination, and CMS compliance.
TechLink Systems, Inc.
Everett, WA
Guaranteed Hours: 72 hours per 2 week period. Total Staffed Beds: 571 total for both campuses.
GQR Healthcare
$2989 - $3084
Everett, MA
As an award-winning talent partner, we support healthcare professionals through every step of that process, offering meaningful opportunities, clear guidance, and long-term partnership. *Estimated weekly pay includes projected hourly wages and weekly meal and lodging per diems for eligible clinicians based on nationally published GSA rates.
Magnet Medical
$2507
Orange, CA
Monitoring of Length of Stay and Discharge Planning: Monitor patient length of stay (LOS) to identify potential delays in discharge and ensure that patients are not staying in the hospital longer than necessary. The RN in this role works with healthcare providers, insurance companies, and patients to review medical records, treatment plans, and clinical data to determine the appropriate level of care and ensure compliance with healthcare policies and regulations.
Magnet Medical
$2406
Orono, ME
Monitoring of Length of Stay and Discharge Planning: Monitor patient length of stay (LOS) to identify potential delays in discharge and ensure that patients are not staying in the hospital longer than necessary. The RN in this role works with healthcare providers, insurance companies, and patients to review medical records, treatment plans, and clinical data to determine the appropriate level of care and ensure compliance with healthcare policies and regulations.
National Staffing Solutions
$2031.03 - $2345.61
Orange, CA
We`re currently seeking a RN - Utilization Review to join our amazing team with the following qualifications: One or more year(s) of experience as a RN. Licensed to practice as a RN with active license(s) in the state(s) in which employed and practices.
Pyramid Consulting, Inc
$75 - $85
Santa Clara, CA
Utilization Management:-Performs daily pre-admission, admission, and concurrent utilization reviews using guidelines, institutional policies/procedures, and other information to determine appropriate levels of care and readiness for discharge. By applying to our jobs you agree to receive calls, AI-generated calls, text messages, or emails from Pyramid Consulting, Inc. and its affiliates, and contracted partners.
Job.com LLC
$2900 - $3000
Greenbrae, CA
We are seeking an experienced Registered Nurse (RN) – Utilization Review to join our healthcare team in an acute care hospital setting. Collaborate with physicians, case managers, and healthcare teams to optimize patient outcomes.
Specialty Professional Services
$2143.58 - $2256.4
Washington, DC
Our Client is currently seeking Utilization Review for positions in Washington, DC for a 5x8 Days shift. The ideal candidate will possess a current DC license or Compact license Depending on the state.
Lancesoft Inc
$1990 - $2076
Torrance, CA
Facility: Providence SoCal Shared Services Case Management . Position: Registered nurse | Utilization Review .
GQR Healthcare
$1740
Fort Wayne, IN
Benefits: Day 1 Insurance Cigna medical, MetLife dental and vision insurance License reimbursement for new licenses needed for each assignment Discounts with hotels and rental cars A dedicated recruiter and support team that will help you every step of the way to sure you start on time and have an exceptional experience Referral bonus up to $700 About the Company: As an award-winning talent partner, we support healthcare professionals through every step of that process, offering meaningful opportunities, clear guidance, and long-term partnership.
GQR Healthcare
$1566
Davie, FL
Benefits: Day 1 Insurance Cigna medical, MetLife dental and vision insurance License reimbursement for new licenses needed for each assignment Discounts with hotels and rental cars A dedicated recruiter and support team that will help you every step of the way to sure you start on time and have an exceptional experience Referral bonus up to $700 About the Company: As an award-winning talent partner, we support healthcare professionals through every step of that process, offering meaningful opportunities, clear guidance, and long-term partnership.
GQR Healthcare
$1357
Round Rock, TX
Benefits: Day 1 Insurance Cigna medical, MetLife dental and vision insurance License reimbursement for new licenses needed for each assignment Discounts with hotels and rental cars A dedicated recruiter and support team that will help you every step of the way to sure you start on time and have an exceptional experience Referral bonus up to $700 About the Company: As an award-winning talent partner, we support healthcare professionals through every step of that process, offering meaningful opportunities, clear guidance, and long-term partnership.
GQR Healthcare
$1357
Austin, TX
Benefits: Day 1 Insurance Cigna medical, MetLife dental and vision insurance License reimbursement for new licenses needed for each assignment Discounts with hotels and rental cars A dedicated recruiter and support team that will help you every step of the way to sure you start on time and have an exceptional experience Referral bonus up to $700 About the Company: As an award-winning talent partner, we support healthcare professionals through every step of that process, offering meaningful opportunities, clear guidance, and long-term partnership.
GQR Healthcare
$1357
Brownsville, TX
Benefits: Day 1 Insurance Cigna medical, MetLife dental and vision insurance License reimbursement for new licenses needed for each assignment Discounts with hotels and rental cars A dedicated recruiter and support team that will help you every step of the way to sure you start on time and have an exceptional experience Referral bonus up to $700 About the Company: As an award-winning talent partner, we support healthcare professionals through every step of that process, offering meaningful opportunities, clear guidance, and long-term partnership.
GQR Healthcare
$1693
Asheville, NC
Benefits: Day 1 Insurance Cigna medical, MetLife dental and vision insurance License reimbursement for new licenses needed for each assignment Discounts with hotels and rental cars A dedicated recruiter and support team that will help you every step of the way to sure you start on time and have an exceptional experience Referral bonus up to $700 About the Company: As an award-winning talent partner, we support healthcare professionals through every step of that process, offering meaningful opportunities, clear guidance, and long-term partnership.
GQR Healthcare
$1566
Brooksville, FL
Benefits: Day 1 Insurance Cigna medical, MetLife dental and vision insurance License reimbursement for new licenses needed for each assignment Discounts with hotels and rental cars A dedicated recruiter and support team that will help you every step of the way to sure you start on time and have an exceptional experience Referral bonus up to $700 About the Company: As an award-winning talent partner, we support healthcare professionals through every step of that process, offering meaningful opportunities, clear guidance, and long-term partnership.
GQR Healthcare
$1508
Webster, TX
Benefits: Day 1 Insurance Cigna medical, MetLife dental and vision insurance License reimbursement for new licenses needed for each assignment Discounts with hotels and rental cars A dedicated recruiter and support team that will help you every step of the way to sure you start on time and have an exceptional experience Referral bonus up to $700 About the Company: As an award-winning talent partner, we support healthcare professionals through every step of that process, offering meaningful opportunities, clear guidance, and long-term partnership.
GQR Healthcare
Lebanon, NH
Benefits: Day 1 Insurance Cigna medical, MetLife dental and vision insurance License reimbursement for new licenses needed for each assignment Discounts with hotels and rental cars A dedicated recruiter and support team that will help you every step of the way to sure you start on time and have an exceptional experience Referral bonus up to $700 About the Company: As an award-winning talent partner, we support healthcare professionals through every step of that process, offering meaningful opportunities, clear guidance, and long-term partnership.
GQR Healthcare
$1972
Asheville, NC
Benefits: Day 1 Insurance Cigna medical, MetLife dental and vision insurance License reimbursement for new licenses needed for each assignment Discounts with hotels and rental cars A dedicated recruiter and support team that will help you every step of the way to sure you start on time and have an exceptional experience Referral bonus up to $700 About the Company: As an award-winning talent partner, we support healthcare professionals through every step of that process, offering meaningful opportunities, clear guidance, and long-term partnership.
Compunnel Healthcare
$50 - $52
Atlanta, GA
Role Responsibilities:Perform medical necessity reviews for outpatient services using MCG guidelines, KP criteria, and LCD criteria. Job Title: Registered Nurse (RN) – Utilization Review (UR) Facility: Kaiser Permanente – Regional Office, Atlanta, GA.