Utilization Review Nurse
OU Health
Position opening: Utilization Review Nurse at OU Health, Remote. Employment type: Full-Time. If you are looking for a new opportunity, review the details below and apply through the link provided. Posted: Oct 21, 2026. OU Health seeks an experienced Utilization Review Nurse (RN) to support the Children’s Behavioral Health Center. The role involves evaluating medical necessity, coordinating with Payors, and ensuring appropriate hospital stay authorizations after fall 2026 start. Levels I–III reflect increasing experience and education, with RN licensure required and a strong emphasis on regulation, documentation, and patient-centered care. Telework options may be available with secure PHI handling. #J-18808-Ljbffr
- ...Description: Nurses - are you looking for a change? Want to work no nights, and no holidays... ...DESCRIPTION: This individual will utilize clinical knowledge and communication... ...individual will defer decision to a second level reviewer. This individual interfaces with case...SuggestedTemporary workRemote workMonday to FridayFlexible hours
- ...To support a mission-driven health organization, the full-time Utilization Review Nurse - RN will conduct medical necessity reviews, escalate non-certifications for secondary clinical review, and analyze clinical records to ensure timely and compliant care determinations...SuggestedFull timeRemote work
- ...A healthcare services provider is seeking a Remote Utilization Review Nurse to coordinate clinical resources, ensuring compliance with healthcare standards. Responsibilities include processing authorizations, reviewing documentation, and collaborating with teams to meet...SuggestedContract workRemote work
- ...experience performing care for hospitalized patients ~2 years of Utilization Review (UR) experience reviewing hospital admissions for medical... ...setting. Minimum Requirements Education ~ Nursing Diploma/Associate's - Nursing Experience ~2-5 years...SuggestedFull timeReliefLocal areaRemote workMonday to FridayFlexible hoursShift work
- ...Gainwell Technologies LLC is looking for a Utilization Review Nurse to work remotely in Maine. You will conduct reviews for medical necessity and appropriateness of services, utilizing clinical criteria and guidelines. Qualified candidates should have an active Maine...SuggestedRemote workFlexible hours
- ...Responsible for utilization review work for emergency admissions and continued stay reviews Responsibilities Review and evaluate... ...setting in emergency room, critical care and/or medical/surgical nursing At least 2 years utilization management experience in...Full timeFor contractorsWork at officeRemote workShift workWeekend workWeekday work
- ...and year-end reports. Responsibilities: 1. Conducts on-site reviews at participating provider offices to assess environment, quality... ...n health care industry. 2. Requires License Practical Nurse License or an active New Jersey Registered Nurse License. 1. Requires...Remote work
$65k - $78k
...learning, and career development. Your Role In Our Mission Review admissions, procedures, services, and supplies for medical... ...rationale in medical management systems. Assist in training new nurses, provide feedback, and stay updated on clinical guidelines....Full timeWork at officeRemote workWork from homeFlexible hours- ...meaningfully. Note: New Jersey RN Active License is required. Role Description This is a Field work contract role for a Utilization Review Nurse. The Utilization Review Nurse will be responsible for performing utilization management, reviewing medical records,...Contract workRemote work
$95k - $107.5k
...Job Type Full-time Description Title: Nurse Reviewer, Utilization Management Job Type: Full-time Location: Hybrid - 4 days per week in Brighton, MA office; 1 day remote FLSA Status: Exempt About Us BrightonOne is a nonprofit social enterprise...Full timeLocal areaRemote work- ...submit it. Responsible for performing Workers' Compensation utilization review, which includes prospective, concurrent, expedited, and... ...Education: Diploma, Associate, bachelor's degree in nursing, or Master's level (or higher) degree in a Nursing, Health or...Remote workLong distance
$35 - $45.94 per hour
...Hi, we're Oscar. 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 treatment as needed. You will make recommendations regarding...Hourly payFull timeFor contractorsRemote workWork from homeRelocationHome officeWeekend work- ...Utilization Review Nurse Location: [City, State / Remote] Employment Type: Full-Time Experience: 2-5+ Years Job Summary We are seeking a detail-oriented and experienced Utilization Review Nurse to evaluate the medical necessity, appropriateness, and...Full timeSecond jobWork at officeRemote work
- ...Overview Title: Clinical Review Nurse – Prior Authorization Review Location: Fully Remote (PST Time Zone - WA/OR Resident)... ...Clinical Review Nurse for Prior Authorization Review to join our Utilization Management team. In this role, you will conduct concurrent...Contract workRemote work
$35 - $45 per hour
...Base pay range $35.00/hr - $45.00/hr Direct message the job poster from IntePros IntePros is seeking a Remote Utilization Review Nurse serves as a key clinical liaison, coordinating resources and services to meet patients’ needs while ensuring compliance with federal,...Contract workRemote workWeekend work$40 per hour
...responsible for performing initial, concurrent review activities; discharge care coordination... .... Provides information regarding utilization management requirements and operational... ...providers and facilities. Registered Nurse (RN) with valid, current, unrestricted license...Full timeContract workWork at officeRemote work- ...member care. Rotating weekend hours are required to address utilization review cases. Roles and Responsibilities Prepares clinical reviews... ...experience. Must have a current, unrestricted Texas nursing license or Compact License. Please include your license number...Live inRemote workFlexible hoursWeekday work
- ...Utilization Review Nurse Join our team at Cobalt Benefits Group and start an exciting new career in employee benefits solutions. As a Utilization Review Nurse, you'll play an important role in helping us offer customized, self-funded insurance options to our clients...Full timeTemporary workSummer workWork at officeRemote workFlexible hours
- ...who reside in long-term care facilities. In partnership with nursing home operators, these Medicare Advantage plans manage... ...~ Employee Referral Bonus Program JOB SUMMARY The Utilization Review Nurse is to assess the medical necessity and quality of healthcare...Full timeTemporary workLocal areaRemote work
- A global talent management firm is seeking a Utilization Review Nurse for a contract role based in Pennington, NJ. The role involves performing utilization management, reviewing medical records, and coordinating discharge planning. Candidates must have an active RN license...Contract workRemote work
- ...Currently seeking a Utilization Management RN . Please see details and qualifications below... ...Must have an active PA license or a Nurse Licensure Compact to include PA. ** Minimum... ...conditions through medical record review to determine medical necessity for services...Immediate startRemote workDay shift
- RN - Utilization ReviewLocation: New York, NY 10004Contract: 13 weeksSchedule: 3 Days/Week |... ...hiring an experienced RN - Utilization Review for a contract opportunity in New York,... ...utilization review, along with strong community nursing and quality improvement skills....Hourly payContract workLocal areaWork from homeDay shift3 days per week
- ...Utilization Review Registered Nurse Job Summary Join our team and be a part of our mission to deliver accessible, high-quality, affordable, and compassionate healthcare. Prairie Lakes Healthcare System is a non-profit healthcare system serving 10 counties in...Full timePart timeWork from homeMonday to FridayFlexible hoursWeekend work
$1,600 - $1,800 per week
...NOW HIRING: Registered Nurse - Utilization Management Location: Buckley AFB & Peterson AFB, Colorado Military Health System Compensation... ...2 consecutive months in Utilization Management, Utilization Review, or Case Management ~• Preferred Certifications: Not...Contract workImmediate startRemote workMonday to Friday$77.08k - $119.47k
...77,075.00 - $119,466.00 Responsible for Utilization Management, Quality Screening and Delay... ...Qualifications And Ideal Characteristics Registered nurse with a New York State current license.... ...with skills applicable to utilization review process. Excellent written and verbal...Remote workShift work$35 - $40 per hour
...We are seeking an experienced Registered Nurse (RN) with health plan or payer-side Utilization Management (UM) experience to support clinical quality review and AI model development for prior authorization use cases. The ideal candidate will have expertise in applying...Hourly payLocal areaRemote workShift work- ...Alignment Health is seeking an inpatient review nurse to join the remote utilization management team. You will assist patients through the continuum of care in collaboration with the patient’s primary care physician, facility case manager, discharge planner and contracted...Remote work
- ...Centene is seeking a Nursing professional to perform concurrent reviews from a home-based setting, ensuring appropriate care levels and discharge planning... ...with Medical Affairs and educating providers on utilization processes. Schedule is Mon-Fri, 8am-5pm Central with...Remote work
- ...Utilization Review Nurse This position has a remote option for those living close and will be able to come into the hospital as needed. The Utilization Review Nurse is responsible for determining the clinical appropriateness of care provided to patients and ensuring...Full timeRemote work
$2,248 - $2,468 per week
...Utilization Review Registered Nurse Supplemental Health Care is connecting Utilization Review Registered Nurses with top-tier hospital contracts in Syracuse, New York. Travel or stay local, either way, we'll guide you to an opportunity that matches your goals, offering...Weekly payFull timeContract workLocal areaShift work
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