Average salary: $93,259 /yearly
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- A healthcare organization in Albany, NY seeks a skilled RN for a clinical review position. You'll be responsible for facilitating reviews of... ...at least 2 years of clinical nursing experience, including utilization review, and an active RN license. Excellent analytical skills...SuggestedHourly pay
$29.05 - $67.97 per hour
...looking for a Clinical Nurse to provide support for medical claim and internal appeals review. The successful candidate will have at least 2 years of nursing experience, including utilization review and medical claims review. Key responsibilities include facilitating...SuggestedHourly pay- ...provider in Houston is seeking an experienced clinical nurse to support medical claim reviews and internal appeals. This role requires at least 2 years of nursing experience, including utilization review, and an active Registered Nurse license. The successful candidate will...Suggested
$29.05 - $67.97 per hour
...healthcare provider in Dallas is seeking a Clinical Reviewer to ensure compliance in medical claim processing. The role requires an active RN license and a minimum of two years of clinical experience, including utilization review. Responsibilities include facilitating...SuggestedHourly pay$29.05 - $67.97 per hour
A healthcare provider is seeking a Clinical Reviewer in Miami, Florida. The role involves supporting medical claim reviews and appeals... ...two years of clinical nursing experience, particularly in utilization review and claims. Competitive hourly pay ranges from $29.05 to...SuggestedHourly pay$29.05 - $67.97 per hour
...organization in Jacksonville, Florida seeks a qualified RN to support medical claims and internal appeals review activities. Responsibilities include clinical... ...of two years of nursing experience, including utilization review. The position offers a competitive hourly pay...SuggestedHourly pay$35 per hour
A health solutions company is seeking a licensed LPN or RN Clinical Reviewer to work remotely. This role involves reviewing medical records... ...clinical experience, specifically in Prior Authorization and Utilization Review. The position also requires maintaining solid...SuggestedRemote jobHourly payWeekend work$36 - $40 per hour
...A healthcare organization is seeking a Clinical Reviewer, Nurse, to join their utilization management team. This non-clinical role allows for a better work-life balance while ensuring quality patient care. Responsibilities include evaluating cases, monitoring care standards...SuggestedHourly payEvolent
Nashville, TN4 days ago$57.28 - $88.92 per hour
...leading healthcare provider in Los Angeles is seeking a qualified Registered Nurse to oversee utilization review and care coordination. The ideal candidate will have a California RN License, 3 years of experience in utilization management, and clinical experience in...SuggestedHourly pay- A healthcare organization in Santa Clarita, California is seeking a skilled nurse for a utilization review role focused on promoting high-quality and cost-effective care. The ideal candidate will have a California Registered Nurse License and at least three years of experience...Suggested
- ...healthcare services company is seeking a Clinical Care Reviewer based in Doral, FL. The role requires a current FL RN licensure and a minimum of 3 years of nursing... ...or ICU. Candidates should have experience with Utilization Review, familiarity with Interqual Criterion,...Suggested
- A healthcare provider in Jacksonville, Florida is seeking a Utilization Review Coordinator to monitor treatment activities and interface with the treatment team. The ideal candidate will hold a nursing or social work degree, possess strong communication skills, and be...SuggestedFull timeWeekend work
- A healthcare organization seeks a Clinical Reviewer to support medical claims and appeals review activities... ...claims. Candidates must have an active RN license and at least 2 years of nursing experience, including utilization review and coding. Strong analytical skills and...SuggestedHourly pay
$29.05 - $56.64 per hour
...company is seeking a Registered Nurse to support medical claim reviews and ensure compliance with regulations. The role involves... ...should have at least two years of nursing experience, including utilization review and knowledge of coding. Competitive pay ranges from $2...SuggestedHourly pay- A healthcare organization is seeking Clinical Utilization Review Nurses (RN) for a remote position to assess healthcare services in line with Alabama Medicaid requirements. Candidates must possess a BA/BS in Nursing, an active RN license in Alabama, and at least 3 years...SuggestedRemote job
- ...evidence based clinical guidelines. Conducts prior authorization reviews to determine financial responsibility Qualifications 2 years... ...with Hospital Nursing (Med-Surg, ER) Well versed in Utilization Management-Must be able to determine elective vs urgent request...Private practice
$33 - $37 per hour
A national healthcare staffing firm seeks an experienced RN Utilization Review Nurse in Troy, MI. Responsibilities include utilization review for Medicaid and Medicare, managing authorization processes, and collaborating with healthcare teams to ensure quality care. Ideal...Hourly payMonday to Friday$55.56 - $85.96 per hour
A healthcare facility in California is seeking a Utilization Review Case Manager to validate patient admissions and levels of care. The role involves performing patient chart reviews, securing authorizations for clinical services, and collaborating with healthcare teams...Hourly pay- A healthcare organization in Texas is seeking an RN Utilization Review Coordinator to perform utilization reviews and ensure medical necessity compliance. The role involves collaborating with healthcare teams, managing denial appeals, and supporting discharge planning....Full time
- A healthcare provider in Chesapeake, Virginia seeks a Utilization Review Nurse to utilize clinical expertise for patient care management. The role... ...reviews, and ensuring compliance. Candidates need an RN licensure with a preference for BSN and over three years of clinical...
- ...in Glendale, California, seeks a skilled registered nurse for utilization review and care coordination. This role emphasizes providing quality... ...candidate will have a strong nursing background, a California RN license, and experience in utilization and case management. Benefits...
- A regional academic health system in Kentucky seeks an RN for Utilization Review to support patient-centered care. The role involves conducting medical necessity reviews, collaborating with healthcare professionals, and managing utilization processes in compliance with...Full time
- ...employees. Ready to join our quest for better? Job Description The RN Utilization Specialist reflects the mission, vision, and values of NM,... ...expertise in hospital utilization. The RNUS through regular reviews and audits and collaboration with the clinical team,...For contractorsCasual workWork at officeLocal areaRelocation package
- A healthcare organization in Washington D.C. is seeking a Clinical Utilization Review Nurse (RN) for a remote position. This full-time PRN role involves assessing medical necessity and quality of healthcare services through utilization reviews. The ideal candidate will...Remote jobFull timeReliefWeekend workAfternoon shift
- ...compliance with regulations, analyzing clinical requests, and conducting prior authorization reviews. The ideal candidate should have 2 years of inpatient nursing, familiarity with Utilization Management, and experience with ICD10 and CPT coding. Interested candidates should...
$29.05 - $67.97 per hour
...health care provider in Fort Worth is seeking a skilled RN to provide support in medical claims and internal appeals review. The ideal candidate will have at least 2 years of clinical experience, including utilization review, as well as an active RN license....Hourly pay$56.44 - $87.63 per hour
...RN Utilization Review Location: Irvine, CA. This position is per diem and will work remotely, 8‑hour day shifts. Overview Provide prospective, retrospective, and concurrent utilization reviews for our Southern CA ministries. Conduct clinical reviews and review medical...Hourly payDaily paidRemote workShift workDay shiftProvidence Service
Irvine, CA4 days ago$57.28 - $88.92 per hour
...Description Responsible for providing utilization review and coordination of care throughout the healthcare continuum to promote quality and cost effective care to the members. Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence...Daily paidMinimum wageWork at officeLocal areaShift workProvidence Service
Mission Hills, CA16 days ago$90k - $100k
...A healthcare organization is seeking an RN Concurrent Review to ensure compliance with utilization review processes. This role involves telephonic reviews, clinical assessments, and collaboration within healthcare teams. The ideal candidate will have a Bachelor's degree...P3 Health Partners
Omaha, NE4 days ago$2,427 per week
...PRIDE Health is seeking a travel nurse RN Utilization Review for a travel nursing job in Washington, District of Columbia. Job Description & Requirements ~ Specialty: Utilization Review ~ Discipline: RN ~ Start Date: 05/11/2026 ~ Duration: 13 weeks...Weekly payZero hours contractShift workPRIDE Health
Washington DC4 days ago
