Utilization Review Nurse Jobs
Utilization Review Nurse jobs are open across health insurance, managed care, hospital systems, and third-party administrators, from staff to senior and supervisory levels, with specializations in acute care, behavioral health, and case management. Find a role that fits from the openings below and apply directly.
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Showing 4 of 151+ Utilization Review Nurse jobs
**PRN - AS NEEDED & ONSITE | ***THIS IS NOT REMOTE OR CONTRACT****
**RATE OF PAY DEPENDENT UPON EDUCATION, EXPERIENCE AND RN LICENSURE
***MUST HOLD AN ARKANSAS REGISTERED NURSE LICENSE
***MUST HAVE UTILIZATION REVIEW EXPERIENCE
***THIS POSITION DOES NOT WORK ON HOLIDAYS
Rivendell Behavioral Health Services of Arkansas is seeking a Utilization Review Specialist for full time status. The Utilization Review Specialist ensures that inpatient admissions & continued hospital stays are medically necessary and that patients receive the highest quality of health care in the most resourceful manner.
Key roles of the Utilization Review Specialist include but are not limited to the following:
- Reviews documentation to support severity of illness, intensity of services, need for current level of treatment, and notifies supervisor of any deficiencies.
- Conducts admissions and continued-stay reviews with payors (Medicaid, Medicare, private insurance) for authorizations and reports to treatment team and supervisor any certification problems.
- Reviews the denial and appeals process for assigned caseload by identifying cases with potential for denial, identifies actions, which need to occur to avoid denials and follows through with process for appealing actual denials.
- Is responsible for assuring that all disciplines (nursing, therapy, recreational therapy, physician, education) are documenting quality progress notes as required. Any instances of noted deficiencies will be reported immediately to supervisor.
- Communicates with the clinicians and other departments regarding certification or payor issues that impact length of stay. Is able to communicate patient’s payor status to physician to include quality issues and necessity for doctor to doctor review. Is able to communicate available options for patients.
- Maintains a good working relationship with referral sources as well as knowledge of community resources. May occasionally act as a resource to others relating to aftercare options.
- Strong communication skills with the ability to build a good working rapport with customers, clinicians, physicians, and staff are imperative to a having success as a Utilization Review Specialist.
- ***THIS IS NOT REMOTE OR CONTRACT****
As a full time employee at Rivendell Behavioral Health you are eligible for our Comprehensive Benefits Package including:
- Challenging and rewarding work environment
- Competitive Compensation
- Excellent Medical, Dental, Vision, and Prescription Drug Plan
- Generous Paid Time Off
- 401(K) with company match and discounted stock plan
- Career development opportunities within UHS and its Subsidiaries
- ***THIS IS NOT REMOTE OR CONTRACT****
Universal Health Services, Inc. (UHS) is one of the nation’s largest and most respected health care management companies, operating through its subsidiaries acute care hospitals, behavioral health facilities and ambulatory centers nationwide. Founded in 1978, UHS subsidiaries now have more than 83,000 employees. The UHS business strategy is to build or purchase health care properties in rapidly growing markets and create a strong franchise based on exceptional service and effective cost control. Our success comes from a responsive management style and a service philosophy based on integrity, competence and compassion.
At UHS, we're looking for exceptional people who share our vision and values, who share our focus on hard work, enthusiasm, teamwork, loyalty, trust and cooperation. We've embraced these traits and built a team of employees who consistently work to achieve the highest level of service excellence. People are our most valuable resource at UHS as we are committed to providing high quality acute care and behavioral health services to residents of the communities we serve. We are equally committed to offering our employees unlimited opportunity in an environment that encourages professional development.
*UHS is a registered trademark of UHS of Delaware, Inc., the management company for Universal Health Services, Inc. and a wholly-owned subsidiary of Universal Health Services, Inc. Universal Health Services, Inc. is a holding company and operates through its subsidiaries including its management company, UHS of Delaware, Inc. All healthcare and management operations are conducted by subsidiaries of Universal Health Services, Inc. To the extent any reference to "UHS or UHS facilities" on this website including any statements, articles or other publications contained herein relates to our healthcare or management operations it is referring to Universal Health Services' subsidiaries including UHS of Delaware. Further, the terms "we," "us," "our" or "the company" in such context similarly refer to the operations of Universal Health Services' subsidiaries including UHS of Delaware. Any employment referenced in this website is not with Universal Health Services, Inc. but solely with one of its subsidiaries including but not limited to UHS of Delaware, Inc.
UHS is not accepting unsolicited assistance from search firms for this employment opportunity. Please, no phone calls or emails. All resumes submitted by search firms to any employee at UHS via-email, the Internet or in any form and/or method without a valid written search agreement in place for this position will be deemed the sole property of UHS. No fee will be paid in the event the candidate is hired by UHS as a result of the referral or through other means.
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.
We believe that diversity and inclusion among our teammates is critical to our success.
Notice
At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: https://uhs.alertline.com or 1-800-852-3449.
Job Type: Full-time
Pay: $25.00 - $35.00 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee assistance program
- Flexible spending account
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Referral program
- Retirement plan
- Tuition reimbursement
- Vision insurance
Education:
- Associate (Preferred)
License/Certification:
- Registered Nurse (Required)
Ability to Relocate:
- Benton, AR 72019: Relocate before starting work (Required)
Work Location: In person
**PRN - AS NEEDED & ONSITE | ***THIS IS NOT REMOTE OR CONTRACT****
**RATE OF PAY DEPENDENT UPON EDUCATION, EXPERIENCE AND RN LICENSURE
***MUST HOLD AN ARKANSAS REGISTERED NURSE LICENSE
***MUST HAVE UTILIZATION REVIEW EXPERIENCE
***THIS POSITION DOES NOT WORK ON HOLIDAYS
Rivendell Behavioral Health Services of Arkansas is seeking a Utilization Review Specialist for full time status. The Utilization Review Specialist ensures that inpatient admissions & continued hospital stays are medically necessary and that patients receive the highest quality of health care in the most resourceful manner.
Key roles of the Utilization Review Specialist include but are not limited to the following:
- Reviews documentation to support severity of illness, intensity of services, need for current level of treatment, and notifies supervisor of any deficiencies.
- Conducts admissions and continued-stay reviews with payors (Medicaid, Medicare, private insurance) for authorizations and reports to treatment team and supervisor any certification problems.
- Reviews the denial and appeals process for assigned caseload by identifying cases with potential for denial, identifies actions, which need to occur to avoid denials and follows through with process for appealing actual denials.
- Is responsible for assuring that all disciplines (nursing, therapy, recreational therapy, physician, education) are documenting quality progress notes as required. Any instances of noted deficiencies will be reported immediately to supervisor.
- Communicates with the clinicians and other departments regarding certification or payor issues that impact length of stay. Is able to communicate patient’s payor status to physician to include quality issues and necessity for doctor to doctor review. Is able to communicate available options for patients.
- Maintains a good working relationship with referral sources as well as knowledge of community resources. May occasionally act as a resource to others relating to aftercare options.
- Strong communication skills with the ability to build a good working rapport with customers, clinicians, physicians, and staff are imperative to a having success as a Utilization Review Specialist.
- ***THIS IS NOT REMOTE OR CONTRACT****
As a full time employee at Rivendell Behavioral Health you are eligible for our Comprehensive Benefits Package including:
- Challenging and rewarding work environment
- Competitive Compensation
- Excellent Medical, Dental, Vision, and Prescription Drug Plan
- Generous Paid Time Off
- 401(K) with company match and discounted stock plan
- Career development opportunities within UHS and its Subsidiaries
- ***THIS IS NOT REMOTE OR CONTRACT****
Universal Health Services, Inc. (UHS) is one of the nation’s largest and most respected health care management companies, operating through its subsidiaries acute care hospitals, behavioral health facilities and ambulatory centers nationwide. Founded in 1978, UHS subsidiaries now have more than 83,000 employees. The UHS business strategy is to build or purchase health care properties in rapidly growing markets and create a strong franchise based on exceptional service and effective cost control. Our success comes from a responsive management style and a service philosophy based on integrity, competence and compassion.
At UHS, we're looking for exceptional people who share our vision and values, who share our focus on hard work, enthusiasm, teamwork, loyalty, trust and cooperation. We've embraced these traits and built a team of employees who consistently work to achieve the highest level of service excellence. People are our most valuable resource at UHS as we are committed to providing high quality acute care and behavioral health services to residents of the communities we serve. We are equally committed to offering our employees unlimited opportunity in an environment that encourages professional development.
*UHS is a registered trademark of UHS of Delaware, Inc., the management company for Universal Health Services, Inc. and a wholly-owned subsidiary of Universal Health Services, Inc. Universal Health Services, Inc. is a holding company and operates through its subsidiaries including its management company, UHS of Delaware, Inc. All healthcare and management operations are conducted by subsidiaries of Universal Health Services, Inc. To the extent any reference to "UHS or UHS facilities" on this website including any statements, articles or other publications contained herein relates to our healthcare or management operations it is referring to Universal Health Services' subsidiaries including UHS of Delaware. Further, the terms "we," "us," "our" or "the company" in such context similarly refer to the operations of Universal Health Services' subsidiaries including UHS of Delaware. Any employment referenced in this website is not with Universal Health Services, Inc. but solely with one of its subsidiaries including but not limited to UHS of Delaware, Inc.
UHS is not accepting unsolicited assistance from search firms for this employment opportunity. Please, no phone calls or emails. All resumes submitted by search firms to any employee at UHS via-email, the Internet or in any form and/or method without a valid written search agreement in place for this position will be deemed the sole property of UHS. No fee will be paid in the event the candidate is hired by UHS as a result of the referral or through other means.
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.
We believe that diversity and inclusion among our teammates is critical to our success.
Notice
At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: https://uhs.alertline.com or 1-800-852-3449.
Job Type: Full-time
Pay: $25.00 - $35.00 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee assistance program
- Flexible spending account
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Referral program
- Retirement plan
- Tuition reimbursement
- Vision insurance
Education:
- Associate (Preferred)
License/Certification:
- Registered Nurse (Required)
Ability to Relocate:
- Benton, AR 72019: Relocate before starting work (Required)
Work Location: In person
Utilization Review Nurse Jobs by Experience Level
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Find Utilization Review Nurse JobsUtilization Review Nurse Job Market
Who's Hiring
Top Industries Hiring
- Healthcare & Medical Services
- Insurance
- Education
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- Technology & Software
What Employers Look For
The qualifications that appear most often in utilization review nurse jobs.
- Active registered nurse license with at least two years of acute care clinical experience
- Working knowledge of InterQual or Milliman evidence-based clinical criteria sets
- Experience with prior authorization, concurrent review, or discharge planning processes
- Proficiency with electronic health records and payer portal documentation systems
- Certified Case Manager (CCM) credential or willingness to obtain within a defined timeframe
- Strong written communication skills for denial letters and clinical documentation in compliance with regulatory standards
Tips for Your Utilization Review Nurse Job Search
Tailor your resume to UR criteria
Highlight your clinical decision-making experience alongside specific criteria sets you've used, such as InterQual or Milliman. Employers want to see that you can apply evidence-based guidelines, not just that you have bedside nursing hours.
Lead with your certifications upfront
Certified Case Manager or Registered Health Information Administrator credentials often appear as preferred qualifications in utilization review nurse postings. List them immediately after your name so reviewers spot them before reading your experience section.
Filter openings by payer versus provider side
Roles at insurance companies focus on prior authorization and denial management, while hospital-based positions lean toward concurrent review and discharge planning. Knowing which side fits your background helps you target the right listings and write sharper cover letters.
Apply early to roles that fit
Migrate Mate lists utilization review nurse openings from across the United States in one place, so you can find roles that match and apply directly to each listing.
Prepare for competency-based interview questions
Interviewers frequently ask how you handled a denial that conflicted with a physician's recommendation. Prepare two or three specific examples where you applied clinical criteria, communicated a decision clearly, and documented the outcome in compliance with payer requirements.
Negotiate remote or hybrid terms strategically
Many utilization review nurse roles are performed entirely by phone and electronic health record, making remote arrangements common. Ask about equipment provisions, productivity metrics, and audit processes during the offer stage so expectations are documented before you accept.
Utilization Review Nurse Jobs: Frequently Asked Questions
Which companies are hiring the most utilization review nurses?
The companies hiring the most utilization review nurses right now include Providence, Ensemble Health Partners, and UT Southwestern Medical Center, with the largest share of openings in California, Texas, and Ohio, based on current listings on Migrate Mate as of November 2026. Managed care organizations and large hospital systems consistently account for the highest volume of postings.
How many utilization review nurse jobs are remote?
About 71% of utilization review nurse openings are fully remote or hybrid as of November 2026, reflecting how much of the work happens over phone and electronic health record systems rather than at the bedside. Prior authorization and telephonic case management sub-specialties tend to have the highest concentration of remote-eligible postings.
How do you become a utilization review nurse?
You become a utilization review nurse by first earning your registered nurse license and gaining clinical experience, typically in a hospital or acute care setting. From there, you build familiarity with payer criteria sets like InterQual or Milliman, pursue a Certified Case Manager credential if possible, and apply to roles in insurance companies, managed care organizations, or hospital utilization management departments.
Can you get a utilization review nurse job with limited UR experience?
Yes, employers routinely hire registered nurses with strong acute care backgrounds into entry-level utilization review roles and provide on-the-job training on criteria application and payer processes. Emphasizing experience with discharge planning, care coordination, or insurance verification strengthens your application, and roles labeled 'utilization management nurse' or 'clinical reviewer' often have more flexible experience requirements.
What does the utilization review nurse interview process look like?
The process typically begins with a phone screen from a recruiter or nurse manager covering your clinical background and familiarity with criteria sets. A second round usually involves a panel or one-on-one interview with scenario-based questions about denial decisions and physician communication. Some employers also include a brief written exercise where you review a clinical scenario and document a coverage recommendation.
Where can I find and apply to utilization review nurse jobs?
You can find and apply to utilization review nurse jobs on Migrate Mate, which lists current openings from across the United States. Find the roles that match your clinical background and the care setting you prefer, then apply directly to each listing. No separate sign-up step is needed before you apply.
See All 151+ Utilization Review Nurse Jobs
Find roles that match your experience and apply in just a few clicks.
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