Mid Level Utilization Review Nurse Jobs
Mid level utilization review nurse jobs go to nurses ready to own complex case reviews, guide clinical decisions with limited oversight, and mentor less experienced staff through the authorization process. Openings are concentrated in Healthcare & Medical Services, Insurance, and Technology & Software, with 60% remote or hybrid availability, and employers like Memorial Healthcare System, Kyyba, and Orlando Health hiring at this level now.
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Showing 5 of 8+ Mid Level Utilization Review Nurse jobs
Location: 100% REMOTE
Contract Duration: 12+ month [Possible Extension]
License Requirements: MI RN License
1. Mandatory Requirements to Apply
- Nursing Diploma or Associate Degree required; BSN preferred.
- 5+ years in healthcare/health-related fields.
- 3–5 years of Care Management and/or Utilization Management experience.
- Strong hands-on knowledge of InterQual criteria and utilization management.
- Experience with clinical reviews, staff training, quality management, and/or audits.
- Knowledge of ICD-10, CPT, CMS, NCQA, PA 60, and HIPAA.
- Strong communication, analytical, training, and project management skills.
- Proficiency with Microsoft Office, Teams, SharePoint, and healthcare systems.
2. Roles & Responsibilities
- Train and educate staff and provider facilities on InterQual criteria, clinical policies, utilization management, and departmental processes.
- Conduct clinical quality reviews and audits to support quality and regulatory requirements.
- Develop and update InterQual-focused training materials, manuals, and educational programs.
- Mentor new employees and work with leadership and subject matter experts to identify training needs.
- Support new systems, process improvements, accreditation activities, and quality initiatives.
3. Pay & Benefits
- $35–$39/hour
- 100% remote – Michigan residents only
- 9 days of Paid Time Off
- Health Insurance (Dental, Medical and Vision)
- All equipment provided by the client
Pay: $35.00 - $39.00 per hour
Benefits:
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
Experience:
- Registered Nurse: 6 years (Required)
- Utilization Review: 4 years (Required)
- InterQual: 3 years (Required)
License/Certification:
- MI Registered Nurse License (Required)
Location:
- Michigan (Required)
Work Location: Remote
Location: 100% REMOTE
Contract Duration: 12+ month [Possible Extension]
License Requirements: MI RN License
1. Mandatory Requirements to Apply
- Nursing Diploma or Associate Degree required; BSN preferred.
- 5+ years in healthcare/health-related fields.
- 3–5 years of Care Management and/or Utilization Management experience.
- Strong hands-on knowledge of InterQual criteria and utilization management.
- Experience with clinical reviews, staff training, quality management, and/or audits.
- Knowledge of ICD-10, CPT, CMS, NCQA, PA 60, and HIPAA.
- Strong communication, analytical, training, and project management skills.
- Proficiency with Microsoft Office, Teams, SharePoint, and healthcare systems.
2. Roles & Responsibilities
- Train and educate staff and provider facilities on InterQual criteria, clinical policies, utilization management, and departmental processes.
- Conduct clinical quality reviews and audits to support quality and regulatory requirements.
- Develop and update InterQual-focused training materials, manuals, and educational programs.
- Mentor new employees and work with leadership and subject matter experts to identify training needs.
- Support new systems, process improvements, accreditation activities, and quality initiatives.
3. Pay & Benefits
- $35–$39/hour
- 100% remote – Michigan residents only
- 9 days of Paid Time Off
- Health Insurance (Dental, Medical and Vision)
- All equipment provided by the client
Pay: $35.00 - $39.00 per hour
Benefits:
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
Experience:
- Registered Nurse: 6 years (Required)
- Utilization Review: 4 years (Required)
- InterQual: 3 years (Required)
License/Certification:
- MI Registered Nurse License (Required)
Location:
- Michigan (Required)
Work Location: Remote
See All 8 Mid Level Utilization Review Nurse Jobs
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Top Industries Hiring
- Healthcare & Medical Services
- Insurance
- Technology & Software
Mid Level Utilization Review Nurse Jobs: Frequently Asked Questions
How do I get a mid level utilization review nurse job?
Highlight your independent case management experience, your familiarity with InterQual or Milliman clinical criteria, and any measurable outcomes you have driven, such as reduced denial rates or faster authorization turnaround. Tailor your resume to show that you can own complex cases without close supervision, and emphasize experience coordinating between payers, physicians, and care teams as a core competency.
Which companies hire mid level utilization review nurses?
Companies hiring mid level utilization review nurses right now include Memorial Healthcare System, Kyyba, and Orlando Health, based on current listings on Migrate Mate as of August 2026. Health plans, managed care organizations, hospital systems, and third-party utilization management firms are the most active employers at this experience level.
Are there remote mid level utilization review nurse jobs?
Yes, and remote availability is notably strong for this role compared to most nursing positions. About 60% of mid level utilization review nurse openings are remote or hybrid as of August 2026, reflecting the documentation-focused, payer-facing nature of the work that does not require bedside presence.
How do I move up to a mid level utilization review nurse role?
Build a foundation of bedside clinical experience, then move into initial UR exposure through case management or discharge planning work. Over time, deepen your command of payer criteria, appeal processes, and denial management. Demonstrating ownership of a full case load, contributing to process improvements, and showing consistent accuracy in clinical determinations signals readiness for a mid level designation.
Which industries hire the most mid level utilization review nurses?
Mid Level utilization review nurse roles concentrate in Healthcare & Medical Services, Insurance, and Technology & Software, based on current listings on Migrate Mate as of August 2026. These sectors drive hiring because payer compliance, cost containment, and care coordination demands are highest in large-volume clinical and insurance environments that rely on experienced UR nurses to protect both patient outcomes and reimbursement integrity.