Top 3257 Utilization review nurse Jobs

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Nurse Practitioner - F/T - Reno, NV
MEDEVAL —Reno, NV
- $120,000 - $150,000 a year
- Extended hours
- Nursing
- Blood sampling
- Microsoft Excel
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9d
Home Health QA Review Nurse - SOC & Discharge
First Call Home Health —Salem, OR
- $40 - $48 an hour
- Full-time
- Background check
- RN License
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
8d
Hospice Admissions Nurse
Eventide Hospice —Englewood, CO
- $90,000 - $100,000 a year
- Full-time
- Hybrid work
- RN License
- HIPAA
- Inpatient
- Health insurance
- Dental insurance
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20h
Clinical Review and Appeals Specialist
Life Care Centers of America —Cleveland, TN
- Weekends as needed
- Nursing
- RN License
- Customer service
- Health insurance
- Dental insurance
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RN MDS Coordinator
Mountain View Post Acute —Barstow, CA
- $55 - $60 an hour
- Full-time
- Background check
- Skilled nursing facility
- RN License
- 401(k)
- Flexible schedule
Quick Apply
2d
Concurrent Utilization Review Nurse, RN
NeueHealth —Los Angeles, CA
- $74,286.15 - $111,429.23 a year
- Remote
- Nursing
- RN License
- Mid-level
- Paid holidays
- Health insurance
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Utilization Review Nurse
Cobalt Benefits Group LLC —Dallas, TX
- $90,000 - $98,000 a year
- Full-time
- Remote
- Nursing
- Microsoft Excel
- Microsoft Outlook
- Health savings account
- AD&D insurance
Quick Apply
14d
Utilization Review Nurse
FLORIDA PACE CENTERS, INC. —Miami, FL
- Weekends as needed
- Remote
- Acute care
- Background check
- Nursing
- Free parking
- Health insurance
Quick Apply
3d
Utilization Review Nurse
Health Business Solutions LLC —Remote
- Remote
- Nursing
- RN License
- Bachelor of Science
1d
Utilization Review Nurse
HAMASPIK CHOICE INC —Spring Valley, NY
- $45 - $47 an hour
- Full-time
- Nursing
- RN License
- Mid-level
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Clinical Reimbursement & Utilization Coord
St Camillus Residential Health —Syracuse, NY
- $24 - $30 an hour
- Full-time
- Mid-level
- Case management
- LPN
- Free parking
- Dental insurance
Quick Apply
8d
Utilization Management Outpatient Authorization Nurse
Champion Health Plan is a Medicare Advantage Prescription Drug HMO C-SNP serving Medicare beneficiaries with End-Stage Renal Disease. —Long Beach, CA
- From $67,000 a year
- Full-time
- Nursing
- LVN
- HIPAA
- Health insurance
- Dental insurance
Quick Apply
Utilization Review Nurse
University Medical Center of Southern Nevada —Las Vegas, NV
- $40.72 - $63.12 an hour
- Weekends as needed
- Nursing
- RN License
- Office
- Health insurance
- Dental insurance
Quick Apply
Utilization Review Nurse (Medicare)
HAMASPIK CHOICE INC —Spring Valley, NY
- $41 - $47 an hour
- Full-time
- Nursing
- RN License
- Mid-level
Quick Apply
Utilization Specialist
RiverWoods Behavioral Health —Riverdale, GA
- Part-time
- CPR Certification
- Nursing
- RN License
Utilization Review RN
Memorial Health —Springfield, IL
- $32.95 - $52.73 an hour
- Full-time
- Acute care
- Nursing
- RN License
SBS - Utilization Authorization Coordinator (UM Review Nurse)
Choice Medical Group —Camarillo, CA
- $48 - $55 an hour
- Full-time
- LVN
- RN License
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
Utilization Management Nurse
TEXAS INDEPENDENCE HEALTH PLAN INC —Austin, TX
- Weekends as needed
- Hybrid work
- Nursing
- Microsoft Excel
- Microsoft Outlook
Quick Apply
Travel RN Case Manager – Utilization Review & Discharge Planning | $57–$62/hr | Portales, NM
MTK Healthcare —New Mexico
- $57 - $62 an hour
- Contract
- RN License
- Hospital
- 5 years
Quick Apply
18h
Utilization Review Nurse (RN)
Lighthouse Care Center of Augusta —Augusta, GA
- Full-time
- Nursing
- Psychiatry
- RN License
- Health insurance
- Dental insurance
Quick Apply

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Nurse Practitioner - F/T - Reno, NV

MEDEVAL -
Reno, NV

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Job Details

Full-time
$120,000 - $150,000 a year
9 days ago

Qualifications

Computer operation
Customer communication
Microsoft Excel
RN License
Regulatory compliance
HIPAA
Master's degree in nursing
Master's degree
Evidence-based practice
Nurse Practitioner (NP)
Master of Nursing
Health information regulatory compliance
Advanced practice provider
Typing
Productivity software
Clinical confidentiality policies
Medical terminology

Full Job Description

SUMMARY

The Nurse Practitioner (NP) is responsible for conducting Compensation & Pension (C&P) examinations, Physical Health Assessments (PHAs), Department of the Interior (DOI) examinations, and related claimant evaluations for veterans, active-duty service members, reservists, and other designated populations within the clinic setting.

The Nurse Practitioner performs focused history and physical examinations, reviews medical and service records, evaluates diagnostic testing, and completes detailed evaluative reports in accordance with Veterans Health Administration (VHA), Veterans Benefits Administration (VBA), Department of Disability and Medical Assessment (DMA), and organizational guidelines.

This role supports clinical quality, operational efficiency, claimant satisfaction, and regulatory compliance by ensuring timely, accurate, and professional examination services. Nurse Practitioners in this role do not function as primary care providers and do not prescribe medications, provide treatment, or establish ongoing plans of care under this scope of practice.

ESSENTIAL JOB FUNCTIONS

Conduct Compensation & Pension (C&P) examinations for veterans and service members.
Conduct Physical Health Assessments (PHAs), reservist annual physicals, Department of the Interior (DOI) examinations, and related claimant evaluations.
Obtain comprehensive claimant health histories and perform focused physical examinations and assessments.
Review Functional Capacity Certificates, medical records, service records, diagnostics, and claimant-provided documentation to support evaluation processes.
Utilize clinical assessment findings and medical judgment to formulate medical diagnoses and opinions when applicable within examination guidelines.
Complete timely, accurate, legible, and compliant clinical documentation and evaluative reports in accordance with applicable regulations, policies, and client requirements.
Conduct and interpret diagnostic testing including Pulmonary Function Tests (PFTs), Electrocardiograms (EKGs), and Ankle Brachial Index (ABI) testing as appropriate.
Assist with blood draws, diagnostic support, and additional clinical tasks when needed.
Ensure all reports, addendums, and required documentation are completed within established submission timelines and quality expectations.
Maintain familiarity with VBA worksheets, DMA guidelines, VHA/VBA examination standards, and applicable client requirements.
Participate in chart reviews, quality improvement initiatives, utilization review activities, and operational workflow improvements.
Demonstrate awareness of and sensitivity to claimant rights, confidentiality, and customer service standards.
Maintain professionalism, objectivity, and unbiased clinical documentation in all examination activities.
Collaborate effectively with Medical Assistants, operational leadership, providers, and support staff to ensure smooth clinic operations and claimant flow.
Serve as a mentor and clinical resource for Medical Assistants, and operational staff as needed.
Communicate operational concerns, workflow issues, or opportunities for improvement to leadership in a timely manner.
Participate in provider meetings, training activities, continuing education, and operational updates to maintain current knowledge of clinical and operational standards.
Adjust effectively to fluctuating claimant volumes, operational demands, and scheduling changes while maintaining quality and professionalism.
Perform additional clinical or operational duties as assigned based on business needs.

MINIMUM REQUIRED QUALIFICATIONS

Education and/or Experience

Graduate of an accredited school of nursing required.
Active and unrestricted Registered Nurse (RN) and Nurse Practitioner (NP) license required.
Master’s degree in Nursing required.
One or more years of nursing or clinical examination experience preferred.
Compensation & Pension (C&P) examination experience preferred.
Experience with computerized charting and healthcare documentation systems preferred.
Previous experience in occupational health, military health evaluations, or ambulatory clinic environments preferred.
Strong clinical assessment, examination, and diagnostic interpretation skills.
Excellent written and verbal communication abilities.
Strong attention to detail and documentation accuracy.
Ability to maintain professionalism, objectivity, and claimant-centered communication during evaluations.
Knowledge of medical terminology, diagnostic procedures, and evidence-based clinical practices.
Ability to work efficiently in a fast-paced clinical environment while maintaining quality and timeliness standards.
Strong organizational, analytical, and problem-solving skills.
Ability to work independently while collaborating effectively within interdisciplinary and operations teams.
Ability to maintain confidentiality and comply with HIPAA and regulatory requirements.
Typing proficiency of at least 35 WPM preferred.

ESSENTIAL COMPETENCIES

QUALIFICATIONS

Must be proficient in multiple software programs, including but not limited to Microsoft Word, Excel, and the Internet.
Must be a qualified typist with a minimum of 35 W.P.M.
Must demonstrate exceptional communication skills.
Must be able to work independently, prioritize work activities and use time efficiently.
Must be able to maintain confidentiality.
Must be able to stay focused and concentrate under normal or heavy distractions.

LANGUAGE/COMMUNICATION SKILLS

Ability to read, analyze and interpret common correspondence, medical records and itemized billing statements, and legal contracts and documents.
Ability to write clearly and informatively to all required audiences and edit own work for appropriate spelling and grammar.
Ability to respond appropriately and professionally to all inquiries or complaints from customers, regulatory agencies, upper management, and/or members of the business community.
Ability to effectively present information one-on-one, in small groups, and/or to clients or vendors of the company.

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

This position generally consists of:

Ability to work at a desk or similar office-type furnishings up to 8 hours a day or longer as required by business needs.
Ability to operate a computer up to 4 hours at a time.
Ability to travel to different floors of the office or other locations.
Ability to move throughout the office.
Occasionally lifting and/or carrying up to 20 lbs.
Occasionally pushing/pulling up to 20 lbs.

WORK ENVIRONMENT

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Extended hours are occasionally required beyond the regular eight (8) hour work day.
The noise level in the work environment is usually moderate.

DISCLAIMER

This Job Description is not an exhaustive list of all functions employees may be required to perform in the described role, and additional functions may be required. This Job Description is applicable to the above position with ExamWorks and/or any of its affiliates (collectively referred to as “ExamWorks”). ExamWorks reserves the right to revise this Job Description at any time with or without notice to employees. Employment with ExamWorks is at-will, and nothing in this Job Description changes that at-will status. Employees must be able to perform the essential functions of this position satisfactorily. If requested, reasonable accommodations may be made to enable employees with disabilities to perform the essential functions of this position, unless such accommodations would cause an undue hardship to ExamWorks

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Refine Your Search

utilization review nurse jobs

Nurse Practitioner - F/T - Reno, NV

Home Health QA Review Nurse - SOC & Discharge

Hospice Admissions Nurse

Clinical Review and Appeals Specialist

RN MDS Coordinator

Concurrent Utilization Review Nurse, RN

Utilization Review Nurse

Utilization Review Nurse

Utilization Review Nurse

Utilization Review Nurse

Clinical Reimbursement & Utilization Coord

Utilization Management Outpatient Authorization Nurse

Utilization Review Nurse

Utilization Review Nurse (Medicare)

Utilization Specialist

Utilization Review RN

SBS - Utilization Authorization Coordinator (UM Review Nurse)

Utilization Management Nurse

Travel RN Case Manager – Utilization Review & Discharge Planning | $57–$62/hr | Portales, NM

Utilization Review Nurse (RN)

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