Utilization Review Nurse
Kinston, NC
Host Healthcare
4x10 hrs, Days
Referral Bonus

Job Opportunity: Utilization Review Nurse

Location: Kinston, North Carolina
Employment Type: Travel/Contract
Contract Length: 13 weeks

Job Summary

This is an in-person Utilization Review Nurse position working Monday through Friday, 8:30 AM – 5:00 PM, with no weekends or on-call duties. The role involves facilitating utilization management processes to ensure appropriate care delivery, including evaluating admissions, levels of care, continued hospitalization, and readiness for care transition. The nurse will conduct concurrent reviews, resolve care delays, provide clinical information to third-party payers for reimbursement, and collaborate with physicians and the care team to support authorization of services.

Shift Details

• 5 days a week, 8-hour shifts (Monday to Friday)
• No weekends or call required

Required Qualifications

• Valid RN license in North Carolina
• Associate of Science in Nursing (ASN) or Associate Degree in Nursing (ADN)
• Minimum 2 years of Utilization Review experience, including experience within the last year
• One completed travel assignment
• Experience in an Acute Care setting, including acute hospital experience
• Experience with Epic electronic health record system
• BLS certification issued by the American Heart Association or American Red Cross
• Orientation Safety Manual Acknowledgement

Orientation

• 24 hours

Key Responsibilities

• Apply established criteria to evaluate appropriateness of admissions and levels of care
• Conduct concurrent reviews to ensure timely patient movement through care continuum
• Collaborate with care teams, patients, and families to resolve care or transition delays
• Communicate with physicians to ensure proper documentation for service authorization
• Provide clinical information to third-party payers to support reimbursement

Compliance & Documentation Requirements

• Background checks including 7-year criminal history and education verification
• Drug screening (10-panel) within 90 days of start
• Physical exam within 1 year of start
• Immunizations and health documents including Tdap, TB testing, MMR, Varicella, Hepatitis B, Flu vaccine (seasonal), and COVID vaccination proof if applicable
• Required certifications must be current and valid at start date (ACLS, BLS, PALS, NRP as applicable)
• Facility-specific training and competency exams during orientation

Additional Notes

• This is not a remote position; must work onsite
• Average daily census approximately 30 patients
• Facility requires compliance with OSHA, HIPAA, and Joint Commission annual training

This position is ideal for experienced Utilization Review Nurses with acute hospital and EPIC experience who have prior travel contract experience and are looking for a weekday, no-call assignment in North Carolina.