Utilization Review Nurse
Kinston, North Carolina
UNC Lenoir Health Care

Job Opportunity: Utilization Review Nurse

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

Job Summary

• In-person role (not remote)
• Shift: Monday to Friday, 8:30 AM – 5:00 PM (5 days x 8 hours)
• No weekends or on-call duties
• Average daily census: 30 patients
• Orientation: 24 hours

This position supports utilization management to ensure appropriate care delivery by evaluating admissions, level of care, continued hospitalization, and readiness for care transition. The nurse conducts concurrent reviews, resolves care or transition delays, and collaborates with care teams and third-party payers to support reimbursement and authorization processes.

Required Qualifications

• Valid Registered Nurse (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
• Experience in an Acute Care setting
• Experience with Epic electronic health record system
• Completion of at least one travel nursing assignment
• Basic Life Support (BLS) certification issued by the American Heart Association or American Red Cross

Health & Compliance Requirements

• Physical exam within 1 year of start
• Negative 10-panel drug screen within 90 days of start (instant drug screens allowed as placeholder if pending)
• Immunizations/vaccinations required:

  • Tdap vaccine within 10 years (titer not accepted)
  • 2 MMR vaccines or positive titers for measles, mumps, rubella (boosters required if low/equivocal titer)
  • 2 Varicella vaccines, positive titer, or physician-documented history (boosters required if low/equivocal titer)
  • Hepatitis B vaccine series and positive titer or declination accepted
  • Annual flu vaccine required during flu season (medical or religious exemptions accepted with approval; declinations not accepted)
• COVID-19 vaccination proof required if vaccinated (requirement may be waived if not vaccinated)
• Negative TB test or chest X-ray within 1 year (Qgold/Tspot or 2-step PPD)
• TB questionnaire required if history of positive TB test

Background & Verification

• 7-year criminal background check within 90 days of start, updated annually
• EPLS/GSA/SAM and HHS/OIG checks required within 30 days of start and updated every 30 days while on assignment
• Education verification required within 90 days of start
• Primary source license verification within 30 days of start
• NURSYS verification required within 30 days of start

Additional Requirements

• Must complete facility-specific LMS modules during orientation
• Skills checklist required
• Medication/pharmacology competency exam required for care/case managers

Summary

This Utilization Review Nurse role is a travel contract position requiring a minimum of 2 years of utilization review and acute hospital experience, EPIC proficiency, and prior travel experience. The position involves daytime weekday shifts with no weekends or call, focusing on utilization management and coordination of care in a hospital setting. Candidates must meet comprehensive licensure, certification, health, and background requirements.