Travel Utilization Review Nurse Jobs

Utilization review nurses are registered nurses who specialize in combining their clinical and administrative experience to monitor the quality of patient care while helping control health care costs. UR nurses are deeply committed to health care quality and patient safety. They help prevent overuse or misuse of medical resources and monitor insurance claims for patients to ensure their medical procedures and services are covered.

UR nurses play a vital role behind the scenes because they’re one of the primary ways that health care providers and insurance companies control costs for patients. This job can involve difficult decisions as UR nurses strive to strike a balance between quality control, high-quality patient care, and cost-efficiency of health care services.

Utilization review nursing is an in-demand specialty on Vivian where you’ll find jobs for utilization review nurses at prestigious medical facilities around the nation.

We currently have 13 matching Utilization Review Nurse jobs.

View job details for Registered Nurse (RN) - Utilization Review

Registered Nurse (RN) - Utilization Review

  • Boise, ID
    • Flexible
Overview St. Luke’s Health System is seeking an Utilization Reviewer to join our Utilization Management team.   The Utilization Reviewer – RN is responsible for evaluating medical ...
Permanent

$29-49/hr

View job details for Registered Nurse (RN) - Utilization Review

Registered Nurse (RN) - Utilization Review

  • Boise, ID
    • Flexible
Overview St. Luke’s Health System in Boise is seeking an Utilization Reviewer to join our Utilization Review team.   The Utilization Reviewer – RN is responsible for evaluating me ...
Permanent

$29-49/hr

View job details for Registered Nurse (RN) - Utilization Review

Registered Nurse (RN) - Utilization Review

  • Boise, ID
    • Flexible
Overview St. Luke’s Health System is seeking an Utilization Reviewer to join our Utilization Management team.   The Utilization Reviewer – RN is responsible for evaluating medical ...
Permanent

$29-49/hr

View job details for Registered Nurse (RN) - Utilization Review

Registered Nurse (RN) - Utilization Review

  • Boise, ID
    • Flexible
Overview St. Luke’s Health System in Boise is seeking an Utilization Reviewer to join our Utilization Review team.   The Utilization Reviewer – RN is responsible for evaluating me ...
Permanent

$29-49/hr

View job details for Travel Nurse RN - Utilization Review

Travel Nurse RN - Utilization Review

  • Massena, NY
    • 5x8 hrs
    • Days
Location: MASSENA, NY Setting: Hospital Employment Type: Traveler Utilization Review/Quality Assurance - UR/QA to join our travel team in MASSENA, NY! This is a full time tr ...
Travel
3 days ago

$3,759/wk

View job details for Travel Nurse RN - Utilization Review

Travel Nurse RN - Utilization Review

  • Potsdam, NY
    • 5x8 hrs
    • Days
Location: Potsdam, NY Setting: Hospital Employment Type: Traveler Utilization Review/Quality Assurance - UR/QA to join our travel team in Potsdam, NY! This is a full time tr ...
Travel
3 days ago

$3,759/wk

View job details for Travel Nurse RN - Utilization Review

Travel Nurse RN - Utilization Review

  • Potsdam, NY
    • 5x8 hrs
    • Evenings
Location: Potsdam, NY Setting: Hospital Employment Type: Traveler Utilization Review/Quality Assurance - UR/QA to join our travel team in Potsdam, NY! This is a full time tr ...
Travel
3 days ago

$3,759/wk

View job details for Travel Nurse RN - Utilization Review

Travel Nurse RN - Utilization Review

  • Massena, NY
    • 3x12 hrs
Focus Staff Job ID #a1q4w000006J3qMAAS. Pay package is based on 12 hour shifts and 36 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted ...
Travel
3 days ago

$3,398/wk

View job details for Travel Nurse RN - Utilization Review

Travel Nurse RN - Utilization Review

  • Potsdam, NY
    • 3x12 hrs
Focus Staff Job ID #a1q4w000006J3ofAAC. Pay package is based on 12 hour shifts and 36 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted ...
Travel
3 days ago

$3,398/wk

View job details for Travel Nurse RN - Utilization Review

Travel Nurse RN - Utilization Review

  • Detroit, MI
    • 5x8 hrs
Focus Staff Job ID #a1q4w000006J2yeAAC. Pay package is based on 8 hour shifts and 40 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted ...
Travel
4 days ago

$2,680/wk

View job details for Travel Nurse RN - Utilization Review

Travel Nurse RN - Utilization Review

  • Clearwater, FL
    • 5x8 hrs
    • Days
Location: Clearwater, FL Setting: Hospital Employment Type: Traveler Utilization Review/Quality Assurance - UR/QA to join our travel team in Clearwater, FL! This is a full t ...
Travel

$2,489/wk

View job details for Travel Nurse RN - Utilization Review

Travel Nurse RN - Utilization Review

  • Tampa, FL
    • 5x8 hrs
    • Days
Location: Tampa, FL Setting: Hospital Employment Type: Traveler Utilization Review/Quality Assurance - UR/QA to join our travel team in Tampa, FL! This is a full time travel ...
Travel

$2,362/wk

View job details for Travel Nurse RN - Utilization Review

Travel Nurse RN - Utilization Review

  • Kansas City, MO
    • 3x12 hrs
Focus Staff Job ID #a1q4w000006J49OAAS. Pay package is based on 12 hour shifts and 36 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted ...
Travel
3 days ago

$1,596/wk

Looking for the highest paying Utilization Review Nurse jobs?

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Utilization Review Nurse FAQs

What does a utilization review nurse do?

The primary role of utilization review nurses is similar whether they work for a health care provider or an insurance company, although everyday tasks vary to some degree. As employees of the insurance industry, UR nurses focus on pre-certifying patients for medically necessary procedures and hospitalizations and determining whether patients meet the standards for insurance reimbursement.

As hospital employees, UR nurses also determine whether patients are eligible for insurance coverage on specific treatments. They also help patients compare their covered treatments and medications to ensure they don’t pay out-of-pocket for hospital/doctor visits and treatments because they’re outside their health insurance coverage. Other duties may include:

  • Helping eliminate prolonged admissions and unnecessary procedures

  • Obtaining prior authorization for medical procedures

  • Performing regular reviews of care and audits of charting to ensure patients receive necessary care without burdening the health care system

  • Educating patients on the benefits/limitations of their Medicaid, Medicare, or private health care coverage

  • Aiding with discharge plans that smoothly and safely transition patients to other facilities or their homes

  • Working closely with insurance companies to ensure health care providers are reimbursed for services

  • Solving problems with pending claims and preventing claim denials

Where do utilization review nurses work?

UR nurses serve as liaisons between patients, health care providers, and third-party payers. They may work on the medical side of utilization review with employment in inpatient and outpatient clinical settings, including hospitals, nursing homes, and home health agencies. They also may work on the insurance side and work for traditional medical insurance carriers or managed care companies. Worker’s compensation bureaus and government agencies, such as Medicare and Medicaid, also may employ utilization review nurses.

What skills make a good utilization review nurse?

Good UR nurses have a broad base of nursing knowledge/experience and familiarity with evidence-based practice. Critical thinking skills and attention to detail are crucial for reviewing medical records and patient histories to make recommendations that effectively balance appropriate health care services with cost and quality. Exceptional UR nurses are highly accurate in performing and auditing clinical documentation. They have advanced organization skills to keep up with potentially heavy caseloads and superior verbal and written communication skills to communicate clearly and concisely with patients, health care providers, and insurance representatives. All combined, good UR nurses have the skills to ensure patient safety, reduce medical errors, and eliminate unnecessary services without adding potentially harmful delays in care.

How to become a Utilization Review Travel Nurse

UR nurses must be licensed registered nurses, which requires a minimum of an associate degree in nursing and passing the NCLEX-RN to obtain RN licensure. However, most employers prefer UR nurses to have a Bachelor of Science in Nursing. Employers also prefer hiring UR nurses with extensive hands-on nursing experience and an administrative background. Previous UR experience and certification are often preferred. UR nurses may want to pursue Health Care Quality & Management Certification from the American Board of Quality Assurance and Utilization Review Physicians or Nursing Case Management Certification from the American Nurses Credentialing Center.

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Recently filled jobs

Travel Nurse RN - Utilization Review

  • Falls Church, VA
    • 5x8 hrs
    • Days
We’re seeking talented healthcare professionals whose adventure game is as strong as their clinical game. Those that want flexibility and high pay, we have the positions fo ...
Travel
9 days ago

$3,390/wk

Travel Nurse RN - Utilization Review

  • Falls Church, VA
    • 5x8 hrs
    • Days
We’re seeking talented healthcare professionals whose adventure game is as strong as their clinical game. Those that want flexibility and high pay, we have the positions fo ...
Travel

$3,390/wk

Travel Nurse RN - Utilization Review

  • Schenectady, NY
    • 5x8 hrs
    • Days
The benefits of taking a travel nursing job with Cross Country Nurses include:Free Private Housing or Generous Housing Allowance Comprehensive Health Insurance with Prescription Co ...
Travel

$3,700/wk

Travel Nurse RN - Utilization Review

  • Schenectady, NY
    • 5x8 hrs
    • Days
The benefits of taking a travel nursing job with Cross Country Nurses include:Free Private Housing or Generous Housing Allowance Comprehensive Health Insurance with Prescription Co ...
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$3,655/wk

Travel Nurse RN - Utilization Review

  • Merced, CA
    • 5x8 hrs
    • Days
We’re seeking talented healthcare professionals whose adventure game is as strong as their clinical game. Those that want flexibility and high pay, we have the positions fo ...
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$3,346/wk

Travel Nurse RN - Utilization Review

  • Red Bluff, CA
    • 5x8 hrs
    • Days
We’re seeking talented healthcare professionals whose adventure game is as strong as their clinical game. Those that want flexibility and high pay, we have the positions fo ...
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$6,157/wk

Travel Nurse RN - Utilization Review

  • Schenectady, NY
    • 5x8 hrs
    • Days
The benefits of taking a travel nursing job with Cross Country Nurses include:Free Private Housing or Generous Housing Allowance Comprehensive Health Insurance with Prescription Co ...
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$3,715/wk

Travel Nurse RN - Utilization Review

  • Schenectady, NY
    • 5x8 hrs
    • Days
The benefits of taking a travel nursing job with Cross Country Nurses include:Free Private Housing or Generous Housing Allowance Comprehensive Health Insurance with Prescription Co ...
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$3,715/wk

Travel Nurse RN - Utilization Review

  • Red Bluff, CA
    • 4x10 hrs
    • Days
We’re seeking talented healthcare professionals whose adventure game is as strong as their clinical game. Those that want flexibility and high pay, we have the positions fo ...
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$6,157/wk

Travel Nurse RN - Utilization Review

  • Marina Del Rey, CA
    • 5x8 hrs
    • Days
8 Hour day shift
Travel

$3,400/wk