Utilization Review Nurse
Global Force USA · United States · US
Utilization Review
Remote
Nurse
Demand78
Career growth62
Healthcare fit82
Remote potential30
5-year outlook
Utilization review nursing roles typically offer stable pay tied to acute-care RN experience and payer/UM credentials; growth is strongest for those with InterQual/Milliman and managed-care exposure, but exact compensation varies by employer and location.
Clinical license
Required
Applicant reach
narrow
Seniority
senior
Employment type
full-time
Date found
2026-10-18
Intelligence details
Flexible work details
- Engagement type
- Permanent
- Hours
- Full-time
- Eligible countries
- United States
- License jurisdiction
- US
- Profession fit
- Nurse
- Rate period
- Annual
Listing via Himalayas.
Eligibility, licensing, and location restrictions can change. Always confirm details on the source posting before applying.
Why this is worth applying to
Worth considering only if you are a Nevada-licensed RN with strong acute-care, utilization management, discharge planning, and InterQual/Milliman experience. It is not an entry point into non-clinical work for clinicians without prior UM exposure.
Who should apply
Nevada-licensed RNs with acute hospital experience, utilization management, case management, clinical documentation improvement, discharge planning, and recent InterQual/Milliman use.
CV angle
Frame acute-care RN experience around utilization review, discharge planning, InterQual/Milliman criteria, payer compliance, chart documentation, and multidisciplinary communication; quantify caseloads, denial avoidance, and audit outcomes where real.
Skills to highlight
- Utilization review
- InterQual
- Milliman Care Guidelines
- Discharge planning
- Medical chart review
- Medicare/Medicaid compliance
- Clinical documentation improvement
- Case management
Role summary
Reviews inpatient admissions and medical charts against payer and utilization criteria, documents appropriateness and efficiency of care, and supports compliance with Medicare/Medicaid and accreditation standards.
We publish our own intelligence summary, never the full job description. Always confirm details with the employer when you apply.