Utilization review nurse resume examples from 2026
Land interviews using Zippia's AI-powered resume builder.
All resume examples
How to write a utilization review nurse resume
Craft a resume summary statement
A well-written resume summary is basically an elevator pitch. You are summing up your skills and experience in a few sentences to wow recruiters, hiring managers, and decision makers into giving you an interview. Here are some tips to putting your best foot first with your resume summary:
Step 1: Start with your professional title, or the one you aspire to.
Step 2: Detail your years of experience in utilization review nurse-related roles and your industry experience.
Step 3: What are your biggest professional wins? Here is your opportunity to highlight your strongest accomplishments by placing them at the start of your resume.
Step 4: Don't forget, your goal is to summarize your experience. Keep it short and sweet, so it's easy for recruiters to quickly understand why you're a great hire.
Hiring managers spend under a minute reviewing resumes on average. This means your summary needs to demonstrate your value quickly and show why you are the perfect fit for the utilization review nurse position.Please upload your resume so Zippia’s job hunt AI can draft a summary statement for you.
List the right project manager skills
Many resumes are filtered out by hiring software before a human eye ever sees them. A robust Skills section can let recruiters (and bots) know you have the skills to do the job. Here is how to make the most of your skills section:
- Start with the job listing. Frequently, the keywords looked for by recruiters will be listed. Be careful to include all skills in the job listing you have experience with.
- Consider all the software and tools you use on a daily basis. When in doubt, list them!
- Make sure you use accurate and up to date terms for all the skills listed.
Here are example skills to include in your “Area of Expertise” on a utilization review nurse resume:
- Medical Necessity
- Patients
- Acute Care
- Discharge Planning
- Utilization Management
- Utilization Review
- Community Resources
- Outpatient Services
- Clinical Knowledge
- Home Health
- Patient Care
- Appeals
- CPT
- Medical Directors
- Clinical Judgment
- Medical Care
- Clinical Review
- Chart Review
- Proactive Planning
- HIPAA
- Social Work
- CMS
- Concurrent Review
- Health Care Services
- Inpatient Admissions
- Health Plan
- ICD-9
- Interqual Criteria
- Medicare
- Medicaid
Zippia’s AI can customize your resume for you.
How to structure your work experience
Your employment history is arguably one of the most important parts of your resume. It shows you have experience and foundation in your field to successfully master the utilization review nurse position. Here is how to most effectively structure your work experience:
- List your most recent experience first, followed by earlier roles in reverse chronological order. Employers care about your most recent experience the most.
- Start with your job title, company name, city, and state on the left. Align dates in month and year format on the right-hand side.
- Include only recent, relevant jobs.
How to write utilization review nurse experience bullet points
Effective job bullet points do more than just describe your job duties. Instead, they should be specific and measurable accomplishments. Here are some strategies to mastering job bullet points:
- Use strong action verbs like Led, Built, or Optimized.
- Follow up with numbers when possible to support your results. How much did performance improve? How much revenue did you drive?
- Wrap it up by explaining the actions you took to achieve the result and how you made an impact.
Here are examples from great utilization review nurse resumes:
Work history example #1
Utilization Review Nurse
St. Vincent Infirmary Med Cent
- Applied International Classifications of Disease and Current Procedural Terminology with appropriate Medicare Part B claim review.
- Selected to critique professional provider policies for update based on claims experience and Medicare regulations.
- Supervised MDS compliance in 12 facilities.
- Collected, organized, entered, measured and analyzed quality assurance information to support identified facility initiatives and goals.
- Attended to patients as -go to person- with daily assessment from Day 1 until their decision to treat or return home.
Work history example #2
Utilization Review Nurse
DaVita
- Educated patients and/or family regarding procedure and management of health related to end stage renal disease including hypertension and diabetes.
- Initiated the Case Management and UR programs at this facility to comply with CMS.
- Worked on ad hoc team developing CPT editing system for workman's Compensation Telecommute position.
- Reviewed urgent concurrent admission cases using InterQual criteria and other plan specific guidelines for medical necessity and rate of coverage.
- Served on committee to develop/revise national internal treatment guidelines for company with medical director Dr. Melissa Bean.
Work history example #3
Managed Care Coordinator
Hilton Worldwide Holdings
- Performed confidential verification of customer income status according to government procedures.
- Included maintaining a Facebook page, creating monthly e-newsletters and working with church leadership to tailor discipleship resources.
- Practiced appropriate patient care within the scope of Clinical Care Extender throughout ER, OR, Rehabilitation, and Telemetry departments.
- Reviewed all attendants' time sheets for accurate payroll hours, for distribution to home office.
- Experienced with ICD -9, ICD-10 and CPT codes.
Work history example #4
Medical Surgical Staff Nurse
Kaiser Permanente
- Provided direct patient care through the administration of venipuncture, EKG's, pregnancy tests, injections, and medication.
- Promoted learning environment for all team members and maintained standards of efficiency and cost effectiveness.
- Created first Kaiser educational program on Renal, Pulmonary and GI procedures for pediatrics.
- Handled MultiSpeciality Ambulatory Surgery as Pre OP/PACU/Post RN and delivered high quality patient care through strong knowledge base.
- Interpreted potentially life threatening changes in EKG rhythms and intervened appropriately.
Zippia’s AI can customize your resume for you.
Add an education section to your resume
The education section should display your highest degree first.
Place your education section appropriately on your resume. If you graduated over 5 years ago, this section should be at the bottom of your resume. If you just graduated and lack relevant work experience, the education section should go to the top.
If you have a bachelor's or master's degree, do not list your high school education. If your graduation year is more than 15-20 years ago, it's better not to include dates in this section.
Here are some examples of good education entries from utilization review nurse resumes:
Master's Degree in nursing
Grand Canyon University, Phoenix, AZ
2000 - 2001
Bachelor's Degree in nursing
Miami Dade College, Miami, FL
2003 - 2006
Highlight your utilization review nurse certifications on your resume
If you have any additional certifications or education-like achievements, add them to the education section.
Start simple. Include the full name of the certification. It's also good to mention the organization that issued the certification. Next, specify when you obtained the certification.
Here are some of the best certifications to have on utilization review nurse resumes:
- Certified Case Manager (ACM)
- Legal Nurse Consultant Certified (LNCC)
- Medical Assistant
- Certified Nurse Assistant (CNA)
- Certified Nurse Technician (CNT)
- Certified Managed Care Nurse (CMCN)
- Certified Gastroenterology Licensed Vocational/Practical Nurse (LPN/LVN)
- Medical-Surgical Nursing (RN-BC)
- Certified Nurse Educator (CNE)
- Family Nurse Practitioner