Skip to main content

Our Application system is currently undergoing planned system maintenance on 4/9 at 11pm PST.

During this time, please sign up for and come back after 7am PST on 4/10 to apply for jobs.

Already Applied?
Log in Here.

Clinical Denial/Utilization Review Nurse

R19622 Miami, Florida

Transforming the future of healthcare isn’t something we take lightly. It takes teams of the best and the brightest, working together to make an impact.

As one of the largest healthcare technology companies in the U.S., we are a catalyst to accelerate the journey toward improved lives and healthier communities.

Here at Change Healthcare, we’re using our influence to drive positive changes across the industry, and we want motivated and passionate people like you to help us continue to bring new and innovative ideas to life.

If you’re ready to embrace your passion and do what you love with a company that’s committed to supporting your future, then you belong at Change Healthcare.

Pursue purpose. Champion innovation. Earn trust. Be agile. Include all. 

Empower Your Future. Make a Difference.

Clinical Denials-Utilization Review Nurse

Overview of Position

The Clinical Denial Utilization Review Nurse is responsible for conducting clinical reviews to justify and dispute payer denials. The role will develop case studies, coordinate with hospital operations and payers to ensure optimal results in denial prevention. The clinical denial coordinator will oversee quality assurance for clinical denials, including development of protocol and training.  This position will be onsite at our client site in Miami, Florida.

What will be my duties and responsibilities in this job?

  • Provide clinical argument, using available Medical Records, to justify and dispute payer denials, all levels of appeals included.
  • Develop monthly case studies, identifying payer and hospital operational opportunities
  • Compile reports as requesting by the ROS client and operations, specific to payers, operations and clinical reviews
  • Participate in performance meetings as requested by ROS client and operations
  • Develop and conduct quality reviews of all clinical reviews, including training.

What are the requirements needed for this position?

  • 5+ years Utilization Review or Case Management nursing experience
  • Extensive knowledge in evidence-based protocols– Hospital Case Management such as Milliman and/or Interqual guidelines
  • Experience analyzing data and presenting those findings to both leadership and operational teams
  • Strong experience utilizing Microsoft Office applications to include:  Excel, Word, and PowerPoint
  • Bachelor of Science or LPN in Nursing
  • Current valid State of Florida or multi state license as a Registered Nurse

What are the working conditions and physical requirements of this job?

General office demands

How much should I expect to travel?

Employees in roles that require travel will need to be able to qualify for a company credit card or be able to use their own personal credit card for travel expenses and submit for reimbursement.

Join our team today where we are creating a better coordinated, increasingly collaborative, and more efficient healthcare system!

Equal Opportunity/Affirmative Action Statement

Change Healthcare is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, genetic information,  national origin, disability, or veteran status. To read more about employment discrimination protections under federal law, read EEO is the Law at and the supplemental information at

If you need a reasonable accommodation to assist with your application for employment, please contact us by sending an email to with "Applicant requesting reasonable accommodation" as the subject. Resumes or CVs submitted to this email box will not be accepted.

Click here to view our pay transparency nondiscrimination policy.

Change Healthcare maintains a drug free workplace and conducts pre-employment drug-testing, where applicable, in accordance with federal, state and local laws.

Talent Acquisition Process


Visit our career site, create a profile, and submit your application. Make sure to observe the job description and see how your background can align to the requirements of the role.


Once you apply for a job opening, the Sourcing Specialist or Talent Adviser will review your resume ensuring your background matches the minimum job requirements. Selected candidates will be invited for a phone screen.


Steps will vary by team, but typically include: Talent Advisor phone screen, hiring manager interview, and a combination of technical screens and panel interviews.


If you're selected, you can expect the Talent Advisor to reach out with specific offer details. During this stage you will be provided with an electronic offer letter and other new hire documents.


Once you've received your offer letter, our onboarding team will get you ready for Week 1 and set you up for success! Onboarding tasks may include a background check, drug screening, and other job specific requirements.



Visit our career site, create a profile, and submit your application. Make sure to observe the job description and see how your background can align to the requirements of the role.

Job Alerts

Don't see the role you're looking for or not ready to apply yet?

Sign-up to get the latest opportunities at Change Healthcare.

Sign Up