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Case Review Nurses Jobs (NOW HIRING)

Actalent

Clinical Concurrent Review Nurse

Phoenix, AZ · On-site

Actalent is Hiring a Team of Concurrent Review Nurses (Utilization Management)!! This role performs ... The nurse collaborates closely with physicians, case managers, social workers, and other healthcare ...

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How much do case review nurses jobs pay per hour?

As of Sep 8, 2026, the average hourly pay for case review nurses in the United States is $47.53, according to ZipRecruiter salary data. Most workers in this role earn between $35.34 and $57.45 per hour, depending on experience, location, and employer.

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For Case Review Nurses jobs, the most frequently searched job titles are:

Supervisor Utilization Review RN

Dallas, TX • On-site

Baylor Scott & White Health
Outpatient Health Care • 10K+ employees
Learn more about Baylor Scott & White Healthexternal

Full-time

Posted 25 days ago

Baylor Scott & White Health rating

7.4

Company rating: 7.4 out of 10

Based on 775 frontline employees who took The Breakroom Quiz

263rd of 898 rated healthcare providers

Job description

Job Summary

You supervise utilization review for RNs. You oversee processes daily. Guide on complex cases. Identify staff education opportunities. Connect departments through communication.

Essential Functions of the Role

  • Supervising Utilization Review Department, assigning tasks, assessing productivity, conducting quality reviews, and advising team on peer-to-peer appeals. Also conducting denial research.
  • Collecting data to generate weekly reports that aid in improving staff outcomes and enhancing quality metrics.
  • Collaborate with the Medical Director and Care Coordination when patients don't meet criteria. Updating Clinical Resource Manager as needed.
  • Assigning daily tasks to staff members to ensure service levels are maintained at an optimal level.
  • Monitors daily observation reports to identify and address any potential problems.
  • Handling escalations from Utilization Review Nurses and other staff members.
  • Conducting quality reviews as needed.
  • Responding to inquiries from staff members and stakeholders regarding Utilization Review.
  • Serve as a Subject Matter Expert (SME) for Utilization Review workflow issues, complex cases, denials, and customer interactions, both internal and external.

Key Success Factors

  • Possessing a helpful nature that assists others in identifying and solving challenges.
  • Skilled in mentoring and encouraging colleagues for the enhancement of their clinical proficiency.
  • Exceptional written and conversational abilities.
  • Proficient at collaborating effectively with employees of varying ranks, including those at the highest level of leadership.
  • Familiarity with discharge planning, case management, and utilization review. processes, case handling and the review of resource usage.
  • Experience in strategically directing work among team members based on established policies and protocols.
  • Aptitude in making sound hiring and termination suggestions.
  • Proficiency in training colleagues and assessing their performance.
  • Basic digital skills like using Microsoft Office, information security, managing schedules and payroll, electronic medical documentation, and email use

Qualification

  • EDUCATION - Associate's Degree
  • MAJOR - Nursing
  • EXPERIENCE - (4) Four Years of Experience

What Baylor Scott & White Health employees say

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