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Clinical Review Rn Jobs (NOW HIRING)

Bellevue Hospital

RN - Utilization Review

Manhattan, NY · On-site

$2.7K/wk

Details Client Name Bellevue Hospital Job Type Travel Offering Nursing Profession RN Specialty Utilization Review Job ID 37956884 Job Title RN - Utilization Review Weekly Pay $2742.5 Shift Details ...

NTT DATA Services

BPO Clinical Review Specialist

FL · On-site

$76K/yr

Clinical Reviewer Specialist (RN) Position Summary The Clinical Reviewer Specialist is responsible for performing clinical and medical necessity reviews to support the timely and accurate processing ...

Schneck Medical Center

UTILIZATION REVIEW RN

Seymour, IN · On-site

Bachelors Degree in Nursing with case management certification LICENSE/CERTIFICATION Licensed RN in ... EXPERIENCE Minimum: 2-3 years of acute care clinical experiencePreferred: 3-5 years of acute care ...

Orison

RN - Utilization Review

Elmhurst, NY · On-site

The RN will review clinical documentation, apply established medical guidelines, and collaborate with physicians, case managers, health plans, and other healthcare professionals to ensure appropriate ...

Pure Infusion

RN Clinical Review Specialist

Sandy, UT · On-site

As a Registered Nurse Clinical Review Specialist at Pure Healthcare, you are responsible for ensuring timely approval and renewal of patient care services to allow Pure Healthcare to meet patient ...

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Clinical Review RN information

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How much do clinical review rn jobs pay per hour?

As of Sep 13, 2026, the average hourly pay for clinical review rn in the United States is $47.93, according to ZipRecruiter salary data. Most workers in this role earn between $35.58 and $57.21 per hour, depending on experience, location, and employer.

What is a clinical review RN?

Clinical Review RNs, or Clinical Review Registered Nurses, are licensed nurses who evaluate medical records, treatment plans, and health care documentation to ensure that patient care meets established standards and guidelines. They play a critical role in reviewing the medical necessity, appropriateness, and efficiency of healthcare services provided to patients. Clinical Review RNs often work for insurance companies, hospitals, or healthcare organizations to help with utilization management, case review, and quality assurance. Their expertise helps improve patient outcomes and manage healthcare costs by ensuring the right care is delivered at the right time.

What skills and qualifications are needed to thrive as a clinical review RN?

To thrive as a Clinical Review RN, you need a robust clinical nursing background, strong assessment skills, and an active RN license, often with experience in case management or utilization review. Familiarity with utilization management software, electronic health records, and knowledge of insurance regulations or CMS guidelines is typically required. Excellent communication, critical thinking, and attention to detail help set outstanding Clinical Review RNs apart. These skills ensure accurate clinical evaluations, compliance with regulations, and effective coordination between patients, providers, and payers.

How does a clinical review RN collaborate with other healthcare professionals during the patient care review process?

A Clinical Review RN regularly works with physicians, case managers, social workers, and insurance representatives to assess the medical necessity and appropriateness of patient care plans. They participate in interdisciplinary meetings, provide clinical insights, and help ensure that care decisions align with policies and regulations. This collaboration is key to streamlining the review process, minimizing delays in patient care, and supporting optimal outcomes for both patients and the healthcare organization.

What is the difference between Clinical Review Rn vs Medical Reviewer?

AspectClinical Review RnMedical Reviewer
CredentialsRegistered Nurse (RN) license, clinical experienceMedical degree (MD or DO), specialized training
Work EnvironmentHealthcare facilities, insurance companies, telehealthHospitals, insurance companies, consulting firms
Employer & Industry UsageInsurance, healthcare providers, government agenciesInsurance, legal, healthcare consulting
Primary FocusAssessing medical records, determining coverage eligibilityEvaluating medical cases, providing expert opinions

While both roles involve reviewing medical information, Clinical Review Rns primarily assess insurance claims and medical records as registered nurses, whereas Medical Reviewers are typically physicians with advanced medical training who evaluate complex cases and provide expert opinions. Understanding these differences helps in choosing the right career path or job search focus.

How to become a clinical review RN?

To become a clinical review RN, you typically need to earn a Bachelor of Science in Nursing (BSN) or an associate degree in nursing, pass the NCLEX-RN exam to obtain licensure, and gain clinical experience in healthcare settings. Additional certifications in case management or utilization review can enhance qualifications for this role.

What does a clinical review RN do?

A clinical review RN evaluates medical records, treatment plans, and patient data to determine coverage, appropriateness, and compliance with healthcare policies. They often work for insurance companies or healthcare organizations, requiring strong clinical knowledge, attention to detail, and certification such as a registered nurse license. Their assessments help ensure proper patient care and cost-effective treatment decisions.
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Clinical Review RN jobs near you
Infographic showing various Clinical Review Rn job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 13% Part Time, 3% Contract, and 1% Nights. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $99,696 per year, or $47.9 per hour.

RN - Utilization Review

Manhattan, NY • On-site

Bellevue Hospital
Health Care and Social Assistance • 201 - 500 employees
Learn more about Bellevue Hospitalexternal

$2.7K/wk

Other

Posted 9 days ago

Job description

Details
Client Name
Bellevue Hospital
Job Type
Travel
Offering
Nursing
Profession
RN
Specialty
Utilization Review
Job ID
37956884
Job Title
RN - Utilization Review
Weekly Pay
$2742.5
Shift Details
Shift
8a-4p
Scheduled Hours
40
Job Order Details
Start Date
09/21/2026
End Date
11/14/2026
Duration
8 Week(s)
Job Description
About the Position
Specialty: RN - Utilization Review
Experience: 2+ years of experience in utilization review, case management, or acute care nursing
License: Active State or Compact RN License
Certifications: BLS - AHA; Certified Case Manager (CCM) preferred
Must-Have: Strong understanding of insurance guidelines, medical necessity criteria (e.g., InterQual or MCG), and discharge planning
Description: The Utilization Review RN is responsible for reviewing medical records to determine the appropriateness and medical necessity of hospital admissions and continued stays. The nurse collaborates with providers, insurance companies, and case managers to ensure compliance with coverage guidelines and supports optimal patient outcomes while managing healthcare costs.
Requirements
Required for Onboarding:
  • Active RN License
  • BLS

Client Details
Address
462 1st Avenue
City
New York City
State
NY
Zip Code
10016

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