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Clinical Review Rn Jobs (NOW HIRING)

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Clinical Review Nurse

Lake Mary, FL · On-site

As a Utilization Review Nurse, you will utilize your critical thinking skills, clinical expertise ... Licensed Nurse Practitioner (LPN) or Registered Nurse (RN) required * Comprehensive knowledge of ...

CHI Health

Utilization Review RN

Job Summary and Responsibilities As our Utilization Review RN, you will play a pivotal role in ... You will serve as a clinical expert, collaborating with attending physicians, consultants, and care ...

OU Health (Parent)

Utilization Review RN

Whittier, CA · On-site

$2.8K/wk

Details Client Name PIH HEALTH Job Type Travel Offering Nursing Profession Registered Nurse Specialty Utilization Review Job ID 18027156 Job Title Utilization Review RN Weekly Pay $2800.0 Shift ...

CHI Health

Utilization Review RN

Omaha, NE · On-site

$33.51 - $48.58/hr

Job Summary and Responsibilities As our Utilization Review RN, you will play a pivotal role in ... You will serve as a clinical expert, collaborating with attending physicians, consultants, and care ...

TEEMA Group

Clinical Quality Review Nurse

Phoenix, AZ · Remote

$41 - $44/hr

CLINICAL QUALITY REVIEWER (RN or LCSW) Location: USA- Remote in approved states Overview: TEEMA is partnering with a leading organization supporting a large-scale federal healthcare program to ...

KPC Global MSO

Utilization Review RN

Santa Ana, CA · On-site

SUMMARY The Utilization Review RN reviews client health records to ensure proper utilization of ... Coordinates discharge referrals as requested by clinical staff, fiscal intermediary, patients, and ...

Providence Service

Utilization Review RN

Portland, OR · On-site

Oregon Registered Nurse License * Five (5) years Clinical experience in an acute adult medical/surgical care setting, OR Five (5) years Current Utilization Review or Case Management experience.

Lancesoft INC

Utilization Review RN

Atlanta, GA · On-site

$3.0K - $3.1K/wk

Utilization Review RN - Target Review * Health Plan Insurance (no acute care) * BLS (AHA) * RN state license Company Description LanceSoft is rated as one of the largest staffing firms in the US by ...

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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 9, 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.

Utilization Review Registered Nurse

Kearney, NE • On-site

Ironside Human Resources
Recruiting and Staffing Services • 1 - 10 employees
Learn more about Ironside Human Resourcesexternal

Full-time

Re-posted 4 days ago

Job description

\n <\/head>\n \n \n

A facility located near Lexington, Nebraska <\/b>is seeking a Utilization Review Registered Nurse <\/b>to join their team!\n
<\/p>\n

Utilization Review Registered Nurse Opportunity:<\/b>\n
<\/p>\n

    \n
  • Full\-time, permanent position\n
    <\/li>\n
  • Schedule: Monday\-Friday, 9:00AM\-5:00PM\n
    <\/li>\n
  • Collaborates with providers, departments, and community resources to ensure patient\-centered care and effective communication of care plans\n
    <\/li>\n
  • Supports utilization review, quality data collection, compliance, and accurate medical documentation while maintaining patient safety and infection control standards\n
    <\/li>\n <\/ul>\n

    Utilization Review Registered Nurse Requirements:<\/b>\n
    <\/p>\n

      \n
    • NE Registered Nurse License\n
      <\/li>\n
    • Associate's or Bachelor's degree in Nursing required (Bachelor's preferred)\n
      <\/li>\n
    • At least two years of nursing experience\n
      <\/li>\n
    • BLS certification required within six months of hire\n
      <\/li>\n
    • Strong communication, documentation, and confidentiality skills with the ability to collaborate with patients, staff, insurance representatives, and regulatory agencies while following infection control protocols\n
      <\/li>\n <\/ul>\n

      The Location:<\/b>\n
      <\/p>\n

        \n
      • Located in South Central Nebraska\n
        <\/li>\n
      • Maintains more than 100 acres of green space, public parks, trails, a skate park, aquatic center, indoor sports field house and racquets center\n
        <\/li>\n
      • Not far from Johnson Lake which offers boating, fishing, and trails\n
        <\/li>\n
      • Known for a welcoming small\-town feel with affordable living and a strong sense of community\n
        <\/li>\n <\/ul>\n
        \n Interested? Contact Aidan G. | Ironsidehr.com | 469\-921\-0777 | aidan@ironsidehr.com\n
        \n <\/div>\n <\/span>\n
        \n <\/body>\n<\/html>
Ironside Human Resources logo

About Ironside Human Resources

Sourced by ZipRecruiter

Ironside Human Resources, based in Dallas, TX, US, is a national healthcare recruitment company that offers staffing solutions to hospitals and healthcare providers across the United States. With an official website located at ironsidehr.com, the firm specializes in direct-hire recruitment for diverse sectors, including nursing, allied health, ancillary, administrative and executive-level roles in the healthcare industry. The company was founded in 2011 and has since committed to solving the healthcare staffing shortage through their unique, cost-effective recruitment strategies. Their core commitment is defined by their professional integrity, exceptional customer service, and dedication to delivering value and effective solutions.

Industry

Recruiting and staffing services

Company size

1 - 10 Employees

Headquarters location

Dallas, TX, US

Year founded

2011

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