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Clinical Review Rn Jobs (NOW HIRING)

IPRO

Clinical Reviewer (RN)

Jericho, NY · On-site

$38.46 - $43.27/hr

Clinical Reviewer (RN) As a Clinical Reviewer (RN), you will complete the full spectrum of ... You will utilize your knowledge and expertise of the review program to conduct clinical level ...

Cohere Health

Clinical Review & Correspondence RN

$31 - $35/hr

Clinical Review & Correspondence RN The Clinical Review & Correspondence RN plays a critical role in supporting utilization management operations by conducting medical necessity reviews, preparing ...

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 ...

HealthHelp

Nurse - Clinical Review

$65K - $75K/yr

Nurse - Clinical Review Performs utilization review of cases to determine if the request meets ... Remote Compensation Disclosure The base salary for this position is $65,000 [LVN/LPN], $75,000 [RN] ...

HealthCare Support

Utilization Management

Houston, TX · On-site

$38 - $40.86/hr

Daily Responsibilities for Remote BH Utilization Review RN: * Evaluate a member's clinical condition through the review of medical records to determine the medical necessity for patient's behavioral ...

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 ...

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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 10, 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.

Travel Nurse RN - Utilization Review - $2,189 per week in Fort Myers, FL

Fort Myers, FL

TravelNurseSource
Health Care and Social Assistance • 11 - 50 employees
Learn more about TravelNurseSourceexternal

$2.1K/wk

Full-time

Medical, Life, Retirement

Posted 28 days ago

Job description

Registered Nurse (RN) | Utilization Review Location: Fort Myers, FL Agency: TGL MedStaff Pay: $2,189 per week Shift Information: Days - 5 days x 8 hours Contract Duration: 14 Weeks Start Date: 9/28/2026

About the Role:

TravelNurseSource is working with TGL MedStaff to find a qualified Utilization Review RN in Fort Myers, Florida, 33966!

TGL MedStaff is seeking a Utilization Review Registered Nurse (RN) for a travel assignment in Fort Myers, FL to start on 9/28/2026. This assignment is for a 14 weeks contract. You will be working 5 days per week, 8 hours per shift and on Days. This position offers a pay rate of $2,189.00 per week. As an Utilization Review RN, you'll review patient records to ensure care is appropriate and meets coverage guidelines. This role gives you the chance to make a meaningful impact on healthcare quality while helping patients receive the right care at the right time.

Please note: Specific shift schedules, start dates, and contract details will be discussed during the application process. We encourage you to apply today to learn more about this exciting opportunity.

Ready to take your Utilization Review experience on the road? Apply now to connect with a recruiter and learn more about this exciting opportunity.

About Florida
  • Tropical and subtropical climate with hot, humid summers and mild winters.
  • Beaches, Everglades, Keys, theme parks, and flat terrain with highest point at 345 feet.
  • Features Disney World, the largest of all Disney parks globally.
  • No state income tax; major retirement destination.
  • Space Coast home to Kennedy Space Center and rocket launches.

About TGL MedStaff

We are on a mission to bring The Good Life to everyone. Our highest priority is quality patient care, the wellbeing of our traveling clinicians, and meeting the unique needs of our partner healthcare facilities. We are committed to ensuring our partner facilities have the quality staff they need to provide top notch care. We are committed to helping our traveling clinicians identify and secure opportunities that fulfill their desire for adventure as well as passion for their work. We believe the good life includes access to quality healthcare and we are committed to doing our part to facilitate the movement of resources to areas of highest need to ensure quality care is available where most necessary.

Requirements Required for Onboarding
  • BLS
  • Core Mandatory Exam - Nursing
  • Ishihara Compliant Color Vision Exam
  • National Patient Safety Goal Policy
  • OSHA for Healthcare Personnel
  • RN - Pharmacology - General - HSH Exam

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