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Entry Level Rn Utilization Review Nurse Jobs in Philadelphia, PA

Humana

Compliance UM Nurse (Wed - Sun)

Trenton, NJ · On-site

Become a part of our caring community The Compliance Nurse 2 reviews utilization management ... Licensed Registered Nurse (RN) in a compact state with no disciplinary action.?? * Must have?valid ...

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Entry Level Rn Utilization Review Nurse information

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$42

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How much do entry level rn utilization review nurse jobs pay per hour?

As of Aug 10, 2026, the average hourly pay for entry level rn utilization review nurse in Philadelphia, PA is $42.67, according to ZipRecruiter salary data. Most workers in this role earn between $33.70 and $48.99 per hour, depending on experience, location, and employer.
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Entry Level Rn Utilization Review Nurse jobs near you
Infographic showing various Entry Level Rn Utilization Review Nurse job openings in Philadelphia, PA as of June 2026, with employment types broken down into 74% Full Time, 15% Part Time, and 11% Contract. Highlights an 91% Physical, 2% Hybrid, and 7% Remote job distribution, with an average salary of $88,746 per year, or $42.7 per hour.

Utilization Review Nurse (On-Site)

Elite

King Of Prussia, PA • On-site

Full-time

Re-posted 23 days ago

Job description

Utilization Review Nurse for Workers' Comp
Office Location - Montgomery County Area
Job Purpose:
Review Workers Compensation requests submitted by the provider, requestor, claimant or carrier to determine the medical necessity of the treatment utilizing clinical expertise and evidence-based treatment guidelines.
**Please note that this is an In-office position.
Duties:
  • Perform an evaluation of the medical data for utilization review requests.
  • Confirm accurate completion of data intake.
  • Collect additional relevant data as needed with regard to determining medical necessity.
  • Analyze the collected data to apply evidence-based guidelines.
  • Review requests and make certification decisions, when appropriate, or prepare a case for peer review referral.
  • Coordinates information between all parties (injured worker, physicians, employer, therapists, attorney, etc)
  • Participate in audits of work product to ensure compliance.
  • Monitor daily processing inventory, including rush/urgent requests.
  • Provide inventory information and raise concerns to clinical director.
  • Complete production logging.
  • Assist leadership team with training and coordinating back-up resources.
Requirements/Skills/Qualifications:
  • Graduate of an accredited school
  • Valid current RN license in good standing
  • Able to perform the professional and technical skills of a Registered Nurse
  • Minimum 2 years of direct patient care
  • Excellent, written and oral communication skills
  • Ability to read and interpret medical reports and treatment guidelines
  • Must be able to maintain confidentiality
  • Must possess strong personal organizational skills
  • Must have experience and knowledge of intermediate computer skills
  • Ability to work independently with little to no supervision
  • Ability to work in a fast-paced and time-sensitive environment
  • Ability to meet deadlines in a production driven environment
  • Ability to work with WORD and EXCEL documents.
Preferences:
  • Experience in Utilization Review, Workers Compensation is a plus

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