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Entry Level Rn Utilization Review Nurse Jobs (NOW HIRING)

Southeast Health

Utilization Review Nurse

Dothan, AL · On-site

Summary The Utilization Review Nurse screens medical records in accordance with contractual ... Current Registered Nurse license in the State of Alabama Minimum Education Preferred * Bachelor ...

Bracane Co

Utilization Review Nurse

Plano, TX · Remote

Austin area - Travis/Williamson Counties or Richardson area - Dallas/Collin Counties*** RN working ... This position is responsible for performing initial, concurrent review activities; discharge care ...

UofL Health

RN Utilization Review

Louisville, KY · On-site

The Utilization Review RN performs activities which support the Utilization Management functions. They are responsible for the delivery of the Utilization Management process including but not limited ...

Houston Methodist

At Houston Methodist, the Utilization Review Nurse (URN) PRN position is a licensed registered nurse (RN) who comprehensively conducts point of entry and concurrent medical record review for medical ...

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

As of Jun 24, 2026, the average hourly pay for entry level rn utilization review nurse in the United States is $42.28, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 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 the United States as of June 2026, with employment types broken down into 89% Full Time, 1% Part Time, and 10% Contract. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.
Registered Nurse - Utilization Review

Registered Nurse - Utilization Review

Trinity Health

Mishawaka, IN

Part-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 5 days ago

Trinity Health rating

6.5

Company rating: 6.5 out of 10

Based on 349 frontline employees who took The Breakroom Quiz

595th of 875 rated healthcare providers

Job description

Employment Type:Part timeShift:Rotating ShiftDescription:This is a remote position but will need onsite training in Mishawaka Indiana.
Shift: PRN/Days - 8 hr shift
Considering local candidates only!!!
Why Choose Saint Joseph Health System?

  • At Saint Joseph Health System, our values guide every decision we make. Even when challenges arise, we remain committed to our mission: caring for every person who needs us. We invest in our people, our technology, and our capabilities so we can continue delivering exceptional, compassionate care to our communities.

What We Offer

  • Tuition reimbursement for all full-time and part-time colleagues starting on day one

  • Comprehensive benefits beginning day one (Medical, Dental, Vision, PTO, Life Insurance, STD/LTD, and more)

  • Retirement savings plan with employer match

  • Generous paid time off program plus 7 paid holidays

  • No mandatory overtime

  • Employee referral incentive program

  • Access to state-of-the-art equipment, unlimited CEUs, and a supportive team-focused work environment

What You Will Do
  • Conduct clinical reviews of patient records to evaluate medical necessity, appropriateness of admission, treatment, and length of stay across all payor types
  • Apply standardized criteria, regulatory guidelines, and insurance requirements to support reimbursement and compliance
  • Collaborate with physicians, nursing staff, and interdisciplinary teams to ensure appropriate resource utilization and care planning
  • Review admissions and ongoing patient cases; recommend or escalate cases that do not meet criteria to leadership or the Utilization Review Committee
  • Facilitate timely discharges, transfers, and recertifications when level of care is no longer appropriate
  • Partner with Medicare, Medicaid, and private insurers to ensure accurate documentation and reimbursement processes
  • Respond to denials and authorization changes by reviewing medical records and communicating outcomes to care teams and patients
  • Identify trends and utilization concerns; contribute to performance improvement and quality initiatives
  • Maintain accurate records, compile reports, and support utilization review program operations
  • Provide education to clinical staff on documentation requirements, coverage guidelines, and utilization processes
  • Support compliance with all regulatory, accreditation, and organizational standards
  • Participate in committee meetings and assist in development of utilization review plans and processes
What You Will Need
  • Graduate of an accredited Registered Nurse (RN) program; Bachelor's Degree in Nursing preferred
  • Active RN license (state-specific requirement applies)
  • Minimum of 2 years of acute care nursing experience
  • Prior utilization review, case management, or payer review experience preferred
  • Strong knowledge of Medicare, Medicaid, and commercial insurance guidelines
  • Solid understanding of clinical care practices, diagnoses, treatment modalities, and hospital operations
  • Excellent communication skills with the ability to collaborate effectively across teams
  • Strong analytical and critical thinking skills to assess clinical appropriateness and compliance
  • Proficiency in computer systems and Microsoft Office applications
  • Ability to manage multiple priorities in a fast-paced healthcare environment
  • Flexibility to adapt to changing schedules, workflows, and departmental needs

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.

What Trinity Health employees say

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About Trinity Health

Sourced by ZipRecruiter

Trinity Health Ann Arbor is a 537 -bed teaching hospital located on 340 acre campus. Recognized by IBM Watson as a Top 100 Hospital and #1 Teaching Hospital, Trinity Health Ann Arbor has been a leading health care provider for more than 100 years. Trinity Health has received numerous local and national awards in recognition of our leadership, quality outcomes, and clinical excellence.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Livonia, MI, US

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