Summary The Utilization Review Nurse RN conducts initial, concurrent and retrospective chart review for clinical, financial and resource utilization information. Provides intervention and ...
Summary The Utilization Review Nurse RN conducts initial, concurrent and retrospective chart review for clinical, financial and resource utilization information. Provides intervention and ...
Complex, high-risk, or ambiguous cases requiring clinical judgment are referred to a RN Utilization Review for review and determination. Essential Duties and Responsibilities These duties and ...
Complex, high-risk, or ambiguous cases requiring clinical judgment are referred to a RN Utilization Review for review and determination. Essential Duties and Responsibilities These duties and ...
Remote Utilization Review Registered Nurse (UR RN) Nexus Health Systems is seeking an experienced Utilization Review Registered Nurse (UR RN) to join our growing Utilization Management team. This ...
New
Remote Utilization Review Registered Nurse (UR RN) Nexus Health Systems is seeking an experienced Utilization Review Registered Nurse (UR RN) to join our growing Utilization Management team. This ...
New
Remote Utilization Review Registered Nurse (UR RN) Location: Remote (Texas RN License or Compact License Required) Company: Nexus Health Systems Employment Type: Full-Time Make an Impact from ...
Quick apply
Remote Utilization Review Registered Nurse (UR RN) Location: Remote (Texas RN License or Compact License Required) Company: Nexus Health Systems Employment Type: Full-Time Make an Impact from ...
Utilization Review Nurse American Health Plans, a division of Franklin, Tennessee-based American ... Required Registered Nurse Equal Opportunity Employer This employer is required to notify all ...
Utilization Review Nurse American Health Plans, a division of Franklin, Tennessee-based American ... Required Registered Nurse Equal Opportunity Employer This employer is required to notify all ...
Utilization Review Nurse
$34.73 - $45.15/hr
Nurse, Registered (RN) licensure * BSN preferred. 2-5 years previous Utilization Review experience preferred. * Current CPR * Relevant hospital nursing; hospital case management; insurance case ...
Utilization Review Nurse
$34.73 - $45.15/hr
Nurse, Registered (RN) licensure * BSN preferred. 2-5 years previous Utilization Review experience preferred. * Current CPR * Relevant hospital nursing; hospital case management; insurance case ...
Utilization Review Nurse
New Lenox, IL · On-site +1
$34.73 - $45.15/hr
Nurse, Registered (RN) licensure * BSN preferred. 2-5 years previous Utilization Review experience preferred. * Current CPR * Relevant hospital nursing; hospital case management; insurance case ...
Utilization Review Nurse
New Lenox, IL · On-site +1
$34.73 - $45.15/hr
Nurse, Registered (RN) licensure * BSN preferred. 2-5 years previous Utilization Review experience preferred. * Current CPR * Relevant hospital nursing; hospital case management; insurance case ...
Clinical Utilization Review Nurse II
Fairfield, CA · On-site
$544.78/wk
Gale Wilson Boulevard Job Type Travel Offering Nursing Profession RN Specialty Utilization Review Job ID 18899553 Job Title Clinical Utilization Review Nurse II Weekly Pay $544.78 Shift Details Shift ...
New
Clinical Utilization Review Nurse II
Fairfield, CA · On-site
$544.78/wk
Gale Wilson Boulevard Job Type Travel Offering Nursing Profession RN Specialty Utilization Review Job ID 18899553 Job Title Clinical Utilization Review Nurse II Weekly Pay $544.78 Shift Details Shift ...
New
Utilization Review Nurse American Health Plans, a division of Franklin, Tennessee-based American ... Required Registered Nurse Equal Opportunity Employer This employer is required to notify all ...
Utilization Review Nurse American Health Plans, a division of Franklin, Tennessee-based American ... Required Registered Nurse Equal Opportunity Employer This employer is required to notify all ...
Utilization Review Nurse RN - NE Utilization Review Nurse RN - NE * Randallstown, MD * NORTHWEST HOSPITAL * NW CARE MANAGEMENT * Part-time - Weekends - Weekend shifts - 8:00am-4:30pm * RN OTHER ...
Utilization Review Nurse RN - NE Utilization Review Nurse RN - NE * Randallstown, MD * NORTHWEST HOSPITAL * NW CARE MANAGEMENT * Part-time - Weekends - Weekend shifts - 8:00am-4:30pm * RN OTHER ...
UTILIZATION REVIEW NURSE - RN
Houston, TX · On-site
The Utilization Review Registered Nurse (UR RN) is a key contributor to the delivery of appropriate, efficient, and cost-effective patient care. Working collaboratively within a multidisciplinary ...
UTILIZATION REVIEW NURSE - RN
Houston, TX · On-site
The Utilization Review Registered Nurse (UR RN) is a key contributor to the delivery of appropriate, efficient, and cost-effective patient care. Working collaboratively within a multidisciplinary ...
Utilization Review Nurse for Workers' Comp Office Location - Montgomery County Area Job Purpose ... Valid current RN license in good standing * Able to perform the professional and technical skills ...
Utilization Review Nurse for Workers' Comp Office Location - Montgomery County Area Job Purpose ... Valid current RN license in good standing * Able to perform the professional and technical skills ...
Utilization Review Nurse
Las Vegas, NV · On-site
Valid license by the State of Nevada to practice as a Registered Nurse. Additional Position ... Interquel or Milliman utilization review criteria, Medicare/Medicaid guidelines, hospital policies ...
Utilization Review Nurse
Las Vegas, NV · On-site
Valid license by the State of Nevada to practice as a Registered Nurse. Additional Position ... Interquel or Milliman utilization review criteria, Medicare/Medicaid guidelines, hospital policies ...
Come work at the best place to give and receive care! RN Utilization Review Who We Are: Elliot Health System's Care Coordination Department, located in Manchester, NH, plays a vital role in ensuring ...
Come work at the best place to give and receive care! RN Utilization Review Who We Are: Elliot Health System's Care Coordination Department, located in Manchester, NH, plays a vital role in ensuring ...
Utilization Review Nurse
$41.82 - $64.82/hr
Valid license by the State of Nevada to practice as a Registered Nurse. Additional Position ... Interquel or Milliman utilization review criteria, Medicare/Medicaid guidelines, hospital policies ...
Utilization Review Nurse
$41.82 - $64.82/hr
Valid license by the State of Nevada to practice as a Registered Nurse. Additional Position ... Interquel or Milliman utilization review criteria, Medicare/Medicaid guidelines, hospital policies ...
Travel Utilization Review RN - $2,712 per week
Tuba City, AZ · On-site
$2.7K/wk
Utilization Review * Discipline: RN * Start Date: 09/07/2026 * Duration: 13 weeks * 40 hours per week * Shift: 8 hours, days * Employment Type: Travel Zack Group is currently seeking Utilization ...
Travel Utilization Review RN - $2,712 per week
Tuba City, AZ · On-site
$2.7K/wk
Utilization Review * Discipline: RN * Start Date: 09/07/2026 * Duration: 13 weeks * 40 hours per week * Shift: 8 hours, days * Employment Type: Travel Zack Group is currently seeking Utilization ...
RN - Utilization Review
Cedar Rapids, IA · On-site
The Utilization Management Specialist in the Behavioral Health Hospital Outpatient Departments ... State of Iowa Licensed RN * Two years of behavioral health work experience. * Professional ...
RN - Utilization Review
Cedar Rapids, IA · On-site
The Utilization Management Specialist in the Behavioral Health Hospital Outpatient Departments ... State of Iowa Licensed RN * Two years of behavioral health work experience. * Professional ...
Utilization Management Schedule: Day-Shift | Full-Time | Monday-Friday 8:00AM-4:30PM | Weekend ... Registered Nurse credentialed from the Maryland Board of Nursing obtained prior to hire date or job ...
Utilization Management Schedule: Day-Shift | Full-Time | Monday-Friday 8:00AM-4:30PM | Weekend ... Registered Nurse credentialed from the Maryland Board of Nursing obtained prior to hire date or job ...
Travel Utilization Review RN - $2,778 per week
Tuba City, AZ · On-site
$2.7K/wk
Utilization Review * Discipline: RN * Start Date: 09/07/2026 * Duration: 13 weeks * 40 hours per week * Shift: 8 hours, days * Employment Type: Travel Travel, RN - Utilization Review Location: Tuba ...
New
Travel Utilization Review RN - $2,778 per week
Tuba City, AZ · On-site
$2.7K/wk
Utilization Review * Discipline: RN * Start Date: 09/07/2026 * Duration: 13 weeks * 40 hours per week * Shift: 8 hours, days * Employment Type: Travel Travel, RN - Utilization Review Location: Tuba ...
New
Qualifications Associates RN degree required, Bachelor's degree preferred Two years of experience in managed care quality assurance or utilization review RN must have two years of experience in an ...
Qualifications Associates RN degree required, Bachelor's degree preferred Two years of experience in managed care quality assurance or utilization review RN must have two years of experience in an ...
Entry Level Rn Utilization Review Nurse information
See salary details
$21.39 - $25.72
2% of jobs
$25.72 - $30.05
9% of jobs
$33.01 is the 25th percentile. Wages below this are outliers.
$30.05 - $34.38
21% of jobs
The median wage is $37.88 / hr.
$34.38 - $38.70
23% of jobs
$38.70 - $43.03
13% of jobs
$46.39 is the 75th percentile. Wages above this are outliers.
$43.03 - $47.36
10% of jobs
$47.36 - $51.68
8% of jobs
$51.68 - $56.01
5% of jobs
$56.01 - $60.34
5% of jobs
$60.34 - $64.66
2% of jobs
$64.66 - $68.99
2% of jobs
$21
$42
$68
How much do entry level rn utilization review nurse jobs pay per hour?
- International Utilization Review Rn
- Rn Utilization Review Nurse
- Prior Authorization Review Nurse
- Flexible Cigna Utilization Review Nurse
- Utilization Review Nurse Lvn
- Per Diem Chart Review Nurse Practitioner
- Fulltime Cigna Utilization Review Nurse
- Utilization Review Registered Nurse Rn
- Volunteer Rn Utilization Review Nurse
- Utilization Review Nurse Consultant

LifeBridge Health rating
6.3
Based on 80 frontline employees who took The Breakroom Quiz
670th of 887 rated healthcare providers
Job description
The Utilization Review Nurse RN conducts initial, concurrent and retrospective chart review for clinical, financial and resource utilization information. Provides intervention and coordination to decrease avoidable delays and denial of payment. Interfaces with 3rd party payers by providing pertinent, relevant clinical information.
Responsibilities Include:
Reviews the medical record by applying utilization review criteria, to assess clinical, financial, and resource consumption. Enters clinical reviews into the software program. Maintains close communication with external reviewers/internal financial counselors/patient access personnel and performs certification activities as required by payor.
Monitors and identifies patterns or trends in utilization management. Monitors potential and actual denials and coordinates with nurse Care Manager and/or Social Worker for any follow up necessary. Documents in software program the actions taken to coordinate care and avoid denials. Assists nurse Care Managers in communicating with the patient denied hospital days as well as the issuance of Medicare forms including HINN, Detailed Notice of Discharge to patients/family/significant other when they are in disagreement with the discharge plan arranged by attending and Care Management personnel.
Coordinates with the Care Manager to achieve optimal and efficient patient outcomes, while decreasing length of stay and avoid delays and denied days. Utilizes Physician Advisor and administrative personnel for unresolved issues. Identifies opportunities for expedited appeals and collaborates with the Care Manager and Physician Advisor to resolve payer issues. Other tasks as assigned.
Sends appropriate referrals/escalations to the physician advisors to review cases not met with criteria
REQUIREMENTS:
- Registered Nurse License - Current Maryland license or eligibility to obtain Maryland license
- Associate's Degree in Nursing required; BSN or higher preferred
- Minimum of 3 years of related experience
Additional Information
Who We Are:
LifeBridge Health is a dynamic, purpose-driven health system redefining care delivery across the mid-Atlantic and beyond, anchored by our mission to "improve the health of people in the communities we serve." Join us to advance health access, elevate patient experiences, and contribute to a system that values bold ideas and community-centered care.
What We Offer:
Impact: Join a team that values innovation and outcomes, delivering life-saving care to our youngest and most vulnerable patients.
Growth : Opportunities for professional development, including tuition reimbursement and developing foundational skills for neonatal critical care leadership and advanced certification.
Support: A culture of collaboration with resources like unit-based practice councils and advanced clinical education support - improving both workflow efficiency and patient outcomes and allowing you to work at the top of your license.
Benefits : Competitive compensation (additional compensation such as overtime, shift differentials, premium pay, and bonuses may apply depending on job), comprehensive health plans, free parking, and wellness programs.
Why LifeBridge Health?
With over 14,000 employees, 130 care locations, and two million annual patient encounters, we combine strategic growth, innovation, and deep community commitment to deliver exceptional care anchored by five leading centers in the Baltimore region: Sinai Hospital of Baltimore, Grace Medical Center, Northwest Hospital, Carroll Hospital, and Levindale Hebrew Geriatric Center and Hospital.
Our organization thrives on a culture of CARE BRAVELY-where compassion, courage, and urgency drive every decision, empowering teams to shape the future of healthcare.
LifeBridge Health complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex or sexual orientation and gender identity/expression. LifeBridge Health does not exclude people or treat them differently because of race, color, national origin, age, disability, sex or sexual orientation and gender identity/expression.
What LifeBridge Health employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom
About LifeBridge Health
Sourced by ZipRecruiter
LifeBridge Health is a $2B, 13,000 team member healthcare system that Cares Bravely for over 1 million patients annually throughout Maryland. We are comprised of 5 main healthcare centers: Sinai Hospital, Northwest Hospital, Carroll Hospital, Levindale Hebrew Geriatric Center and Hospital, and Grace Medical Center as well as several specialty and primary care locations throughout Baltimore.
Industry
Health care and social assistance
Company size
5,001 - 10,000 Employees
Headquarters location
Baltimore, MD, US
Year founded
1988