Utilization Review Experience, the nurse can come from a Hospital, Home Health, or Managed Care company/ health plan Additional Information Hello! My name is Krishna Gapuz and I am a R ecruiting ...
Utilization Review Experience, the nurse can come from a Hospital, Home Health, or Managed Care company/ health plan Additional Information Hello! My name is Krishna Gapuz and I am a R ecruiting ...
Refers to UR committee any case that surpasses expected LOS, expected cost, or over/under-utilization of resources. * Performs verbal/fax clinical review with payer as determined by nursing judgment ...
Refers to UR committee any case that surpasses expected LOS, expected cost, or over/under-utilization of resources. * Performs verbal/fax clinical review with payer as determined by nursing judgment ...
Refers to UR committee any case that surpasses expected LOS, expected cost, or over/under-utilization of resources. * Performs verbal/fax clinical review with payer as determined by nursing judgment ...
Refers to UR committee any case that surpasses expected LOS, expected cost, or over/under-utilization of resources. * Performs verbal/fax clinical review with payer as determined by nursing judgment ...
Utilization Review Nurse
$34.73 - $45.15/hr
Medical
Dental
Vision
Life
Retirement
PTO
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
Medical
Dental
Vision
Life
Retirement
PTO
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
Oxford, NC · On-site
Three years clinical nursing experience. One year utilization and review experience. Experience with MCG authorization criteria preferred. Knowledge of current nursing principles, techniques ...
Utilization Review Nurse
Oxford, NC · On-site
Three years clinical nursing experience. One year utilization and review experience. Experience with MCG authorization criteria preferred. Knowledge of current nursing principles, techniques ...
RN Utilization Review Nurse
$33 - $37/hr
Are you an experienced RN Utilization Review Nurse looking for a new opportunity with a prestigious healthcare company as a RN Utilization Review Nurse. Do you want the chance to advance your career ...
RN Utilization Review Nurse
$33 - $37/hr
Are you an experienced RN Utilization Review Nurse looking for a new opportunity with a prestigious healthcare company as a RN Utilization Review Nurse. Do you want the chance to advance your career ...
Utilization Review Nurse
Las Vegas, NV · On-site
$41.82 - $64.82/hr
Medical
Retirement
... nursing professionalism, teamwork, and superiority in patient care. Position Summary: Reviews patient admissions for appropriateness, efficiency of resource utilization and compliance with third ...
Utilization Review Nurse
Las Vegas, NV · On-site
$41.82 - $64.82/hr
Medical
Retirement
... nursing professionalism, teamwork, and superiority in patient care. Position Summary: Reviews patient admissions for appropriateness, efficiency of resource utilization and compliance with third ...
Utilization Review Nurse
New Lenox, IL · On-site +1
$34.73 - $45.15/hr
Medical
Dental
Vision
Life
Retirement
PTO
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
Medical
Dental
Vision
Life
Retirement
PTO
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
Salt Lake City, UT · On-site
Retirement
One year Utilization Review or Case Management experience. Licenses Required * Current license to practice as a Registered Nurse in the State of Utah, or obtain one within 90 days of hire under the ...
Utilization Review Nurse
Salt Lake City, UT · On-site
Retirement
One year Utilization Review or Case Management experience. Licenses Required * Current license to practice as a Registered Nurse in the State of Utah, or obtain one within 90 days of hire under the ...
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 ...
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 ...
Utilization Review Nurse
$34.73 - $45.15/hr
Medical
Dental
Vision
Life
Retirement
PTO
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
Medical
Dental
Vision
Life
Retirement
PTO
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
Murray, UT · On-site +1
Refers to UR committee any case that surpasses expected LOS, expected cost, or over/under-utilization of resources. * Performs verbal/fax clinical review with payer as determined by nursing judgment ...
Utilization Review Nurse
Murray, UT · On-site +1
Refers to UR committee any case that surpasses expected LOS, expected cost, or over/under-utilization of resources. * Performs verbal/fax clinical review with payer as determined by nursing judgment ...
Utilization Review Nurse
New Lenox, IL · On-site
$34.73 - $45.15/hr
Medical
Dental
Vision
Life
Retirement
PTO
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
$34.73 - $45.15/hr
Medical
Dental
Vision
Life
Retirement
PTO
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
Albany, NY · On-site
$77K - $119K/yr
... utilization review identifies areas for clinical documentation improvement and contacts appropriate ... Minimum Qualifications: • Registered nurse with a New York State current license. • Associate ...
New
Utilization Review Nurse
Albany, NY · On-site
$77K - $119K/yr
... utilization review identifies areas for clinical documentation improvement and contacts appropriate ... Minimum Qualifications: • Registered nurse with a New York State current license. • Associate ...
New
Utilization Review Nurse
New Lenox, IL · On-site
$34.73 - $45.15/hr
Medical
Dental
Vision
Life
Retirement
PTO
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
$34.73 - $45.15/hr
Medical
Dental
Vision
Life
Retirement
PTO
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
Albany, NY · On-site
$77K - $119K/yr
While performing utilization review identifies areas for clinical documentation improvement and ... Registered nurse with a New York State current license. Associate's degree required. Bachelor ...
New
Utilization Review Nurse
Albany, NY · On-site
$77K - $119K/yr
While performing utilization review identifies areas for clinical documentation improvement and ... Registered nurse with a New York State current license. Associate's degree required. Bachelor ...
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 ...
Cases are presented to the Utilization Review to recommend the committee to determine if a second ... Determined by the Maryland State Board of Nursing under the licensing requirements for Registered ...
Cases are presented to the Utilization Review to recommend the committee to determine if a second ... Determined by the Maryland State Board of Nursing under the licensing requirements for Registered ...
Utilization Review Nurse
Southfield, MI · On-site
$42 - $46/hr
Medical
Dental
Vision
Retirement
Job Summary Our client is seeking a Utilization Review Nurse. This role involves managing the full lifecycle of Independent Review Organization (IRO) cases, ensuring compliance with regulatory ...
Utilization Review Nurse
Southfield, MI · On-site
$42 - $46/hr
Medical
Dental
Vision
Retirement
Job Summary Our client is seeking a Utilization Review Nurse. This role involves managing the full lifecycle of Independent Review Organization (IRO) cases, ensuring compliance with regulatory ...
Utilization Review Nurse
Southfield, MI · On-site
$42 - $46/hr
Medical
Dental
Vision
Retirement
Job Summary Our client is seeking a Utilization Review Nurse to manage the full lifecycle of Independent Review Organization (IRO) cases. The primary responsibilities include reviewing clinical ...
Utilization Review Nurse
Southfield, MI · On-site
$42 - $46/hr
Medical
Dental
Vision
Retirement
Job Summary Our client is seeking a Utilization Review Nurse to manage the full lifecycle of Independent Review Organization (IRO) cases. The primary responsibilities include reviewing clinical ...
Entry Level 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 utilization review nurse jobs pay per hour?
As of Aug 17, 2026, the average hourly pay for entry level 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.
What is an entry level utilization review nurse?
An Entry Level Utilization Review Nurse is a registered nurse (RN) who is new to the field of utilization review. Their main responsibilities include assessing medical records, ensuring that patients receive appropriate and necessary care, and verifying that health services are delivered according to established guidelines and insurance requirements. They typically work for hospitals, insurance companies, or managed care organizations and collaborate with healthcare providers to support quality patient outcomes while managing costs. This role often serves as a stepping stone to more advanced positions in healthcare administration or case management.
What are the key skills and qualifications needed to thrive as an entry level utilization review nurse, and why are they important?
To thrive as an Entry Level Utilization Review Nurse, you need a registered nurse (RN) license, knowledge of clinical guidelines, and an understanding of healthcare regulations. Familiarity with utilization management software, electronic health records (EHR), and relevant certifications such as Certified Case Manager (CCM) or Accredited Case Manager (ACM) are often beneficial. Strong analytical thinking, attention to detail, and effective communication skills help you review cases accurately and collaborate with providers. These skills ensure appropriate care decisions, compliance with payer requirements, and optimal patient outcomes.
What are some common challenges faced by entry level utilization review nurses, and how can they overcome them?
Entry level Utilization Review Nurses often encounter challenges such as adapting to complex insurance policies, learning to review medical records efficiently, and communicating effectively with physicians and case managers. To overcome these challenges, new nurses should seek mentorship from experienced colleagues, participate in ongoing training sessions, and familiarize themselves with the organization's review protocols and documentation systems. Building strong communication skills and staying up to date with regulatory changes will also help in navigating the learning curve and ensuring successful case reviews.
What is the difference between Entry Level Utilization Review Nurse vs Utilization Review Nurse?
| Aspect | Entry Level Utilization Review Nurse | Utilization Review Nurse |
|---|---|---|
| Credentials | RN license, possibly some certification | RN license, often with additional certifications |
| Work Environment | Hospitals, insurance companies, healthcare facilities | Insurance companies, healthcare organizations |
| Job Responsibilities | Assist in reviewing patient cases, gather data, support senior staff | Evaluate medical necessity, review patient records, make coverage decisions |
The Entry Level Utilization Review Nurse typically supports the more experienced Utilization Review Nurse by gathering information and assisting in case reviews. Both roles require an RN license and work within healthcare or insurance settings, but the entry-level position involves more support tasks, while the Utilization Review Nurse makes critical coverage decisions.
How to get into utilization review as an entry level utilization review nurse?
To become an entry-level utilization review nurse, candidates typically need a nursing license (RN) and relevant clinical experience. Gaining knowledge of insurance policies, medical coding, and utilization review processes through training or certification programs such as the Certified Professional in Healthcare Quality (CPHQ) can improve job prospects.
More about Entry Level Utilization Review Nurse jobs
What cities are hiring for Entry Level Utilization Review Nurse jobs?
Cities with the most Entry Level Utilization Review Nurse job openings:
What are the most commonly searched types of Utilization Review Nurse jobs?
The most popular types of Utilization Review Nurse jobs are:
What states have the most Entry Level Utilization Review Nurse jobs?
States with the most job openings for Entry Level Utilization Review Nurse jobs include:
What job categories do people searching Entry Level Utilization Review Nurse jobs look for?
The top searched job categories for Entry Level Utilization Review Nurse jobs are:
- Prior Authorization Review Nurse
- Registered Nurse Review Analyst
- Rn Utilization Review Nurse
- Utilization Management Review Nurse
- Senior Rn Utilization Review Nurse
- Optum Utilization Review Nurse
- Remote Utilization Review Nurse Practitioner
- Utilization Review Nurse Lvn
- International Utilization Review Nurse
- Therapy Utilization Review
Job description
Company Description
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!
Interested in being considered?
IF IS JOB OPPORTUNITY IS FOR YOU, GIVE ME A CALL AT 321-574-6926
Job Description
Day to Day Responsibilities:
Conducts utilization management activities in accordance with Utilization Management policies and procedures. Responds to calls, conducts certification reviews, facilitates the discharge planning and referral process and coordinates denials with physician advisors for all assigned programs.
Receives prospective & concurrent requests for service. Coordinates certification reviews for pre-admission, continued stay and retroactive reviews. Interprets and applies clinical information to make delivery decisions and determine appropriate level of care for utilization review activities. (50%)
Follows departmental policies & procedures for review, determination & notification. Ensures day to day UM processes are conducted in accordance with NCQA, URAC and other regulatory standards. (15%)
Maintains effective interactions/communication w/ outside providers to assure appropriate delivery of service to members. (10%)
Reviews requests for medical necessity (referring cases to medical director that require additional expertise). Coordinate denials with physician advisors (10%)
Documents all activities per APS policies and procedures. (15%)
Work Environment / Physical Demands:
Work is performed in a professional office setting, business casual dress environment.
Working extended hours may be required as needed.
IF IS JOB OPPORTUNITY IS FOR YOU, GIVE ME A CALL AT 321-574-6926 ASAP!
Qualifications
RN License in NY with 2 years of experience
Computer literate. This includes simultaneous use of multiple programs and applications; navigating varied file formats; performing copy/paste, save, and update information in multiple formats.
Utilization Review Experience, the nurse can come from a Hospital, Home Health, or Managed Care company/ health plan
Additional Information
Hello!
My name is Krishna Gapuz and I am a Recruiting Consultant with Healthcare Support. I specialize in the placement of medical professionals nationwide (both clinical and non-clinical). We just had an amazing opportunity become available for a Utilization Review RN right in Syracuse, NY (Zip Code 13202). They are looking to start a qualified candidate as quickly as possible (pending hire requirements). This is an amazing opportunity for a Monday - Friday 8:00a.m.-6:00p.m. job with a stable, prestigious company (This Company is one of the leading providers of Healthcare in your area!)
If you would like to be considered for this opportunity please respond to this Email as soon (today) as possible! (or you're more than welcome to call me at my office 321-574-6926.
If you opt to respond to this Email, please include:
- Why did you leave your last position and how long ago (or why are you looking to leave your current position)?
- How much were you last making (hourly)?
- If offered, how soon could you start?
About Healthcare Support
Sourced by ZipRecruiter
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!Healthcare Support Staffing, Inc. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.
Industry
Recruiting and staffing services
Company size
201 - 500 Employees
Headquarters location
Maitland, FL, US
Year founded
2003