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Freelance Utilization Review Nurse Jobs (NOW HIRING)

... they relate to utilization review and discharge planning and payer regulations. MINIMUM EDUCATION AND EXPERIENCE: Required: * Graduate of an accredited professional nursing school * Current ...

... they relate to utilization review and discharge planning and payer regulations. MINIMUM EDUCATION AND EXPERIENCE: Required: * Graduate of an accredited professional nursing school * Current ...

... they relate to utilization review and discharge planning and payer regulations. MINIMUM EDUCATION AND EXPERIENCE: Required: * Graduate of an accredited professional nursing school * Current ...

Job Summary The Utilization Review (UR) Nurse has acute knowledge and skills in areas of utilization management (UM), medical necessity, and patient status determination. This individual supports the ...

The Utilization Review Nurse ensures appropriate utilization of health services by performing initial, concurrent and retrospective clinical case reviews. This role collaborates and communicates with ...

... they relate to utilization review and discharge planning and payer regulations. MINIMUM EDUCATION AND EXPERIENCE: Required: * Graduate of an accredited professional nursing school * Current ...

... they relate to utilization review and discharge planning and payer regulations. MINIMUM EDUCATION AND EXPERIENCE: Required: * Graduate of an accredited professional nursing school * Current ...

$80 - $100/hr

The Utilization Reviewer has the unique ability to follow the patient from admission to discharge and provide the physician and nursing staff with the best possible options for post hospital care for ...

Job Summary The Utilization Review (UR) Nurse has acute knowledge and skills in areas of utilization management (UM), medical necessity, and patient status determination. This individual supports the ...

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 ...

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Freelance Utilization Review Nurse information

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$42

$68

How much do freelance utilization review nurse jobs pay per hour?

As of Sep 5, 2026, the average hourly pay for freelance 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 a freelance utilization review nurse?

A Freelance Utilization Review Nurse is a registered nurse who independently reviews medical records to determine the necessity, efficiency, and appropriateness of healthcare services. They work on a contract basis for insurance companies, healthcare organizations, or third-party review agencies. Their primary role is to ensure that treatments meet established guidelines and are cost-effective. Unlike full-time utilization review nurses, freelancers have the flexibility to choose their workload and clients. This role requires strong analytical skills, clinical experience, and knowledge of insurance policies and healthcare regulations.

What skills and qualifications are needed to thrive as a freelance utilization review nurse?

To thrive as a Freelance Utilization Review Nurse, you need a valid RN license, strong clinical assessment skills, and experience in care management or utilization review. Familiarity with electronic medical records (EMRs), utilization management software, and understanding of insurance guidelines or regulations such as Medicare and Medicaid are crucial. Attention to detail, critical thinking, and effective verbal and written communication help you excel when working independently and reviewing complex medical records. These abilities ensure accurate case evaluations, regulatory compliance, and constructive collaboration with healthcare providers and insurance representatives.

What are the common work environments and daily responsibilities of a freelance utilization review nurse?

Freelance Utilization Review Nurses typically work remotely, reviewing patient medical records, evaluating treatment plans for medical necessity, and documenting findings for insurance or healthcare organizations. Daily tasks often involve communicating with physicians and case managers to gather additional information or clarify details in patient care. You may also handle a flexible caseload, prioritize urgent reviews, and ensure all documentation meets regulatory standards. This independent work structure offers flexibility but requires organization and strong self-motivation to manage priorities and deadlines. Collaboration is usually virtual, using secure platforms to connect with healthcare team members and clients.

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States with the most job openings for Freelance Utilization Review Nurse jobs include:

Infographic showing various Freelance Utilization Review Nurse job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 14% Part Time, 1% Temporary, and 3% Contract. Highlights an 88% Physical, 3% Hybrid, and 9% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

Utilization Review Nurse

Merrimack Health

Methuen, MA โ€ข On-site

Full-time

Posted 9 days ago


Job description

Position Summary
Responsible for determining the appropriateness of hospital admission, utilization of resources and medical necessity for continued stay. Responsible for working with the Clinical Care Coordinator and Complex Care Manager to facilitate timely discharge, assure medical documentation accurately reflects the patient's severity of illness; and ensures compliance with the conditions of participation as they relate to utilization review and discharge planning and payer regulations.
MINIMUM EDUCATION AND EXPERIENCE:
Required:
  • Graduate of an accredited professional nursing school
  • Current Massachusetts Nursing license
  • Bachelor's degree. - Preferred
  • 5 years case management experience in an acute care setting with discharge planning, continuing care, care management, and utilization review.
  • Five years clinical nursing experience
  • Demonstrated verbal, written skills
  • Computer skills

Preferred:
  • Master's degree.