Warner Robins, GA · On-site
$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 ...
Warner Robins, GA · On-site
$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 ...
Manhattan, NY · On-site
$60 - $61/hr
Minimum 5 years of clinical nursing experience * Experience in Care Coordination, Utilization Review, and Discharge Planning * MLTC experience required * Computer proficiency required * PRI and ...
Manhattan, NY · On-site
$60 - $61/hr
Minimum 5 years of clinical nursing experience * Experience in Care Coordination, Utilization Review, and Discharge Planning * MLTC experience required * Computer proficiency required * PRI and ...
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 ...
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 ...
Syracuse, NY · On-site
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 ...
Syracuse, NY · On-site
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 ...
... 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 ...
Albany, NY · On-site
$77 - $119/hr
## Utilization Review NurseApplylocations: 43 New Scotland Avenue Albany, NY 12208time type: Full ... Minimum Qualifications:** • Registered nurse with a New York State current license. • Associate ...
Albany, NY · On-site
$77 - $119/hr
## Utilization Review NurseApplylocations: 43 New Scotland Avenue Albany, NY 12208time type: Full ... Minimum Qualifications:** • Registered nurse with a New York State current license. • Associate ...
$43.51 - $68.56/hr
Utilization Review Nurse - Full Time Shift: 8:00am - 4:30pm with rotating weekend coverage Compensation: The estimated pay for this position is $43.5114 to $68.5608 . The rates shown include a 6% ...
$43.51 - $68.56/hr
Utilization Review Nurse - Full Time Shift: 8:00am - 4:30pm with rotating weekend coverage Compensation: The estimated pay for this position is $43.5114 to $68.5608 . The rates shown include a 6% ...
Queens, NY · On-site
$2.8K/wk
Job title: RN - Utilization Review Job location : East Elmhurst, NY 11370-1381 Shift : 8:30 AM-5:00 PM Length : 8 weeks, Possible extension Local Hourly pay: $60 - $63/hr Travel Weekly Pay upto ...
Queens, NY · On-site
$2.8K/wk
Job title: RN - Utilization Review Job location : East Elmhurst, NY 11370-1381 Shift : 8:30 AM-5:00 PM Length : 8 weeks, Possible extension Local Hourly pay: $60 - $63/hr Travel Weekly Pay upto ...
$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 ...
$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 ...
Fort Lauderdale, FL · On-site
$28.85 - $31.25/hr
Provide outpatient or pharmacy services utilization review Qualifications * Current Florida RN License * 3+ years in recent medical/surgical or critical care experience * 3+ years of Utilization ...
Fort Lauderdale, FL · On-site
$28.85 - $31.25/hr
Provide outpatient or pharmacy services utilization review Qualifications * Current Florida RN License * 3+ years in recent medical/surgical or critical care experience * 3+ years of Utilization ...
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 ...
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 ...
$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 ...
$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 ...
$77 - $119/hr
## Utilization Review NurseApplylocations: 43 New Scotland Avenue Albany, NY 12208time type: Full ... Minimum Qualifications:** • Registered nurse with a New York State current license. • Associate ...
$77 - $119/hr
## Utilization Review NurseApplylocations: 43 New Scotland Avenue Albany, NY 12208time type: Full ... Minimum Qualifications:** • Registered nurse with a New York State current license. • Associate ...
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 ...
Troy, MI · On-site
$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 ...
Troy, MI · On-site
$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 ...
Southfield, MI · On-site
$42 - $46/hr
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 ...
Southfield, MI · On-site
$42 - $46/hr
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 ...
Albany, NY · On-site
$77 - $119/hr
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 ...
Albany, NY · On-site
$77 - $119/hr
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 ...
Houston, TX · On-site
$30 - $40/hr
Job Title: RN Clinical Review Nurse (Utilization Review Nurse) The Clinical Review Clinician for Appeals is responsible for performing clinical reviews to resolve and process appeals by examining ...
Houston, TX · On-site
$30 - $40/hr
Job Title: RN Clinical Review Nurse (Utilization Review Nurse) The Clinical Review Clinician for Appeals is responsible for performing clinical reviews to resolve and process appeals by examining ...
Bakersfield, CA · On-site
$90 - $142/hr
The Utilization Review Nurse classification ranges from less experienced nurses, who will perform administrative tasks concerning Utilization Review and Discharge planning activities, to experienced ...
Bakersfield, CA · On-site
$90 - $142/hr
The Utilization Review Nurse classification ranges from less experienced nurses, who will perform administrative tasks concerning Utilization Review and Discharge planning activities, to experienced ...
Fort Worth, TX · On-site
$38.46 - $43.27/hr
Job Summary Our client is seeking a skilled Utilization Review Nurse to join their team. This role involves analyzing billing data, documenting work, and adhering to HIPAA regulations. The successful ...
Fort Worth, TX · On-site
$38.46 - $43.27/hr
Job Summary Our client is seeking a skilled Utilization Review Nurse to join their team. This role involves analyzing billing data, documenting work, and adhering to HIPAA regulations. The successful ...
$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
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.
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.
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.
Cities with the most Freelance Utilization Review Nurse job openings:
The most popular types of Utilization Review Nurse jobs are:
States with the most job openings for Freelance Utilization Review Nurse jobs include:
The top searched job categories for Freelance Utilization Review Nurse jobs are:
$80 - $100/hr
Other
Posted 11 days ago
The Utilization Reviewer performs concurrent, extended stay and retrospective reviews of admissions using established criteria to determine appropriateness of admission and extended stay. The Utilization Reviewer serves as a resource to medical and hospital staff on utilization and regulatory issues and participates in coordination of individualized patient care services. The Utilization Reviewer plays an integral role in discharge planning and maximizing the continuum of care for patients assigned to his/her assigned unit. 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 the patient.
QualificationsKnowledge, Skills & Abilities: Utilizes a variety of standard office equipment to include computer, printer, fax machine, copier, telephone etc. Basic knowledge of statistics encouraged.
Emory is an equal opportunity employer, and qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by state or federal law.
Emory Healthcare is committed to providing reasonable accommodations to qualified individuals with disabilities upon request.
Scheduled Weekly Hours: 40 FTE: 1 Expanded Work Shift: On Call:
Please note that one week's advance notice is preferred.
Sourced by ZipRecruiter
Health care and social assistance
1,001 - 5,000 Employees
Warner Robins, GA, US
1960
