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Full Time Rn Utilization Review Nurse Jobs (NOW HIRING)

Houston Methodist

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

AbsoluteCare

Utilization Review Nurse

New Orleans, LA · On-site

The Utilization Review Nurse ensures appropriate utilization of health services by performing ... Active Registered Nurse license by the State of Louisiana and/or the state(s) in which the nurse is ...

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 ...

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How much do full time rn utilization review nurse jobs pay per hour?

As of Jul 15, 2026, the average hourly pay for full time 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.

How to get into utilization review as a nurse?

To become a utilization review nurse, you typically need to be a registered nurse (RN) with clinical experience and obtain knowledge of insurance processes and healthcare regulations. Many employers prefer candidates with certifications such as the Certified Professional in Healthcare Quality (CPHQ) or Certified Case Manager (CCM). Gaining experience in case management, medical records review, or insurance settings can also improve your chances of entering utilization review roles.

What is the difference between Full Time Rn Utilization Review Nurse vs Full Time Rn Case Manager?

AspectFull Time Rn Utilization Review NurseFull Time Rn Case Manager
CredentialsRegistered Nurse (RN), often with certification in utilization reviewRegistered Nurse (RN), often with case management certification
Work EnvironmentHospitals, insurance companies, or healthcare organizations focusing on review and approval of careHospitals, clinics, or insurance companies coordinating patient care and discharge planning
Primary ResponsibilitiesReview medical records to determine necessity and appropriateness of servicesCoordinate patient care, develop care plans, and facilitate communication among providers

While both roles require RN credentials and involve patient care, the Full Time Rn Utilization Review Nurse primarily focuses on evaluating the necessity of treatments, whereas the Full Time Rn Case Manager manages overall patient care plans and coordination. Both roles are vital in healthcare settings but serve different functions within patient management and care optimization.

How to make $150,000 as a nurse?

Full Time Rn Utilization Review Nurses can reach a $150,000 salary by gaining extensive experience, obtaining advanced certifications such as CCM or ANCC, and working in high-paying settings like insurance companies or specialty healthcare organizations. Developing strong clinical and administrative skills, working overtime, or taking on leadership roles can also increase earning potential.

How to make $300,000 as a nurse?

Full Time Rn Utilization Review Nurses can increase their earnings by gaining specialized certifications, such as case management or health information management, and working in high-demand settings like insurance companies or managed care organizations. Advancing to senior or managerial roles, working overtime, or taking on consulting opportunities can also boost income to reach or exceed $300,000 annually.

How to make an extra $2000 a month as a nurse?

Full Time Rn Utilization Review Nurses can increase income by taking on overtime shifts, working part-time or per diem roles, or pursuing certifications in specialized areas like case management or insurance review. Developing skills in documentation and telehealth can also open opportunities for remote consulting or freelance work to supplement income.
What cities are hiring for Full Time Rn Utilization Review Nurse jobs? Cities with the most Full Time Rn Utilization Review Nurse job openings:
What are the most commonly searched types of Rn Utilization Review Nurse jobs? The most popular types of Rn Utilization Review Nurse jobs are:
What states have the most Full Time Rn Utilization Review Nurse jobs? States with the most job openings for Full Time Rn Utilization Review Nurse jobs include:
Full Time Rn Utilization Review Nurse jobs near you
Utilization Review Nurse (RN)

Utilization Review Nurse (RN)

Madera Community Hospital

Madera, CA • On-site

Full-time

Posted 27 days ago

Job description

Salary: $55.34-$66.41/hourly

Madera Community Hospital

Located in the heart of Central California, Madera Community Hospital is a General Acute Care, private, not-for-profit hospital dedicated to improving and maintaining the health and wellness of residents throughout the Central Valley. We are committed to identifying and serving our community's needs with compassion, concern, care and safety for every patient. Madera Community Hospital is a growing acute care facility seeking talented individuals with a drive to provide quality care and dedicated to making a difference in our community.

Position Summary: The Utilization Review Nurse assesses, plans, implements and evaluates the needs of patients for discharge planning and utilization review. This includes those who may have Medicare, Medicaid, HMO or private insurance to cover their stay at various units. Discharge planning is coordinated with physicians, Nursing, patient and family who have an ongoing caring relationship with the patient. Utilization review procedures include those stated for discharge planning in addition to knowledge of criteria for Medicare, Medicaid coverage and that of HMO or private insurers.

Qualifications:

  • Minimum of 13 years of related acute care nursing experience and completion of an accredited nursing program required.
  • Experience with Meditech Electronic Health Record (EHR) system preferred.
  • Must have working knowledge of criteria for Medicare, Medicaid, HMO and private insurance coverage.
  • Ability to maintain collaborative working relationships to ensure a positive and productive work environment.
  • Ability to plan and prioritize work with frequent interruptions.
  • Ability to provide exceptional customer service.
  • Effective verbal and written communication skills.
  • Knowledge and proficiency of hospital information technology applications.
  • Requires Current California Board of Nursing Registered Nurse License.
  • Current American Heart Association BCLS certificate required; ACLS certificate preferred.
  • CCM in Case Management preferred.

Madera Community Hospital provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.