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Inpatient Review Nurse Jobs (NOW HIRING)

Integrated Resources

Care Review Nurse

Columbus, OH · On-site

Care Review Nurse Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing ...

Medix

Utilization Review Nurse

Orange, CA · On-site

$38 - $53/hr

The primary goal is to conduct daily inpatient reviews, concurrent reviews, discharge planning, and coordinating care for DME, Home Health, and Skilled Nursing Facility (SNF) placements.

Oscar Health

Utilization Review Nurse

Miami, FL · Remote

$35 - $45.94/hr

We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... Previous experience conducting concurrent or inpatient reviews for a managed care plan This is an ...

Oscar Health

Utilization Review Nurse

Dallas, TX · Remote

$35 - $45.94/hr

We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... Previous experience conducting concurrent or inpatient reviews for a managed care plan This is an ...

Oscar Health

Utilization Review Nurse

Tempe, AZ · Remote

$35 - $45.94/hr

We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... Previous experience conducting concurrent or inpatient reviews for a managed care plan This is an ...

Oscar Health

Utilization Review Nurse

Atlanta, GA · Remote

$35 - $45.94/hr

We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... Previous experience conducting concurrent or inpatient reviews for a managed care plan This is an ...

Leon Medical Centers

Concurrent Review Nurse

Miami, FL · On-site

Concurrent Review Nurse Under the general supervision of the Director of Health Services, the ... This is achieved through the review of inpatient admissions, outpatient precertification, and prior ...

Leon Health Plan

Concurrent Review Nurse

Doral, FL · On-site

This is achieved through the review of inpatient admissions, outpatient precertification, and prior ... Bachelor's degree in Nursing required Experience * Minimum of two (2) years of experience in ...

Leon Health, Inc.

Concurrent Review Nurse

Miami, FL · On-site

This is achieved through the review of inpatient admissions, outpatient precertification, and prior ... Bachelor's degree in Nursing required Experience * Minimum of two (2) years of experience in ...

Leon Health, Inc.

Concurrent Review Nurse

Doral, FL · On-site

This is achieved through the review of inpatient admissions, outpatient precertification, and prior ... Bachelor's degree in Nursing required Experience * Minimum of two (2) years of experience in ...

Leon Medical Centers

Concurrent Review Nurse

Doral, FL · On-site

This is achieved through the review of inpatient admissions, outpatient precertification, and prior ... Bachelor's degree in Nursing required Experience * Minimum of two (2) years of experience in ...

Integrated Resources INC

Care Review Nurse

Columbus, OH · On-site

Works with the Utilization Management team primarily responsible for inpatient medical necessity ... Review cases for in patients/in hospital: skilled care, acute rehab and long term acute care Nurses ...

AbsoluteCare

Utilization Review Nurse

New Orleans, LA · On-site

... inpatient bed days and associated discharge/transitional care plans are appropriate. The ... Review Nurse provides clinical review for different healthcare services requiring authorization ...

AbsoluteCARE

Utilization Review Nurse

New Orleans, LA · On-site

... inpatient bed days and associated discharge/transitional care plans are appropriate. The ... Review Nurse provides clinical review for different healthcare services requiring authorization ...

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Inpatient Review Nurse information

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$17

$38

$65

How much do inpatient review nurse jobs pay per hour?

As of Aug 21, 2026, the average hourly pay for inpatient review nurse in the United States is $38.62, according to ZipRecruiter salary data. Most workers in this role earn between $29.57 and $43.27 per hour, depending on experience, location, and employer.

What is an inpatient review nurse?

Inpatient Review Nurses are registered nurses who assess and review the medical necessity, appropriateness, and quality of care provided to patients admitted to hospitals or other inpatient settings. They evaluate patient records, treatment plans, and coverage policies to ensure compliance with healthcare regulations and payer requirements. Their primary goal is to promote efficient, cost-effective, and high-quality care while also preventing unnecessary hospital stays or procedures.

What are the key skills and qualifications needed to thrive as an inpatient review nurse?

To thrive as an Inpatient Review Nurse, you need a current RN license, strong clinical assessment skills, and experience in utilization review or case management. Familiarity with utilization management software, electronic health records (EHR), and knowledge of regulatory guidelines like Medicare and Medicaid are typically required. Exceptional communication, critical thinking, and attention to detail are valuable soft skills in this role. These skills ensure accurate patient care evaluations, regulatory compliance, and effective collaboration with healthcare teams for optimal outcomes.

How does an inpatient review nurse typically collaborate with physicians and case managers during patient care reviews?

Inpatient Review Nurses work closely with physicians and case managers to ensure that patient care plans meet established medical guidelines and insurance requirements. They frequently participate in interdisciplinary team meetings, provide clinical insights on patient progress, and help coordinate discharge planning. Effective communication and documentation are essential as they often clarify medical necessity and advocate for appropriate patient care. This collaborative environment supports both optimal patient outcomes and compliance with healthcare policies.

What is the difference between Inpatient Review Nurse vs Outpatient Review Nurse?

AspectInpatient Review NurseOutpatient Review Nurse
CertificationsRN license, case management certification often preferredRN license, case management certification often preferred
Work EnvironmentHospitals, inpatient facilitiesClinics, outpatient centers
Job FocusReviewing inpatient hospital stays, ensuring appropriate care and length of stayReviewing outpatient services, follow-up care, and outpatient procedures
Employer & IndustryHospitals, health systemsOutpatient clinics, specialty centers

The main difference between an Inpatient Review Nurse and an Outpatient Review Nurse lies in their work settings and focus. Inpatient Review Nurses primarily evaluate hospital stays and inpatient care, while Outpatient Review Nurses focus on outpatient services and follow-up care. Both roles require RN licensure and often involve case management certifications, but their daily responsibilities and environments differ significantly.

How to become an inpatient review nurse?

To become an inpatient review nurse, you typically need to hold a registered nurse (RN) license, which requires completing an accredited nursing program and passing the NCLEX-RN exam. Relevant experience in medical-surgical or acute care settings, along with knowledge of insurance and healthcare policies, is often preferred. Additional certifications such as case management or utilization review may enhance job prospects.
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Inpatient Review Nurse jobs near you
Infographic showing various Inpatient Review Nurse job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 13% Part Time, 3% Contract, and 1% Nights. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $80,321 per year, or $38.6 per hour.

Care Review Nurse

Integrated Resources

Columbus, OH • On-site

Other

Re-posted 7 days ago

Job description

Care Review Nurse

Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Healthcare members with the right care at the right place at the right time. Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review. Assesses services for Members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines.

Medicaid Division

Duties: Review cases for in patients/in hospital: skilled care, acute rehab and long term acute care Nurses working at the facilities Members are being care for, will be sending over clinical information to be reviewed by the Care Review Clinician. Therefore, this agent will not be traveling and will be reviewing information at the office.

Qualifications: Background Hospital Utilization Management. Insurance Utilization Manager/Review and Millemen Experience (MCG). No case managers if that is their only experience. Must have Utilization Review or Management. Utilization Review (1 year +), Past hospital experience (3-4 years of experience, less experience is ok if they have more Utilization Review experience) Potential for longer term dependent on enrollment Workers will be doing Concurrent Inpatient Review MUST have one of the following AT LEAST -Utilization Review in hospital setting Nurses who are used to doing both production and review work

All your information will be kept confidential according to EEO guidelines.

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About Integrated Resources

Sourced by ZipRecruiter

Integrated Resources Inc (IRI), based in Edison, NJ, US, is an esteemed player in the staffing solutions industry with a credible presence on their official website irionline.com. Notably, IRI provides a range of professional staffing services including contract, contract-to-hire, and direct hire solutions to a wide spectrum of industries such as healthcare, life sciences, manufacturing, financial, insurance, and others. Since its inception, IRI has been committed to delivering top-talent and optimum solutions to meet its clients' diverse needs.

Industry

Recruiting and staffing services

Company size

51 - 200 Employees

Headquarters location

Edison, NJ, US

Year founded

1996

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