ZipRecruiter

Log In

1

Internship Rn Utilization Review Nurse Jobs in Madison, WI

WPS

Appeals Registered Nurse

Madison, WI · On-site +1

$30.50 - $40.25/hr

The Appeals RN works in collaboration with the Appeals Examiners/Reps to ensure redeterminations ... Basic knowledge and understanding of medical/clinical review processes (i.e., Appeals/Utilization ...

TNAA TotalMed RN

Travel Endoscopy RN

Madison, WI · On-site

TNAA TotalMed RN is seeking a travel nurse RN Endoscopy for a travel nursing job in Madison, Wisconsin. & Requirements * Specialty: Endoscopy * Discipline: RN * Start Date: 08/31/2026 * Duration: 13 ...

TNAA TotalMed RN

Travel Endoscopy RN

Madison, WI · On-site

TNAA TotalMed RN is seeking a travel nurse RN Endoscopy for a travel nursing job in Madison, Wisconsin. & Requirements * Specialty: Endoscopy * Discipline: RN * Start Date: ASAP * Duration: 13 weeks ...

TNAA TotalMed RN

Travel MS/Tele RN

Madison, WI · On-site

$2.0K - $2.7K/wk

TNAA TotalMed RN is seeking a travel nurse RN Med Surg / Telemetry for a travel nursing job in Madison, Wisconsin. & Requirements * Specialty: Med Surg / Telemetry * Discipline: RN * Start Date: 09 ...

TNAA TotalMed RN

Travel IMC RN

Madison, WI · On-site

TNAA TotalMed RN is seeking a travel nurse RN Intermediate Care for a travel nursing job in Madison, Wisconsin. & Requirements * Specialty: Intermediate Care * Discipline: RN * Duration: 13 weeks ...

TNAA TotalMed RN

Travel IMC RN

Madison, WI · On-site

TNAA TotalMed RN is seeking a travel nurse RN Intermediate Care for a travel nursing job in Madison, Wisconsin. & Requirements * Specialty: Intermediate Care * Discipline: RN * Start Date: 09/28/2026

TNAA TotalMed RN

Travel MS/Tele RN

Madison, WI · On-site

$2.0K - $2.7K/wk

TNAA TotalMed RN is seeking a travel nurse RN Med Surg / Telemetry for a travel nursing job in Madison, Wisconsin. & Requirements * Specialty: Med Surg / Telemetry * Discipline: RN * Start Date: 08 ...

TNAA TotalMed RN

Travel IMC RN

Madison, WI · On-site

TNAA TotalMed RN is seeking a travel nurse RN Intermediate Care for a travel nursing job in Madison, Wisconsin. & Requirements * Specialty: Intermediate Care * Discipline: RN * Duration: 13 weeks ...

TNAA TotalMed RN

Travel IMC RN

Madison, WI · On-site

TNAA TotalMed RN is seeking a travel nurse RN Intermediate Care for a travel nursing job in Madison, Wisconsin. & Requirements * Specialty: Intermediate Care * Discipline: RN * Start Date: 09/14/2026

TNAA TotalMed RN

Travel IMC RN

Madison, WI · On-site

TNAA TotalMed RN is seeking a travel nurse RN Intermediate Care for a travel nursing job in Madison, Wisconsin. & Requirements * Specialty: Intermediate Care * Discipline: RN * Duration: 13 weeks ...

TNAA TotalMed RN

Travel OR RN

Madison, WI · On-site

TNAA TotalMed RN is seeking a travel nurse RN OR - Operating Room for a travel nursing job in Madison, Wisconsin. & Requirements * Specialty: OR - Operating Room * Discipline: RN * Duration: 17 weeks ...

next page

Showing results 1-20

All JobsRn Utilization Review Nurse JobsInternship Rn Utilization Review Nurse JobsInternship Rn Utilization Review Nurse Jobs in Madison, WI

Internship Rn Utilization Review Nurse information

See Madison, WI salary details

$21

$42

$69

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

As of Aug 18, 2026, the average hourly pay for internship rn utilization review nurse in Madison, WI is $42.60, according to ZipRecruiter salary data. Most workers in this role earn between $33.65 and $48.94 per hour, depending on experience, location, and employer.

What is an Internship RN Utilization Review Nurse?

An Internship RN Utilization Review Nurse is a registered nurse who is in a training or internship phase to learn how to evaluate the necessity, appropriateness, and efficiency of healthcare services provided to patients. This role involves reviewing patient records, coordinating with healthcare providers, and ensuring that treatments meet established guidelines and insurance requirements. The internship provides hands-on experience in the field of utilization review, helping nurses transition from direct patient care to a more administrative or case management-focused role. It is an entry-level opportunity for RNs interested in healthcare quality and cost management.

What types of tasks and learning experiences can I expect as an Internship RN Utilization Review Nurse?

As an Internship RN Utilization Review Nurse, you will typically assist experienced utilization review nurses in evaluating patient records, verifying the necessity of medical procedures, and ensuring compliance with insurance or regulatory guidelines. You'll gain exposure to interdisciplinary communication by collaborating with physicians, case managers, and insurance representatives. This role provides valuable insight into how clinical decisions impact both patient outcomes and healthcare costs, helping you develop analytical and communication skills essential for future advancement. Expect to participate in chart reviews, learn about medical necessity criteria, and attend case discussions as part of your hands-on learning.

What are the key skills and qualifications needed to thrive as an Internship RN Utilization Review Nurse, and why are they important?

To thrive as an Internship RN Utilization Review Nurse, you need a solid foundation in nursing principles, clinical assessment, and case management, typically supported by an RN license and current enrollment in a nursing program. Familiarity with medical coding systems (like ICD-10 or CPT), electronic health records (EHRs), and utilization review software is often required. Strong analytical thinking, communication skills, and attention to detail set candidates apart in this role. These competencies are crucial for ensuring appropriate patient care, regulatory compliance, and effective resource utilization within healthcare organizations.

What is the difference between Internship Rn Utilization Review Nurse vs Utilization Review Nurse?

AspectInternship Rn Utilization Review NurseUtilization Review Nurse
CredentialsRN license, internship or training programRN license, certification in utilization review often preferred
Work EnvironmentTraining setting, supervised, learning-focusedClinical or office setting, independent review tasks
Job ResponsibilitiesAssisting in review processes, gaining experiencePerforming utilization reviews, making coverage decisions

Internship Rn Utilization Review Nurse is a training role for nursing students or new graduates gaining experience, while Utilization Review Nurse is a full-time professional responsible for evaluating medical necessity and coverage. The internship role focuses on learning, whereas the utilization review nurse performs independent assessments in healthcare settings.

What are the most commonly searched types of Rn Utilization Review Nurse jobs in Madison, WI?

The most popular types of Rn Utilization Review Nurse jobs in Madison, WI are:

What are popular job titles related to Internship Rn Utilization Review Nurse jobs in Madison, WI?

For Internship Rn Utilization Review Nurse jobs in Madison, WI, the most frequently searched job titles are:

What job categories do people searching Internship Rn Utilization Review Nurse jobs in Madison, WI look for?

The top searched job categories for Internship Rn Utilization Review Nurse jobs in Madison, WI are:

Internship Rn Utilization Review Nurse jobs near you

Appeals Registered Nurse

WPS

Madison, WI • On-site, Remote

$30.50 - $40.25/hr

Full-time

Medical, Dental, Retirement, PTO

Posted 8 days ago

Job description

Role SnapshotThe Appeals Nurse examines medical records and claims information for first-level appeal cases to determine whether services provided were medically necessary and meet Medicare coverage guidelines in accordance with Medicare regulations and policies. The Appeals RN works in collaboration with the Appeals Examiners/Reps to ensure redeterminations are medically reviewed as needed and completed timely.
Salary Range
66-68k
The base pay offered for this position may vary within the posted range based on your job-related knowledge, skills, and experience.
Work LocationWe are open to remote work in the following approved states:
Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, New Jersey, North Carolina, Ohio, South Carolina, Texas, Virginia, Wisconsin
How do I know this opportunity is right for me? If you are interested in the following activities:
  • Review and assess first-level appeal cases for denied services, ensuring all relevant medical documentation, coding, and clinical information are provided to support the appeal.
  • Conduct comprehensive medical record reviews to determine the clinical necessity of services and make recommendations for resolution based on clinical guidelines, policy, and the medical necessity of care.
  • Prepare and submit written appeal letters, including comprehensive rationales and supporting clinical evidence.
  • Ensure timely follow-up on all appeals and ensure proper resolution is reached in accordance with company policies and external regulations.
  • Maintain awareness of healthcare laws, regulations, and policies relevant to the appeals process, ensuring all actions comply with regulatory and contractual requirements.
  • Work with and provide directions to Redetermination Representatives to ensure all redeterminations, which require a clinical decision, are responded to within CMS quality and timelines standards.

Minimum Qualifications
  • Associate's (ASN) or Bachelor's Degree in Nursing (BSN).
  • Active RN license, applicable to state of practice in good standing.
  • One (1) or more years of clinical experience in a healthcare setting (hospital/bedside, case management, MDS/Skilled Nursing, etc.).
  • Excellent written and verbal communication skills, with the ability to communicate complex medical information clearly and concisely.
  • Strong attention to detail and organizational skills to manage multiple cases simultaneously.
  • Basic knowledge and understanding of medical/clinical review processes (i.e., Appeals/Utilization Review).
  • Solid computer skills with experience working in multiple on-line systems including MS Outlook, Teams, OneNote, Word, and Excel.

Preferred Qualifications
  • Experience working for a Medicare Administrative Contractor (MAC) preferred.
  • One (1) or more years of experience working in Medical Management (e.g., MDS role), Medical Review, Utilization Management/Review, or Appeals preferred.
  • Basic Medicare knowledge and/or experience preferred.

Remote Work Requirements
  • Wired (ethernet cable) internet connection from your router to your computer.
  • High speed cable or fiber
  • Minimum of 10 Mbps downstream and at least 1 Mbps upstream internet connection (can be checked at https://speedtest.net).
  • Please review Remote Worker FAQs for additional information.

Benefits
  • Remote and hybrid work options available
  • Performance bonus and/or merit increase opportunities
  • 401(k) with a 100% match for the first 3% of your salary and a 50% match for the next 2% of your salary (100% vested immediately)
  • Competitive paid time off
  • Health insurance, dental insurance, and telehealth services start DAY 1
  • Professional and Leadership Development Programs
  • Review additional benefits: (https://www.wpshealthsolutions.com/careers/)

Who We Are
WPS, a health solutions company, is a leading not-for-profit health insurer and federal government contractor headquartered in Madison, Wisconsin. WPS offers health insurance plans for individuals, families, seniors and group health plans for small to large businesses. We process claims and provide customer support for beneficiaries of the Medicare program and manage benefits for millions of active-duty and retired military personnel across the U.S. and abroad. WPS has been making healthcare easier for the people we serve for nearly 80 years. Proud to be military and veteran ready.
Culture Drives Our Success
WPS' culture is where the great work and innovations of our people are seen, fueled and rewarded. We accomplish this by creating an open and empowering employee experience. We recognize the benefits of employee engagement as an investment in our workforce-both current and future-to effectively seek, leverage, and include differing and unique perspectives that fuel agility and innovation on high-performing teams. This results in people bringing their authentic selves to work every day in an organization that successfully adapts to business changes and new opportunities.
We are proud of the recognition we have received from local and national organization regarding our culture and workplace: WPS Newsroom - Awards and Recognition.
Sign up for Job Alerts
FOLLOW US!
Instagram
LinkedIn
Facebook
WPS Health Blog
Medicare (GHA)
This position supports services under Centers for Medicare & Medicaid Services (CMS) contract(s). As such, the role is subject to all applicable federal regulations, CMS contract requirements, and WPS internal policies, including but not limited to standards for data security, privacy, confidentiality, and program integrity. CMS contractors and their personnel are subject to screening and background investigation including fingerprinting prior to being granted access to information systems and/or sensitive data to safeguard government resources that provide critical services
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights notice from the Department of Labor.

Apply