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Medical Review Rn Jobs in California (NOW HIRING)

HCS 247

Travel Utilization Review RN

Apple Valley, CA · On-site

Utilization Review * Discipline: RN * Start Date: ASAP * Duration: 13 weeks * 40 hours per week ... Medical Dental and Vision Benefits available (For you and family) * Day 1 Medical and Voluntary ...

HCS 247

Travel Utilization Review RN

Apple Valley, CA · On-site

Utilization Review * Discipline: RN * Start Date: 07/27/2026 * Duration: 13 weeks * 40 hours per ... Medical Dental and Vision Benefits available (For you and family) * Day 1 Medical and Voluntary ...

Solomon Page

Travel Utilization Review RN

Hayward, CA · On-site

Utilization Review * Discipline: RN * Start Date: 07/20/2026 * Duration: 13 weeks * 40 hours per ... Offering a comprehensive benefits package, travel nurses have immediate access to medical coverage ...

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Medical Review Rn information

What is a Medical Review RN?

A Medical Review RN is a registered nurse who specializes in reviewing medical records and claims to ensure they meet established guidelines and standards. These nurses often work for insurance companies, government agencies, or healthcare organizations, evaluating the necessity, appropriateness, and efficiency of healthcare services provided to patients. Their role may include determining medical necessity, performing utilization reviews, and supporting appeals or audits. They use their clinical knowledge to interpret complex medical information and collaborate with healthcare providers to support accurate decision-making.

Can I make $500,000 as a nurse?

Medical Review RNs typically do not earn $500,000 annually, as most nursing salaries are below that level. High earnings in nursing usually require advanced roles, specialized certifications, management positions, or work in high-paying industries or locations. Achieving such a salary may involve additional education, experience, and responsibilities beyond standard nursing roles.

What does a medical review RN do?

A Medical Review RN evaluates insurance claims, medical records, and provider documentation to determine coverage and compliance with policies. They ensure accurate assessment of medical necessity, often working with healthcare providers and insurance companies, and may require knowledge of medical coding and documentation standards.

How to make $300,000 as a nurse?

Medical Review RNs can increase their earnings by gaining specialized certifications, such as in case management or legal nurse consulting, and working in high-demand settings like telehealth or insurance companies. Advancing to senior or managerial roles, working overtime, or taking on consulting projects can also boost income toward $300,000 annually.

How does a Medical Review RN collaborate with other healthcare professionals during the review process?

A Medical Review RN often works closely with physicians, case managers, and insurance representatives to ensure that medical claims and treatment plans meet regulatory and clinical guidelines. Collaboration may involve participating in interdisciplinary meetings, discussing complex cases, and providing clinical expertise to support utilization management decisions. Effective communication and teamwork are essential, as you'll need to relay findings, request additional information, and sometimes clarify medical necessity with providers. This collaborative environment helps ensure quality care for patients while maintaining compliance with payer policies.

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

Medical Review RNs can increase their income by taking on additional freelance or per diem review assignments, working overtime, or obtaining specialized certifications to qualify for higher-paying roles. Developing expertise in specific medical areas or coding can also lead to higher-paying opportunities outside regular hours.

What are the key skills and qualifications needed to thrive as a Medical Review RN, and why are they important?

To thrive as a Medical Review RN, you need a strong clinical background, critical thinking skills, and an active RN license, often supported by experience in case management or utilization review. Familiarity with medical coding, claims management software, and knowledge of regulatory guidelines such as Medicare and Medicaid are typically required. Strong attention to detail, excellent written communication, and the ability to work independently are essential soft skills for this role. These competencies ensure accurate and compliant medical record reviews, which are critical for proper claims adjudication and regulatory adherence.
What cities in California are hiring for Medical Review Rn jobs? Cities in California with the most Medical Review Rn job openings:
Medical Review Rn jobs near you
Infographic showing various Medical Review Rn job openings in California as of June 2026, with employment types broken down into 2% As Needed, 77% Full Time, 13% Part Time, and 8% Contract. Highlights an 94% In-person, 2% Hybrid, and 4% Remote job distribution.
CA - Utilization Review RN - $68.85/hr.

CA - Utilization Review RN - $68.85/hr.

Lamb Company

Arcata, CA • On-site

$68.85/hr

Contractor

Posted 18 days ago

Be an early applicant

Job description

Job Summary (List Format) – CA RN Utilization Review Nurse:
- Position: Utilization Review Nurse (Registered Nurse)
- Location: California (within 30-mile radius of hospital; cities include Arcata, Eureka, McKinleyville, Blue Lake, Samoa, Fortuna)
- Schedule: Five 8-hour shifts per week (8:00am – 4:30pm)
- Hours: 40 hours/week guaranteed
- Required Experience: Utilization Management
- Licensure/Certifications:
- Active California RN License
- BLS Certification (Basic Life Support)
- ACLS Certification (Advanced Cardiovascular Life Support)
- Health Requirement: Proof of negative TB screen within past 12 months
- Housing Recommendations: Search FurnishedFinder.com, travelnursehousing.com, Humboldt Craigslist (temporary-sublet section)
- Specialty: Nursing – Utilization Review RN
- Sub-Specialty: Utilization Review
- General Certifications: Not specified beyond BLS/ACLS
- Other: Details accessible via provided link (not included here)

You'll never receive recurrent notifications, aggressive phone calls, or overbearing messages from us. Just support!

Info@lambstaffing.com

www.lambstaffing.com

A US based healthcare staffing firm, Lamb Company has been serving healthcare workers so that healthcare workers may serve their patients since 2019. Our team consists of individuals with likeminded goals to have a heart for providing quality care for patients that without our help, may not receive any. Our job is to find a site that matches well with you and develop a plan to safely and effectively get you implemented into that system. As a small company with owners that are healthcare workers themselves, we understand the difficulty of starting new and finding a home where you are appreciated. We are always available and aim to find you the employment of your dreams. Please reach out with any questions which you may have!