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Medical Review Rn Jobs in Ohio (NOW HIRING)

GQR

RN - Case Manager

Middleburg Heights, OH

$2.10K - $2.20K/wk

Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location: Middleburg ... Benefits: * Day 1 Insurance * Cigna medical, MetLife dental and vision insurance * License ...

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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.

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.

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.

How to become a medical review nurse?

To become a medical review nurse, one must typically earn a nursing license by completing an accredited nursing program and passing the NCLEX-RN exam. Experience in clinical nursing and knowledge of medical coding, documentation, and healthcare regulations are also important, and some roles may require certification in case management or utilization review.
What are popular job titles related to Medical Review Rn jobs in Ohio? For Medical Review Rn jobs in Ohio, the most frequently searched job titles are:
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What cities in Ohio are hiring for Medical Review Rn jobs? Cities in Ohio with the most Medical Review Rn job openings:
Medical Review Rn jobs near you
Infographic showing various Medical Review Rn job openings in Ohio as of May 2026, with employment types broken down into 1% As Needed, 81% Full Time, 13% Part Time, and 5% Contract. Highlights an 100% Physical job distribution.

Utilization Review (UR) Registered Nurse RN

Genie Healthcare

Middleburg Heights, OH

$2.43K/wk

Contractor

Posted 8 days ago

Job description

We are looking for a Travel Utilization Review RN for a great Travel nursing job in Middleburg Heights, OH.

This Utilization Review Travel nursing job pays for 40 hours a week for 13 weeks. With Wanderly you can compare Travel nurse salary from leading Travel nurse agencies in the United States.

With Wanderly you can chat and apply to any agency with Wanderly’s Universal Application, below are the details of this Travel Nursing Job including the Travel nurse salary:

  • Specialty: Utilization Review RN
  • Travel Utilization Review (UR) Registered Nurse : Middleburg Heights, OH
  • Travel Nurse Salary: $2433/Week
  • Start Date: June 01, 2026
  • Travel Nursing Job Assignment Length: 13 weeks
  • Travel Nurse Hours: 40 hours per week
  • Shift: 8 hours, Mid

PK: AD-18332442

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