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Medical Review Rn Jobs in Omaha, NE (NOW HIRING)

CHI Health

Utilization Review RN

Omaha, NE · On-site

$33.51 - $48.58/hr

Job Summary and Responsibilities As our Utilization Review RN, you will play a pivotal role in optimizing healthcare delivery by ensuring medical necessity and appropriate patient status throughout ...

TNAA TotalMed RN

Travel Med Surg RN

Omaha, NE · On-site

$1.9K - $2.5K/wk

TNAA TotalMed RN is seeking a travel nurse RN Med Surg for a travel nursing job in Omaha, Nebraska. & Requirements * Specialty: Med Surg * Discipline: RN * Start Date: 09/28/2026 * Duration: 17 weeks ...

TNAA TotalMed RN

Travel Med Surg Ortho RN

Council Bluffs, IA · On-site

$1.8K - $2.5K/wk

TNAA TotalMed RN is seeking a travel nurse RN Med Surg for a travel nursing job in Council Bluffs, Iowa. & Requirements * Specialty: Med Surg * Discipline: RN * Duration: 13 weeks * 36 hours per week

TNAA TotalMed RN

Travel Med Surg Telemetry RN

Omaha, NE · On-site

$1.9K - $2.6K/wk

TNAA TotalMed RN is seeking a travel nurse RN Med Surg / Telemetry for a travel nursing job in Omaha, Nebraska. & Requirements * Specialty: Med Surg / Telemetry * Discipline: RN * Start Date: 11/16 ...

TNAA TotalMed RN

Travel Med Surg Telemetry RN

Omaha, NE · On-site

$1.9K - $2.6K/wk

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

TNAA TotalMed RN

Travel Med Surg Telemetry RN

Omaha, NE · On-site

$1.9K - $2.6K/wk

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

TNAA TotalMed RN

Travel Med Surg / Telemetry RN

Omaha, NE · On-site

$1.9K - $2.6K/wk

TNAA TotalMed RN is seeking a travel nurse RN Med Surg / Telemetry for a travel nursing job in Omaha, Nebraska. & Requirements * Specialty: Med Surg / Telemetry * Discipline: RN * Start Date: 09/21 ...

TNAA TotalMed RN

Travel Med Surg Tele RN

Fremont, NE · On-site

$1.9K - $2.6K/wk

TNAA TotalMed RN is seeking a travel nurse RN Med Surg / Telemetry for a travel nursing job in Fremont, Nebraska. & Requirements * Specialty: Med Surg / Telemetry * Discipline: RN * Duration: 13 ...

TNAA TotalMed RN

Travel Med Surg Tele RN

Fremont, NE · On-site

$1.9K - $2.6K/wk

TNAA TotalMed RN is seeking a travel nurse RN Med Surg / Telemetry for a travel nursing job in Fremont, Nebraska. & Requirements * Specialty: Med Surg / Telemetry * Discipline: RN * Start Date: 09/21 ...

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Medical Review Rn information

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How much do medical review rn jobs pay per hour?

As of Sep 7, 2026, the average hourly pay for medical review rn in Omaha, NE is $42.96, according to ZipRecruiter salary data. Most workers in this role earn between $32.88 and $51.06 per hour, depending on experience, location, and employer.

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 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 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 to become a medical review RN?

To become a medical review RN, you need to earn a nursing license by completing an accredited nursing program and passing the NCLEX-RN exam. Additionally, gaining experience in clinical settings and obtaining certifications such as Certified Professional Coder (CPC) or specialized training in medical review can enhance qualifications for this role.
Medical Review Rn jobs near you
Infographic showing various Medical Review Rn job openings in Omaha, NE as of August 2026, with employment types broken down into 4% As Needed, 79% Full Time, and 17% Part Time. Highlights an 92% In-person, and 8% Remote job distribution, with an average salary of $89,367 per year, or $43 per hour.

Utilization Review RN

CHI Health

Omaha, NE • On-site

$33.51 - $48.58/hr

Full-time

This job post has expired today. Applications are no longer accepted.

Key responsibilities

  • Perform comprehensive admission and concurrent stay reviews to validate the clinical necessity of care.

  • Collaborate with physicians, consultants, and care teams to apply evidence-based guidelines and facilitate patient care transitions.

  • Engage in proactive denial prevention, coordinate peer-to-peer reviews, and communicate critical status updates to stakeholders.

CHI Health rating

6.5

Company rating: 6.5 out of 10

Based on 130 frontline employees who took The Breakroom Quiz

614th of 898 rated healthcare providers

Job description


Job Summary and Responsibilities

As our Utilization Review RN, you will play a pivotal role in optimizing healthcare delivery by ensuring medical necessity and appropriate patient status throughout the hospitalization journey. You will serve as a clinical expert, collaborating with attending physicians, consultants, and care coordination teams to apply evidence-based guidelines—such as MCG or InterQual—to facilitate seamless patient care transitions. Your expertise in managed care environments and CMS standards will be essential in navigating payer requirements, preventing claim denials, and upholding the high-quality standards of our health system.

Every day you will perform comprehensive admission and concurrent stay reviews to validate the clinical necessity of care, ensuring every patient interaction is documented with precision. You will engage in proactive denial prevention strategies, coordinate peer-to-peer reviews between providers and insurance payers, and communicate critical status updates to stakeholders. By balancing clinical data analysis with professional communication, you will ensure our facility remains compliant with regulatory agencies and Joint Commission standards while supporting the overall progression of care for our diverse patient population.

To be successful in this role, you will hold an active Registered Nurse (RN) license in NE or IA and possess at least two years of acute hospital clinical experience. We are seeking a detail-oriented professional with a strong grasp of utilization management programs, excellent time management skills, and the ability to thrive in a fast-paced, self-directed environment. Proficiency in clinical criteria application, a collaborative mindset, and a commitment to our organizational mission and core values are required to succeed as a key member of our utilization management team.

Job Requirements

Required

  • Graduate of an accredited school of nursing and 1-3 years Minimum two (2) years of acute hospital clinical experience , upon hire or
  • Masters Other In Case Management or Nursing field in lieu of 1 year experience., upon hire and
  • Registered Nurse: NE, upon hire or
  • Registered Nurse: IA, upon hire and


Preferred

  • Bachelors Of Science BSN in Nursing or related healthcare field and 4-6 years Five years of nursing experience, upon hire
  • Certified Case Manager, upon hire and
  • Accredited Case Manager, upon hire
Where You'll Work

CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health. With more than 700 care sites across the U.S., from clinics and hospitals to home-based care and virtual care services, CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our communities need caring and our families need protection. With our combined resources, CommonSpirit is committed to building healthy communities, advocating for those who are poor and vulnerable, and innovating how and where healing can happen, both inside our hospitals and out in the community.

Qualifications:

Required

  • Graduate of an accredited school of nursing and 1-3 years Minimum two (2) years of acute hospital clinical experience , upon hire or
  • Masters Other In Case Management or Nursing field in lieu of 1 year experience., upon hire and
  • Registered Nurse: NE, upon hire or
  • Registered Nurse: IA, upon hire and


Preferred

  • Bachelors Of Science BSN in Nursing or related healthcare field and 4-6 years Five years of nursing experience, upon hire
  • Certified Case Manager, upon hire and
  • Accredited Case Manager, upon hire
Employment Type: Full Time

What CHI Health employees say

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