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Overnight Rn Utilization Review Nurse Jobs (NOW HIRING)

Fusion HCR

Utilization Review Nurse

Las Vegas, NV

Overview Seeking an experienced Utilization Review Nurse (RN) to review patient admissions for medical necessity, appropriate level of care, and compliance with payer guidelines. This role works ...

Fusion HCR

Utilization Review Nurse

Las Vegas, NV

Overview Seeking an experienced Utilization Review Nurse (RN) to review patient admissions for medical necessity, appropriate level of care, and compliance with payer guidelines. This role works ...

CommonSpirit Health

Job Summary and Responsibilities As our Utilization Review Nurse at the Utilization Management Hub ... Registered Nurse with current California License required. * Minimum two (2) years of acute ...

Sedgwick

RN Utilization Review

Frankfort, KY

$73K - $75K/yr

Maintains a score of 90% or higher on monthly internal utilization review audits. * Meets productivity goals as outlined by supervisor. Education & Licensing Active unrestricted RN license in a state ...

New

Sedgwick

RN Utilization Review

Des Moines, IA

$73K - $75K/yr

Maintains a score of 90% or higher on monthly internal utilization review audits. * Meets productivity goals as outlined by supervisor. Education & Licensing Active unrestricted RN license in a state ...

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

As of Jun 8, 2026, the average hourly pay for overnight rn utilization review nurse in the United States is $42.28, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 per hour, depending on experience, location, and employer.

What are some common challenges faced by an Overnight RN Utilization Review Nurse, and how can they be managed?

Overnight RN Utilization Review Nurses often work independently, reviewing medical records and ensuring appropriate patient care while adhering to insurance guidelines. Common challenges include limited access to on-site support staff and the need to make timely decisions with fewer resources available during night shifts. To manage these challenges, strong communication skills, detailed documentation, and familiarity with hospital protocols are essential. Leveraging remote communication tools and establishing clear escalation procedures can also help ensure effective collaboration with day teams and physicians.

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

To thrive as an Overnight RN Utilization Review Nurse, you need a current RN license, strong clinical judgment, and experience in case management or utilization review. Familiarity with healthcare documentation systems, utilization management software, and knowledge of regulatory guidelines such as Medicare and Medicaid are typically required. Excellent analytical thinking, communication, and decision-making skills help you collaborate with providers and advocate effectively for patients. These skills ensure accurate assessments, regulatory compliance, and optimal resource use during overnight hours when independent decision-making is critical.

What is the difference between Overnight Rn Utilization Review Nurse vs Overnight Rn Case Manager?

AspectOvernight Rn Utilization Review NurseOvernight Rn Case Manager
CertificationsRN license, Utilization Review certification (if applicable)RN license, Case Management certification (e.g., CCM)
Work EnvironmentHospitals, insurance companies, healthcare facilities, primarily reviewing patient cases overnightHospitals, clinics, insurance companies, coordinating patient care and discharge planning overnight
Job FocusReviewing medical necessity, insurance coverage, and utilization of resourcesManaging patient care plans, discharge planning, and coordinating services

While both roles require RN licensure and involve patient care, the Overnight Rn Utilization Review Nurse primarily focuses on reviewing medical necessity and insurance coverage overnight, whereas the Overnight Rn Case Manager concentrates on coordinating patient care and discharge planning during overnight shifts. Both roles are essential in healthcare settings but serve different functions within patient management and resource utilization.

What does an Overnight RN Utilization Review Nurse do?

An Overnight RN Utilization Review Nurse is a registered nurse who evaluates the necessity, appropriateness, and efficiency of medical services, procedures, and hospital admissions during the overnight shift. They review patient records, apply clinical guidelines, and collaborate with healthcare teams to ensure that care meets established standards and payer requirements. Their goal is to promote quality care while preventing unnecessary costs or hospital stays, often working with insurance companies and case management teams.
What cities are hiring for Overnight Rn Utilization Review Nurse jobs? Cities with the most Overnight Rn Utilization Review Nurse job openings:
What are the most commonly searched types of Rn Utilization Review Nurse jobs? The most popular types of Rn Utilization Review Nurse jobs are:
What states have the most Overnight Rn Utilization Review Nurse jobs? States with the most job openings for Overnight Rn Utilization Review Nurse jobs include:
Overnight Rn Utilization Review Nurse jobs near you

Travel Nurse RN - Utilization Review

Integrated Healthcare Services

Bakersfield, CA

Contractor

Posted 28 days ago

Job description

Integrated Healthcare Services is seeking a travel nurse RN Utilization Review for a travel nursing job in Bakersfield, California.

Job Description & Requirements
  • Specialty: Utilization Review
  • Discipline: RN
  • Duration: 13 weeks
  • 40 hours per week
  • Shift: 8 hours, days
  • Employment Type: Travel

Job Title: RN - Case Management (Utilization Review)

Location: California

Employment Type: Full-Time

Contract Length: Permanent

Job Summary: The Utilization Review Nurse II is responsible for evaluating medical records, discharge planning, and ensuring compliance with payor documentation requirements to maximize hospital reimbursement.

Job Responsibilities:

  • Evaluate medical records for inpatient admissions to ensure required documentation is present.
  • Initiate Physician Advisories for unwarranted admissions.
  • Conduct ongoing reviews and discuss care changes with attending physicians.
  • Formulate and document discharge plans.
  • Coordinate with hospital services to ensure efficient resource use.
  • Identify pay source issues and provide appropriate referrals.
  • Collaborate with admitting office to prevent inappropriate admissions.
  • Schedule specialized tests and authorize payments under Medically Indigent Adult programs.
  • Review and approve surgery schedules for elective procedures.
  • Coordinate with correctional facilities regarding elective procedures and medical goods.
  • Answer provider questions about reimbursement and documentation requirements.
  • Teach providers payor documentation requirements to maximize reimbursement.
  • Assist in training Utilization Review Nurse I staff.
  • Perform other job-related duties as assigned.

Required Qualifications:

  • Two (2) years of experience as an RN in an acute care hospital, including one (1) year on a medical/surgical ward or unit.
  • One (1) year of utilization review/discharge planning experience in an acute care hospital or two (2) years as a Case Manager in a clinic or physician’s office.
  • Knowledge of payor source documentation requirements and governmental regulations.
  • Understanding of acute care nursing principles, patient disease processes, medical terminology, and hospital routines.
  • Ability to evaluate medical records, assess clinical performance, and communicate documentation needs effectively.
  • Proficiency in gathering and analyzing data for reports and recommendations.

Required Certifications & Licensure:

  • Valid Registered Nurse license in the State of California.
  • Current American Heart Association Healthcare Provider Basic Life Support (BLS) card.

Preferred Qualifications:

  • None specified.

Additional Information: This role requires strong interpersonal skills to collaborate with physicians, health providers, payor sources, and the general public.


QUALIFICATION/LICENSURE
Work Authorization : US Citizen
Preferred years of experience : 2 years
Travel required : No travel required
Shift timings : Days

RightSourcing IHS Job ID #37276836. Pay package is based on 8 hour shifts and 40 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: RN - Utilization Review

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