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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 ...

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 ...

Sedgwick

RN Utilization Review

Juneau, AK

$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

Pierre, SD · On-site

$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

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Overnight Rn Utilization Review Nurse information

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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.
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Overnight Rn Utilization Review Nurse jobs near you
RN Utilization Review Nurse

RN Utilization Review Nurse

Healthcare Support Staffing

Troy, MI

$33 - $37/hr

Full-time

Posted 28 days ago

Job description

Company Description

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!

Job Description

Are you an experienced RN Utilization Review Nurse looking for a new opportunity with a prestigious healthcare company as a RN Utilization Review Nurse. Do you want the chance to advance your career by joining a rapidly growing company? If you answered "yes" to any of these questions - this is the RN Utilization Review Nurse position for you!


Company Job Description/Day to Day Duties:

  • Providing utilization review for the Medicaid and Medicare line of business. Primarily inpatient, skilled nurses facilities, rehab, behavioral health, and home healthcare.
  • Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing members with the right care at the right place at the right time. Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review. Assesses services for Members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines
  • Provider appeals and Utilization reviews and assist with Denial Letters
  • Provides concurrent review and prior authorizations (as needed) according to policy for members as part of the Utilization Management team.
  • Identifies appropriate benefits, eligibility, and expected length of stay for members requesting treatments and/or procedures.
  • Participates in interdepartmental integration and collaboration to enhance the continuity of care for members including Behavioral Health and Long Term Care.


Hours for this Position:

  • Mon-Fri: 8:30am - 5pm


Advantages of this Opportunity:

  • Great salary between $33 - 37!
  • Great benefits!!!
  • Fun and positive work environment!
Qualifications

Minimum Education/Qualifications/Licensures:

  • Must be an RN
  • Utilization Review background in either Managed Care of Provider environment (at least one year)
  • Interqual experience (at least one year)
  • Also has a background in patient, skilled nurses facilities, rehab, and home healthcare.
  • Other basic computer skills necessary: Microsoft Office, Data Entry, etc.
  • Minimum 2-4 years of clinical practice. Preferably hospital nursing, utilization management, and/or case management.
  • Great typing and data entry skills
Additional Information

Interested in being considered?

If you are interested in being considered for this position, please click the apply button below.  Or call John Wood 407-478-0332 ext 225

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About Healthcare Support

Sourced by ZipRecruiter

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!Healthcare Support Staffing, Inc. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.

Industry

Recruiting and staffing services

Company size

201 - 500 Employees

Headquarters location

Maitland, FL, US

Year founded

2003

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