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Overnight Rn Utilization Review Nurse Jobs in Ohio

talent4health

RN - Utilization Review

Cleveland, OH · On-site

$2.2K/wk

Details Client Name Southwest General Hospital Center Southwest General Health Center Job Type Travel Offering Nursing Profession RN Specialty Utilization Review Job ID 18807560 Job Title RN - ...

Prime Time Healthcare

Utilization Review

Cleveland, OH · On-site

Now Hiring: RN Utilization Review - Middleburg Heights, OH Are you a passionate RN professional looking for a new adventure? Prime Time Healthcare is seeking dynamic individuals like you to join our ...

Integrated Resources

Care Review Nurse

Columbus, OH · On-site

Care Review Nurse Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing ...

Belove It Care

Overnight RN

Cleveland, OH

$26 - $33/hr

Overnight RN - Cleveland, Ohio At Belove It Care, we strive to uphold integrity in every interaction, foster continuous learning, promote personal growth, serve with dedication, and provide valuable ...

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Overnight Rn Utilization Review Nurse information

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 are the key skills and qualifications needed to thrive as an Overnight RN Utilization Review Nurse?

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 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 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 are the most commonly searched types of Rn Utilization Review Nurse jobs in Ohio?

The most popular types of Rn Utilization Review Nurse jobs in Ohio are:

What cities in Ohio are hiring for Overnight Rn Utilization Review Nurse jobs?

Cities in Ohio with the most Overnight Rn Utilization Review Nurse job openings:

Overnight Rn Utilization Review Nurse jobs near you

RN - Utilization Review

talent4health

Cleveland, OH • On-site

$2.2K/wk

Other

Posted 27 days ago

Job description

Details
Client Name
Southwest General Hospital Center Southwest General Health Center
Job Type
Travel
Offering
Nursing
Profession
RN
Specialty
Utilization Review
Job ID
18807560
Job Title
RN - Utilization Review
Weekly Pay
$2214.0
Shift Details
Shift
8 Hour Flex
Scheduled Hours
40
Job Order Details
Start Date
07/20/2026
End Date
10/19/2026
Duration
13 Week(s)
Job Description
Job Title
RN Utilization Specialist
City/State: Middleburg Heights, Ohio
Shift: 8 Hour Flex, 07:00:00-15:00:00
Contract Length: 12.71 weeks
Start Date: 07/20/2026
Job Description:
Full-Time 40 hours per week, 5 (8) hour shifts 8a-4:30p, as well as every 3rd weekend.
Requirements:
  • Graduation from an accredited School of Nursing. BSN preferred.
  • Current licensure by Ohio State Board of Nursing.
  • Minimum of five (5) years recent experience in clinical nursing or related nursing field.
  • Previous Care Management, Case Management, or Utilization Management Experience.
  • Experience with doing 30+ reviews a day.
  • Previous experience with screening criteria including Cerner, InterQual, and MCG.
  • Excellent critical thinking and communication skills.
  • Strong computer skills.
  • ACM/CCM Certification helpful.

Client Details
Address
18697 Bagley Rd, Middleburg Heights, OH 44130
City
Middleburg Heights
State
OH
Zip Code
44130

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