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Per Diem 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 ...

UNC Health Careers

Utilization Review Nurse

Kinston, NC · On-site

$32.48 - $38.98/hr

LICENSURE/REGISTRATION/CERTIFICATION Licensed to practice as a Registered Nurse in the state of ... Per Diem Salary Range: $32.48 - $38.98 per hour (Minimum to Midpoint ) Pay offers are determined by ...

Sedgwick

RN Utilization Review

Phoenix, AZ

$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

Atlanta, GA

$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

Annapolis, MD

$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

Providence, RI

$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 per diem rn utilization review nurse jobs pay per hour?

As of Jun 10, 2026, the average hourly pay for per diem 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 Per Diem RN Utilization Review Nurses, and how can they be managed?

Per Diem RN Utilization Review Nurses often face the challenge of adapting quickly to different workflows and documentation systems, since they may work across various departments or facilities. They must stay current with frequently updated insurance policies and regulatory guidelines, which can be complex. Effective time management and strong communication skills are essential, as they regularly collaborate with physicians, case managers, and insurance representatives to ensure appropriate care decisions. Building a habit of ongoing education and maintaining a flexible, detail-oriented approach can help manage these challenges and support success in this dynamic role.

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

To thrive as a Per Diem RN Utilization Review Nurse, you need a current RN license, strong clinical assessment skills, and experience with care coordination and case management. Familiarity with utilization management software, electronic health records (EHRs), and knowledge of insurance policies or CMS guidelines is typically required. Excellent critical thinking, attention to detail, and effective communication skills help in reviewing medical records and collaborating with healthcare teams. These competencies ensure appropriate care utilization, compliance with regulations, and optimal patient outcomes in a dynamic healthcare environment.

What is a Per Diem RN Utilization Review Nurse?

A Per Diem RN Utilization Review Nurse is a registered nurse who works on an as-needed basis to evaluate the necessity, appropriateness, and efficiency of the use of healthcare services, procedures, and facilities. These nurses review medical records and collaborate with healthcare providers to ensure that patients receive appropriate care according to established guidelines and insurance requirements. Their role helps ensure quality care while managing costs and preventing unnecessary services. Per diem positions offer flexible hours and may involve working in hospitals, insurance companies, or remote settings.
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Per Diem Rn Utilization Review Nurse jobs near you
Infographic showing various Per Diem Rn Utilization Review Nurse job openings in the United States as of June 2026, with employment types broken down into 79% Full Time, 6% Part Time, and 15% Contract. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

Travel Nurse RN - Utilization Review

Integrated Healthcare Services

Bakersfield, CA

Contractor

Posted 29 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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