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How much do prn utilization review jobs pay per hour?

As of Jul 24, 2026, the average hourly pay for prn utilization review 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.

How to make an extra $2000 a month as a nurse?

A PRN Utilization Review nurse can increase income by taking on additional shifts, working overtime, or joining per diem pools. Gaining specialized certifications or experience in high-demand areas can also lead to higher pay rates and opportunities for extra earnings.

How to become a utilization reviewer?

To become a utilization reviewer, typically one needs a healthcare-related degree such as nursing, health administration, or a related field, along with experience in clinical or insurance settings. Certification in case management or utilization review, such as the Certified Professional in Healthcare Quality (CPHQ), can enhance job prospects. Strong analytical skills, knowledge of medical policies, and familiarity with electronic health records are also important.

What are the key skills and qualifications needed to thrive in the Prn Utilization Review position, and why are they important?

To excel as a PRN Utilization Review professional, you need a background in nursing or a related healthcare field, along with knowledge of medical necessity criteria and insurance guidelines. Familiarity with electronic medical record (EMR) systems and utilization management software, as well as certification such as CCM or URAC, is often required. Strong analytical abilities, attention to detail, and effective communication are valuable soft skills in this role. These skills are crucial for accurately assessing patient care needs, ensuring compliance, and collaborating efficiently with healthcare teams and payers.

How to make 300,000 dollars as a nurse online?

A PRN Utilization Review nurse can increase earnings by gaining specialized certifications, such as in case management or healthcare analytics, and working for multiple agencies or telehealth companies. Building a strong reputation and negotiating higher pay rates for remote or flexible shifts can also help reach higher income levels, though earning 300,000 annually may require additional roles or advanced experience.

What are the typical daily responsibilities for someone in a PRN Utilization Review role?

A PRN Utilization Review professional typically reviews patient medical records, assesses the appropriateness of hospital admissions and ongoing care, and ensures adherence to established criteria and payer requirements. They often communicate with physicians, nurses, case managers, and insurance representatives to gather information and provide recommendations. The role may involve balancing multiple cases, preparing case summaries, and documenting findings in electronic systems. While the schedule offers flexibility, time management and attention to deadlines are important, especially when working with fast-paced healthcare environments.

Is utilization review a stressful job?

Utilization review is a role that involves evaluating healthcare services for appropriateness and coverage, which can be demanding due to strict deadlines and the need for accuracy. The job may involve high-pressure situations, especially when making critical decisions that impact patient care and insurance claims, but workload and stress levels vary depending on the employer and individual experience. Strong organizational skills and knowledge of healthcare policies can help manage stress in this role.
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Prn Utilization Review jobs near you
Infographic showing various Prn Utilization Review job openings in the United States as of July 2026, with employment types broken down into 21% As Needed, 26% Full Time, 41% Part Time, 1% Temporary, 8% Contract, and 3% Nights. Highlights an 99% Physical, and 1% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.
UTILIZATION REVIEW NURSE-ED (TR/PRN) NIGHTS

UTILIZATION REVIEW NURSE-ED (TR/PRN) NIGHTS

Riverside Healthcare

Kankakee, IL • On-site

$41.31/hr

Temporary

Posted 16 days ago

Job description

Overview
Riverside Healthcare is seeking a dedicated and experienced Utilization Review Nurse to join our Emergency Department team in Kankakee, Illinois. The Utilization Review Nurse will play a crucial role in ensuring that patients receive appropriate and effective care while optimizing resource utilization. This position involves reviewing patient cases, assessing the necessity of admissions and continued stays, and collaborating with healthcare providers to enhance patient outcomes and hospital efficiency by managing documentation and optimizing resource utilization.
Essential Duties
Case Review and Assessment:
  • Conduct thorough reviews of patient cases in the Emergency Department to assess the necessity and appropriateness of admissions, continued stays, and level of care.
  • Utilize clinical knowledge and evidence-based guidelines to make determinations regarding the medical necessity of services.

Collaboration and Communication:
  • Work closely with physicians, nurses, and other healthcare professionals to gather necessary information and discuss care plans.
  • Communicate with insurance providers to obtain authorization for treatments and services, ensuring compliance with payer requirements.
  • Proactively facilitates throughput of all patients by monitoring for census peaks including surgical and procedural patient placement.

Documentation and Reporting:
  • Maintain accurate and detailed documentation of case reviews, decisions, and communications with healthcare providers and insurance companies.
  • Prepare and submit reports as required, including utilization review reports and compliance documentation.

Quality Improvement:
  • Participate in quality improvement initiatives to enhance the efficiency and effectiveness of care provided in the Emergency Department.
  • Analyze utilization patterns and outcomes to identify opportunities for improvement and contribute to the development of best practices.

Compliance and Policy Adherence:
  • Ensure adherence to hospital policies, payer guidelines, and regulatory requirements related to utilization management.
  • Stay informed about changes in healthcare regulations and payer requirements to ensure ongoing compliance.

These are duties that MUST be performed in this job, with or without reasonable accommodation.
Non-essential Duties
  • Assist with training and orientation of new staff members on utilization review processes and procedures.
  • Support administrative tasks related to the utilization review process as needed.
  • Participate in departmental meetings and contribute to discussions on process improvements and policy updates.

Responsibilities
Required Experience
  • Minimum of 3 years of clinical experience in an Emergency Department setting.

Preferred Experience
  • Prior experience in utilization review or case management is preferred
  • Strong clinical assessment and critical thinking skills.
  • Excellent communication and interpersonal skills for effective collaboration with healthcare providers and insurance representatives.
  • Proficiency in electronic health record (EHR) systems and utilization review software.
  • Ability to work independently and manage multiple tasks efficiently in a fast-paced environment.
  • Knowledge of InterQual and/or MCG and local and national coverage determinations.

Required Licensure/Education
  • Active Registered Nurse (RN) license in the State of Illinois.
  • Associates Degree of Nursing (AND)
  • *All new RN;s starting on or after 1/1/25 must complete their Bachelors of Science in Nursing within three years.

Preferred Education
  • Bachelors Degree in Nursing (BSN) from an accredited institution or higher degree*

Employee Health Requirements
Exposure/Sensory Requirements:
Exposure to:
  • Chemicals: Refer to MSDS Sheets
  • Video Display Terminals: Extreme
  • Blood and Body Fluids: Minimal potential
  • TB or Airborne Pathogens: Minimal potential

Sensory requirements (speech, vision, smell, hearing, touch):
  • Speech: Needed for presentations, training, telephone communication, facilitating meetings.
  • Vision: Needed for computer entry, reading memos and literature.
  • Smell: Needed for electrical/fire safety.
  • Hearing: Needed for telephone communication, meetings and listening to employee concerns.
  • Touch: Needed for writing, computer entry, filing.

Activity/Lifting Requirements
Percentage of time during the normal workday the employee is required to:
Sit: 50%
Twist: 0%
Stand: 35%
Crawl: 0%
Walk: 10%
Kneel: 0%
Lift: 5%
Drive: 0%
Squat: 0%
Climb: 0%
Bend: 0%
Reach above shoulders: 0%
The weight required to be lifted each normal workday according to the continuum described below:
Up to 10 lbs: Occasionally
Up to 20 lbs: Occasionally
Up to 35 lbs: Not Required
Up to 50 lbs: Not Required
Up to 75 lbs: Not Required
Up to 100 lbs: Not Required
Over 100 lbs: Not Required
Describe and explain the lifting and carrying requirements. (Example: the distance material is carried; how high material is lifted, etc.):
Brief case, notebook, computer, printed material-transported from one location/meeting to another.
Maximum consecutive time (minutes) during the normal workday for each activity:
Sit: 480
Twist: 0
Stand: 240
Crawl: 0
Walk: 60
Kneel: 0
Lift: 5
Drive: 0
Squat: 0
Climb: 0
Bend: 0
Reach above shoulders: 0
Repetitive use of hands (Frequency indicated):
Simple grasp up to 10 lbs. Normal weight:
Pushing & pulling Normal weight:
Fine Manipulation: Calculator, keyboard, writing instruments
Repetitive use of foot or feet in operating machine control: Not Required
Environmental Factors & Special Hazards
Environmental Factors (Time Spent):
Inside hours: 8
Outside hours : 0
Temperature: Normal Range
Lighting: Average
Noise levels: Average
Humidity: Normal Range
Atmosphere:
Special Hazards: None
Protective Clothing Required: None
Pay Range
USD $41.31 - USD $55.28 /Hr

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