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Review Nurse Jobs (NOW HIRING)

Fusion HCR

Utilization Review Nurse

Las Vegas, NV

Direct Hire - Utilization Review Nurse, this is an onsite position, working with our client in Acute Care. Overview Seeking an experienced Utilization Review Nurse (RN) to review patient admissions ...

Fusion HCR

Utilization Review Nurse

Las Vegas, NV

Direct Hire - Utilization Review Nurse, this is an onsite position, working with our client in Acute Care. Overview Seeking an experienced Utilization Review Nurse (RN) to review patient admissions ...

VillageCare

Utilization Review Nurse

Manhattan, NY

RN- Utilization Review Nurse Inpatient *Hybrid* Must reside within the New York Tri-State Area - NY, NJ, or CT COME WORK FOR THE LEADING, LOCAL MANAGED CARE COMPANY - VILLAGE CARE! VillageCare is ...

Village Care

Utilization Review Nurse

Manhattan, NY · Remote

$95K - $105K/yr

RN- Utilization Review Nurse Inpatient *Hybrid* Must reside within the New York Tri-State Area - NY, NJ, or CT COME WORK FOR THE LEADING, LOCAL MANAGED CARE COMPANY - VILLAGE CARE! VillageCare is ...

Village Care

Utilization Review Nurse

Manhattan, NY · On-site

$95K - $105K/yr

RN- Utilization Review Nurse Inpatient *Hybrid* Must reside within the New York Tri-State Area - NY, NJ, or CT COME WORK FOR THE LEADING, LOCAL MANAGED CARE COMPANY - VILLAGE CARE! VillageCare is ...

Astrana Health, Inc.

UM Review Nurse

Monterey Park, CA · On-site +1

$34 - $42/hr

UM Review Nurse Department: HS - UM Employment Type: Full Time Location: 1600 Corporate Center Dr., Monterey Park, CA 91754 Reporting To: Sandra Castellon Compensation: $34.00 - $42.00 / hour ...

AbsoluteCare

Utilization Review Nurse

New Orleans, LA · On-site

The Utilization Review Nurse ensures appropriate utilization of health services by performing initial, concurrent and retrospective clinical case reviews. This role collaborates and communicates with ...

Oscar Health

Utilization Review Nurse

Tempe, AZ · Remote

$35 - $45.94/hr

We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You will perform frequent case reviews, check medical records and speak with care providers regarding ...

Shannon Health

Utilization Review Nurse

Big Spring, TX · On-site

Job Summary The Utilization Review (UR) Nurse has acute knowledge and skills in areas of utilization management (UM), medical necessity, and patient status determination. This individual supports the ...

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Review Nurse information

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How much do review nurse jobs pay per hour?

As of Jun 17, 2026, the average hourly pay for review nurse in the United States is $38.62, according to ZipRecruiter salary data. Most workers in this role earn between $29.57 and $43.27 per hour, depending on experience, location, and employer.

How to make 150,000 as a nurse?

Review nurses can increase their earnings by gaining specialized certifications, such as nurse anesthetist or nurse practitioner, working in high-demand areas, taking on overtime or per diem shifts, and pursuing employment in private practices or specialty clinics. Advanced education and experience typically lead to higher salaries within the nursing field.

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

To thrive as a Review Nurse, you need a solid background in clinical nursing, strong analytical abilities, and typically an active RN license. Familiarity with medical coding systems (such as ICD-10 and CPT), utilization management software, and electronic medical records is commonly required. Excellent attention to detail, critical thinking, and effective communication skills set top performers apart in this role. These competencies are crucial for ensuring accurate case reviews, compliance with healthcare regulations, and clear collaboration with healthcare teams and insurers.

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

Review nurses can increase their income by taking on per diem or agency shifts, which often pay higher rates, or by working overtime and weekend shifts. Developing specialized skills or certifications in areas like IV therapy or wound care can also qualify nurses for higher-paying roles or consulting opportunities.

What does an RN reviewer do?

An RN reviewer evaluates medical records, clinical documentation, or patient information to ensure accuracy, completeness, and compliance with healthcare standards. They often work in insurance, legal, or healthcare settings, using their nursing expertise to verify information and support decision-making processes. Certification and strong attention to detail are important for this role.

How does a Review Nurse typically collaborate with physicians and other healthcare professionals to ensure accurate patient care decisions?

As a Review Nurse, you will regularly communicate with physicians, case managers, and other healthcare professionals to review medical records, discuss patient care plans, and ensure that treatments align with established guidelines. Collaboration often involves clarifying clinical details, providing evidence-based recommendations, and sometimes participating in interdisciplinary team meetings. This collaborative approach helps ensure that patient care decisions are well-informed, compliant with regulations, and medically necessary, while also supporting efficient healthcare delivery.

How to become a nurse reviewer?

To become a nurse reviewer, you typically need to be a licensed registered nurse with clinical experience in a relevant specialty. Developing strong analytical and communication skills, understanding medical documentation, and gaining experience in healthcare quality or compliance can help qualify for reviewer roles, which often require attention to detail and familiarity with healthcare regulations.

What are review nurses and what do they do?

Review nurses are registered nurses who evaluate medical records and treatment plans to ensure that healthcare services provided to patients are medically necessary and meet regulatory standards. They often work for insurance companies, hospitals, or government agencies, reviewing claims and authorizations for procedures or medications. Their goal is to ensure quality care while controlling costs, and they may communicate with healthcare providers to clarify or obtain additional information. Review nurses play a key role in utilization management and healthcare compliance.

What is the difference between Review Nurse vs Case Manager Nurse?

AspectReview NurseCase Manager Nurse
CertificationsRN license, possibly specialized certificationsRN license, case management certification often preferred
Work EnvironmentInsurance companies, healthcare review organizationsHospitals, clinics, insurance companies, community health
Primary ResponsibilitiesReview medical records for insurance claims, compliance, and coverageCoordinate patient care, develop treatment plans, advocate for patients
Industry UsageInsurance, healthcare reviewHealthcare, insurance, social services

Review Nurses primarily focus on evaluating medical records for insurance claims and compliance, while Case Manager Nurses coordinate patient care and develop treatment plans. Both roles require RN licensure, but their work environments and responsibilities differ significantly.

More about Review Nurse jobs
What cities are hiring for Review Nurse jobs? Cities with the most Review Nurse job openings:
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What states have the most Review Nurse jobs? States with the most job openings for Review Nurse jobs include:
What job categories do people searching Review Nurse jobs look for? The top searched job categories for Review Nurse jobs are:
Review Nurse jobs near you
Infographic showing various Review Nurse job openings in the United States as of June 2026, with employment types broken down into 1% As Needed, 84% Full Time, 13% Part Time, and 2% Contract. Highlights an 99% Physical, and 1% Remote job distribution, with an average salary of $80,321 per year, or $38.6 per hour.

Utilization Review Nurse

Fusion HCR

Las Vegas, NV

Other

Posted 10 days ago

Job description

Fusion HCR is hiring! Direct Hire - Utilization Review Nurse, this is an onsite position, working with our client in Acute Care.
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 closely with clinical teams to ensure efficient resource utilization and quality patient outcomes.
Responsibilities
  • Review admissions using InterQual and/or Milliman criteria
  • Evaluate medical necessity, level of care, and documentation accuracy
  • Ensure compliance with Medicare, Medicaid, and regulatory guidelines
  • Collaborate with physicians, case management, and care teams
  • Support discharge planning and care coordination
  • Document findings and communicate recommendations
Requirements
  • Active RN license (Nevada)
  • 5+ years acute care nursing experience
  • 3+ years Utilization Review experience
  • 3+ years discharge planning experience (acute care)
  • Experience with InterQual (must be able to pass exam)
  • Experience with Milliman guidelines
Preferred
  • Background in Case Management or CDI
  • Strong knowledge of Joint Commission and CMS guidelines
Why Apply
  • Competitive pay
  • Stable, high-demand role
  • Collaborative healthcare environment
Apply Now
If you have strong Utilization Review, InterQual, and acute care experience, we want to hear from you!

Apply