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Rn Nurse Reviewer Jobs (NOW HIRING)

Venturefizz Product Management Community

Lead RN Reviewer

$35 - $37/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Lead RN Reviewer Cohere's Service Operations team is responsible for ensuring that our healthcare partners are supported throughout their lifecycle of using the platform. The Lead RN Reviewer in ...

Elevance Health

Nurse Reviewer 1

Mason, OH · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Nurse Reviewer 1 Nurse Reviewer 1 Location: This role enables associates to work virtually ... Current unrestricted RN license in applicable state(s) required. Preferred Skills, Capabilities and ...

Elevance Health

Nurse Reviewer 1

Atlanta, GA · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Nurse Reviewer 1 Location: This role enables associates to work virtually full-time, with the ... Current unrestricted RN license in applicable state(s) required. Preferred Skills, Capabilities and ...

Peraton

Nurse Reviewer - Medicaid

Reston, VA · On-site

$66K - $106K/yr

At least 3 years of experience in the medical field as a Registered Nurse or other clinician, and/or experience in review of medical claims for coverage and medical necessity. * Current/Active ...

Peraton

Nurse Reviewer - Medicaid

Herndon, VA · On-site

$66K - $106K/yr

At least 3 years of experience in the medical field as a Registered Nurse or other clinician, and/or experience in review of medical claims for coverage and medical necessity. * Current/Active ...

Elevance Health

Nurse Reviewer 1

Miami, FL · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Nurse Reviewer 1 Location: This role enables associates to work virtually full-time, with the ... Current unrestricted RN license in applicable state(s) required. Preferred Skills, Capabilities and ...

Elevance Health

Nurse Reviewer 1

Wilmington, DE · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Nurse Reviewer 1 Location: This role enables associates to work virtually full-time, with the ... Current unrestricted RN license in applicable state(s) required. Preferred Skills, Capabilities and ...

Elevance Health

Nurse Reviewer 1

Mason, OH · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Nurse Reviewer 1 Location: This role enables associates to work virtually full-time, with the ... Current unrestricted RN license in applicable state(s) required. Preferred Skills, Capabilities and ...

Elevance Health

Nurse Reviewer 1

Atlanta, GA · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Nurse Reviewer 1 Location: This role enables associates to work virtually full-time, with the ... Current unrestricted RN license in applicable state(s) required. Preferred Skills, Capabilities and ...

Elevance Health

Nurse Reviewer 1

Grand Prairie, TX · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Nurse Reviewer 1 Location: This role enables associates to work virtually full-time, with the ... Current unrestricted RN license in applicable state(s) required. Preferred Skills, Capabilities and ...

Dane Street, LLC

PRN Utilization Review Nurse Reviewer

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Utilization Management Nurse Reviewer plays a crucial role in healthcare systems by ensuring ... Holds an unrestricted LVN/RN license from an accredited vocational nursing program (for LVNs) or a ...

Zelis

Clinical Nurse Reviewer

Morristown, NJ

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Conduct review of facility and outpatient bills as it compares with medical records and coverage ... Current/active RN License. * Typically has a BA or 3-5 years of experience. * Requires proficiency ...

Zelis

Clinical Nurse Reviewer

Saint Louis, MO

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Conduct review of facility and outpatient bills as it compares with medical records and coverage ... Current/active RN License. * Typically has a BA or 3-5 years of experience. * Requires proficiency ...

Comagine

Clinical Reviewer RN - Alabama

Clinical Utilization Review Nurses (RN) Based In Alabama Comagine Health is a national, mission-driven, nonprofit organization that has engaged in health care quality consulting and quality ...

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All JobsRn Nurse Reviewer Jobs

Rn Nurse Reviewer information

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$37

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How much do rn nurse reviewer jobs pay per hour?

As of Aug 17, 2026, the average hourly pay for rn nurse reviewer in the United States is $37.04, according to ZipRecruiter salary data. Most workers in this role earn between $34.13 and $41.35 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as an RN nurse reviewer, and why are they important?

To excel as an RN Nurse Reviewer, you need a valid RN license, strong clinical knowledge, and experience in case management or utilization review. Familiarity with medical review software, electronic health records (EHRs), and regulatory guidelines like Medicare and Medicaid is typically required. Attention to detail, analytical thinking, and excellent written communication are essential soft skills for evaluating medical records and preparing clear reports. These skills ensure accurate assessments, compliance with healthcare standards, and support quality patient care decisions.

What are some common challenges RN nurse reviewers face when transitioning from bedside nursing to a review role?

Many Rn Nurse Reviewers find the shift from direct patient care to a more analytical, documentation-based environment to be a significant adjustment. Instead of hands-on care, the role focuses on reviewing patient records, applying clinical guidelines, and ensuring compliance with regulatory standards, which requires strong attention to detail and critical thinking. Adapting to stricter productivity metrics, meeting tight deadlines, and collaborating with multidisciplinary teams across remote or office settings are also common challenges. However, the opportunity to positively impact patient outcomes through quality assurance and policy improvement can be very rewarding.

What is an RN nurse reviewer?

RN Nurse Reviewers are registered nurses who evaluate medical records, treatment plans, and healthcare services for quality, compliance, and appropriateness. They often work for insurance companies, hospitals, or healthcare organizations to conduct utilization reviews, ensure adherence to clinical guidelines, and support decisions about healthcare coverage. Their work helps improve patient care, manage costs, and ensure that care meets regulatory and organizational standards.

How to become a registered nurse reviewer?

To become a registered nurse reviewer, you typically need to hold an active RN license, gain clinical nursing experience, and develop strong analytical and communication skills. Some positions may require familiarity with medical record review, healthcare regulations, or certification in case review or utilization management. Continuing education or specialized training in medical review processes can also enhance eligibility.

What is the difference between Rn Nurse Reviewer vs Medical Reviewer?

AspectRn Nurse ReviewerMedical Reviewer
CredentialsRegistered Nurse (RN) license, nursing certificationsMedical degree or nursing license, specialized medical certifications
Work EnvironmentHealthcare facilities, insurance companies, review organizationsHospitals, insurance companies, healthcare consulting firms
Employer & IndustryInsurance companies, healthcare agencies, legal firmsInsurance companies, healthcare organizations, legal firms
Primary FocusReviewing medical records from a nursing perspectiveAssessing medical records for accuracy and compliance from a clinical perspective

Both Rn Nurse Reviewers and Medical Reviewers evaluate medical records, but Rn Nurse Reviewers focus on nursing aspects and patient care, while Medical Reviewers have broader medical expertise. The roles often overlap in insurance and healthcare settings, with the main difference being the scope of medical knowledge applied.

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Rn Nurse Reviewer jobs near you

Disease Specific Care-Perinatal RN - Reviewer

The Joint Commission

Remote

$115K/yr

Other

Posted 14 days ago

Job description

Perinatal Reviewer

Perinatal Reviewer can work anywhere in the United States. Perinatal Reviewer, with minimal immediate direction or supervision, survey and/or review health care organizations throughout the United States. Perinatal Reviewer apply sophisticated analysis skills and inductive reasoning skills to determine a health care organization's degree of compliance with applicable standards and functionality of care delivery systems. Perinatal RN Reviewer must have the credentials, presence and expertise to earn the respect of the health care organizations' professional staff and leadership. Perinatal RN Reviewer must be able to employ advanced and sometimes nuanced communication skills to engage health care organization staff in interactive dialogues on a broad array of health care issues in order to assess compliance and to identify opportunities for improving compliance. Perinatal RN Reviewer must have superior written communication skills to prepare detailed, accurate management reports that clearly link individual standards deficiencies with potential systems vulnerabilities and related organization risk points. Perinatal RN Reviewer must be able to professionally and effectively communicate survey results to health care organization leadership in a constructive and collegial style. Perinatal RN Reviewer are also required to participate in other Joint Commission activities as assigned.

Qualifications
  • DSC Perinatal Reviewers must be a healthcare professional (DO/ MD/RN) with at least three years' experience in coordinating and/or managing the services of Delivery, Postpartum Care, Special Care Nursery, as well as Pediatrics with in an acute care setting. Must have direct experience with at least 2 Joint Commission certifications reviews.
  • Must have current experience in Labor & Delivery, Maternal Care or Neonatal Care.
  • The following certifications are preferred: NeoNatal-Perinatal medicine and/or RN-Board Certified in Perinatal Nursing and/or Perinatal Care Certification through Joint Commission.
  • Registered Nurses requires a Master's Degree

We are hiring for.23 FTE (one week per month) or .48 FTE (Two weeks per month) after orientation and training. These positions could include Sunday travel All positions require 100% nationwide travel.

Due to extensive travel requirements, candidates must be located within approximately 50 miles of a major commercial airport with direct access to domestic and/or international flight routes and facilities capable of accommodating wide-body aircraft.

We are currently hiring for our next orientation class to take place on September 2026.

Equal Opportunity Field

We offer a comprehensive benefit package. For a complete overview of our benefits package, please visit our Joint Commission Career Page

We are an Equal Opportunity Employer. All qualified applicants will receive consideration without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other status protected by law.

Min

USD $115,000.00/year

Max

USD $115,000.00/year

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