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Rn Reviewer Jobs (NOW HIRING)

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Nurse Reviewer

Annapolis Junction, MD · On-site

$40 - $70/hr

Active RN license (state-specific). * Bachelor of Science in Nursing (BSN) preferred. * Minimum 2-3 years of clinical experience, ideally in case management, utilization review, or quality assurance.

Elevance Health

Nurse Reviewer I

Chicago, IL · On-site

$33.92 - $44.42/hr

Nurse Reviewer I Nurse Reviewer I Virtual : This role enables associates to workvirtually ... A current unrestricted RN license in applicable state(s) required. Preferred Skills, Capabilities ...

Elevance Health

Nurse Reviewer I

Las Vegas, NV · On-site

$33.92 - $44.42/hr

Nurse Reviewer I Nurse Reviewer I Virtual : This role enables associates to workvirtually ... A current unrestricted RN license in applicable state(s) required. Preferred Skills, Capabilities ...

Elevance Health

Nurse Reviewer 1

Grand Prairie, TX · On-site

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

Mason, OH · On-site

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

Wilmington, DE

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

Mason, OH · On-site

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

Miami, FL

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 I

Chicago, IL · On-site

$33.92 - $44.42/hr

Nurse Reviewer I Virtual : This role enables associates to workvirtually full-time, except for ... A current unrestricted RN license in applicable state(s) required. Preferred Skills, Capabilities ...

Elevance Health

Nurse Reviewer 1

Wilmington, DE · On-site

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

Tampa, FL · On-site

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 ...

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Rn Reviewer information

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How much do rn reviewer jobs pay per hour?

As of Aug 5, 2026, the average hourly pay for rn 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 is the difference between Rn Reviewer vs Rn?

AspectRn ReviewerRn
CredentialsRegistered Nurse (RN) license, additional certification in medical review or quality assuranceRegistered Nurse (RN) license, standard nursing credentials
Work EnvironmentHealthcare facilities, insurance companies, or medical review organizationsHospitals, clinics, or healthcare settings
Job FocusReviewing medical records for insurance claims, compliance, or quality assuranceProviding direct patient care, nursing duties
Industry UsageInsurance, healthcare quality, medical reviewHealthcare, hospital, clinical settings

The main difference between an Rn Reviewer and an Rn is that the Rn Reviewer specializes in reviewing medical records and insurance claims, often working in insurance or quality assurance roles. In contrast, an Rn provides direct patient care in healthcare settings. Both roles require an RN license, but the Rn Reviewer typically has additional certifications related to medical review or compliance.

How to become an RN reviewer?

To become an RN reviewer, you typically need to be a registered nurse with active licensure and relevant clinical experience. Strong attention to detail, knowledge of medical documentation, and familiarity with healthcare regulations are important, and some positions may require certification in medical review or quality assurance. Gaining experience in patient care and healthcare documentation can help qualify for reviewer roles.

What are some common challenges RN reviewers face when evaluating clinical documentation, and how can they overcome them?

One common challenge Rn Reviewers encounter is ensuring accuracy and completeness in complex clinical documentation, which can vary widely between providers and healthcare settings. Navigating inconsistent or incomplete records requires strong attention to detail and effective communication with clinical staff to clarify ambiguities. Overcoming these challenges often involves staying updated on best practices, leveraging electronic health record (EHR) tools, and collaborating closely with interdisciplinary teams to ensure all relevant information is accurately captured and compliant with regulatory standards.

What is an RN reviewer?

RN Reviewers are registered nurses who evaluate medical records, clinical documentation, and healthcare cases to ensure accuracy, compliance, and quality of care. They often work for insurance companies, hospitals, or healthcare organizations, reviewing patient charts to determine if services meet established guidelines. RN Reviewers play a critical role in utilization management, case review, and quality assurance processes. Their work helps ensure that patients receive appropriate care and that healthcare providers adhere to best practices and regulatory requirements.

How to become a registered nurse reviewer?

To become a registered nurse reviewer, you typically need to hold an active registered nurse (RN) license, which requires completing an accredited nursing program and passing the NCLEX-RN exam. Relevant skills include strong clinical knowledge, attention to detail, and familiarity with medical documentation; some positions may also require experience in case review or healthcare administration.

What are the key skills and qualifications needed to thrive as an RN reviewer?

To thrive as an RN Reviewer, you need a current registered nurse license, strong clinical judgment, and experience in case review or utilization management. Familiarity with medical review software, electronic health records (EHRs), and knowledge of regulatory standards like CMS guidelines is typically required. Excellent analytical skills, attention to detail, and effective written and verbal communication help you stand out in this role. These competencies ensure accurate case evaluations, regulatory compliance, and effective collaboration with healthcare teams.
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What cities are hiring for Rn Reviewer jobs? Cities with the most Rn Reviewer job openings:
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Rn Reviewer jobs near you
Infographic showing various Rn Reviewer job openings in the United States as of July 2026, with employment types broken down into 2% Locum Tenens, 77% Full Time, 7% Part Time, 2% Contract, and 12% Nights. Highlights an 51% Physical, 2% Hybrid, and 47% Remote job distribution, with an average salary of $77,034 per year, or $37 per hour.

Clinical Nurse Reviewer

Saint Peter's Healthcare System

New Brunswick, NJ • On-site

Other

Medical, Dental, Vision, Life, Retirement

This job post has expired today. Applications are no longer accepted.

Saint Peter's University Hospital rating

8.0

Company rating: 8.0 out of 10

Based on 14 frontline employees who took The Breakroom Quiz

135th of 1,054 rated hospitals

Job description

Clinical Nurse Reviewer Quality Management Saint Peter's is among the few hospitals in the world to have earned its 7th consecutive Magnet designation and its first Magnet with Distinction designation. The Magnet with Distinction designation is an elite level of this recognition, awarded to organizations that demonstrate exceptional performance in nursing practices and patient outcomes. Our team of award-winning nurses is growing, and we are looking for talented, compassionate RNs to join our team.

The Clinical Nurse Reviewer will: Collect clinical data on variables, including preoperative risk factors, intraoperative variables and 30 day postoperative mortality outcomes for patients undergoing major and minor surgical procedures in both inpatient and outpatient settings. Enter data into the program's database and meet the caseload accrual requirement protocol, validate and submit the data through a secure, Web-based system. Utilize software applications for data collection and analysis.

Conduct data audits, as instructed. Meet regularly with the Surgeon Champion and quality team to review results. Actively participate in Quality Improvement activities with staff in the Surgery, Medicine, Nursing, Medical Records, Infection Control, Quality/Patient Safety, and the Information Systems departments to improve patient outcomes.

Develop PI plan for department of surgery and anesthesia, collaborate with Chairs of Surgery, Anesthesia, and Director of Quality. Requirements: Licensed Professional Registered Nurse (NJ). Bachelor of Science degree in Nursing (BSN) is required.

Minimum of 1 year experience in one of the following settings: hospitals surgery department, surgery clinic, clinical research, or medical records. Experience in clinical chart review and good communication and relationship building skills are highly desirable. Thorough working knowledge of network database systems and multiple software programs.

Position located on-site with limited remote work hours as allowed based on Director's assessment of department need. We offer competitive base rates that are determined by many factors, including job-related work experience, internal equity, and industry-specific market data. In addition to base salary, some positions may be eligible for clinical certification pay and shift differentials.

The salary range listed for exempt positions reflects full-time compensation and will be prorated based on employment status. Saint Peter's offers a robust benefits program to eligible employees that will support you and your family in working toward achieving and maintaining secure, healthy lives now and into the future. Benefits include medical, dental, and vision insurance; savings accounts, voluntary benefits, wellness programs and discounts, paid life insurance, generous 401(k) match, adoption assistance, back-up daycare, free onsite parking, and recognition rewards.

You can take your career to the next level by participating in either a fully paid tuition program or our generous tuition assistance program. Learn more about our benefits by visiting our site at Saint Peter's. Apply.

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