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Rn Utilization Review Nurse Jobs (NOW HIRING)

Care Career

Travel Utilization Review RN

Fort Myers, FL · On-site

Care Career is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Fort Myers, Florida. & Requirements * Specialty: Utilization Review * Discipline: RN * Start Date ...

Voyage Health

Travel RN Utilization Review

Pocatello, ID · On-site

$1.8K - $1.9K/wk

Position Details Specialty: RN Utilization Review Location: Pocatello, Idaho Employment Type: Travel/Contract Pay: $1859 - $1957 per week Shift: 5x8 Days Start Date: ASAP Contract Length: 13-week ...

Hired by Matrix

RN Utilization Review

Portales, NM · On-site

Job Title: RN Utilization Review City: Portales State: NM Job Type: Travel Discipline: RN Speciality: Utilization Review Facility Setting: Short Term Actut Care (STAC) Accepting Locals per Radius ...

Stcharles

RN Utilization Review

Bend, OR · On-site

$48.30 - $72.45/hr

CHARLES HEALTH SYSTEM TITLE: RN Utilization Management REPORTS TO POSITION: Manager- Utilization Management DEPARTMENT: Utilization Management DATE LAST REVIEWED: November 2024 OUR VISION: Creating ...

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How much do rn utilization review nurse jobs pay per hour?

As of Aug 21, 2026, the average hourly pay for 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 is an RN Utilization Review Nurse?

An RN Utilization Review Nurse evaluates patient care to ensure medical services are necessary, efficient, and compliant with healthcare regulations. They review medical records, collaborate with healthcare providers, and assess treatment plans to optimize patient outcomes while managing costs. These nurses often work for hospitals, insurance companies, or healthcare organizations, ensuring appropriate resource utilization. Their role helps prevent unnecessary procedures and supports quality patient care.

What does an RN Utilization Review Nurse do?

A typical day for an RN Utilization Review Nurse involves reviewing patient medical records to determine the medical necessity of hospital admissions or ongoing care, communicating with physicians, case managers, and insurance representatives, and documenting decisions in electronic health record systems. You will often spend a significant amount of time on critical assessments, phone or email correspondence, and ensuring compliance with regulatory and insurance guidelines. The work is generally office-based or remote, and you may collaborate closely with both clinical and administrative staff. This structured environment allows you to leverage your clinical background while supporting cost-effective, high-quality patient care.

What are the key skills and qualifications needed to thrive as an RN Utilization Review Nurse?

To thrive as an RN Utilization Review Nurse, a current RN license, strong clinical knowledge, and experience with healthcare regulations and insurance guidelines are essential. Familiarity with medical review software, EHR systems, and utilization management platforms—as well as certification such as CCM (Certified Case Manager)—is often required. Strong analytical thinking, attention to detail, and effective communication with interdisciplinary teams set outstanding candidates apart. These skills ensure accurate care assessments, compliance with insurance requirements, and effective coordination between providers, patients, and payers.

How to get into utilization review as a registered nurse?

To become a utilization review nurse, registered nurses typically need clinical experience and knowledge of healthcare policies. Earning certifications such as the Certified Professional in Healthcare Quality (CPHQ) or Utilization Review Certification (URC) can improve job prospects. Familiarity with medical records, insurance processes, and strong communication skills are also important for success in this role.
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Rn Utilization Review Nurse jobs near you
Infographic showing various Rn Utilization Review Nurse job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 13% Part Time, 3% Contract, and 1% Nights. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

RN - Utilization Review

Lee Health Corporate Center

Fort Myers, FL • On-site

Other

Posted 9 days ago

Job description

RN - Utilization Review

Utilization review nurses perform frequent case reviews, check medical records, speak with patients and care providers regarding treatment, and respond to the plan of care. They also make recommendations regarding the appropriateness of care for identified diagnoses based on the research results for those conditions.

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