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Rn Utilization Review Nurse Jobs (NOW HIRING)

talent4health

RN - Utilization Review

Cleveland, OH · On-site

$2.2K/wk

Details Client Name Southwest General Hospital Center Southwest General Health Center Job Type Travel Offering Nursing Profession RN Specialty Utilization Review Job ID 18807560 Job Title RN - ...

Talent4Health

RN - Utilization Review

Fort Myers, FL · On-site

$2.0K/wk

  • Medical

  • Dental

  • Vision

Details Client Name Lee Health-Corporate Center Job Type Travel Offering Nursing Profession RN Specialty Utilization Review Job ID 37756438 Job Title RN - Utilization Review Weekly Pay $2033.0 Shift ...

New

Voyage Health

Travel RN Utilization Review

Tuba City, AZ · On-site

$2.4K - $2.5K/wk

Position Details Specialty: RN Utilization Review Location: Tuba City, Arizona Employment Type: Travel/Contract Pay: $2467 - $2597 per week Shift: 5x8 Days Start Date: ASAP Contract Length: 13-week ...

Medlivo

Travel Nurse RN - Utilization Review

Atlanta, GA · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

Medlivo is seeking a travel nurse RN Utilization Review for a travel nursing job in Atlanta, Georgia. & Requirements * Specialty: Utilization Review * Discipline: RN * Duration: 13 weeks * 40 hours ...

Medlivo

Travel Nurse RN - Utilization Review

Atlanta, GA · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

Utilization Review * Discipline: RN * Duration: 13 weeks * 40 hours per week * Shift: 8 hours, days * Employment Type: Travel Requirements: Active RN license (State License required) BLS ...

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

As of Aug 15, 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 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.

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.

How to get into utilization review as a registered nurse?

To become a utilization review nurse, registered nurses typically need clinical experience, knowledge of healthcare policies, and familiarity with medical records and insurance processes. Earning certifications such as the Certified Professional in Healthcare Quality (CPHQ) or Utilization Review Certification (URAC) can enhance qualifications. Strong analytical skills and understanding of medical necessity criteria are also important for success in this role.

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.

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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, 83% Full Time, 13% Part Time, and 3% Contract. Highlights an 90% Physical, 3% Hybrid, and 7% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

RN - Utilization Review

talent4health

Cleveland, OH • On-site

$2.2K/wk

Other

Posted 18 days ago

Job description

Details
Client Name
Southwest General Hospital Center Southwest General Health Center
Job Type
Travel
Offering
Nursing
Profession
RN
Specialty
Utilization Review
Job ID
18807560
Job Title
RN - Utilization Review
Weekly Pay
$2214.0
Shift Details
Shift
8 Hour Flex
Scheduled Hours
40
Job Order Details
Start Date
07/20/2026
End Date
10/19/2026
Duration
13 Week(s)
Job Description
Job Title
RN Utilization Specialist
City/State: Middleburg Heights, Ohio
Shift: 8 Hour Flex, 07:00:00-15:00:00
Contract Length: 12.71 weeks
Start Date: 07/20/2026
Job Description:
Full-Time 40 hours per week, 5 (8) hour shifts 8a-4:30p, as well as every 3rd weekend.
Requirements:
  • Graduation from an accredited School of Nursing. BSN preferred.
  • Current licensure by Ohio State Board of Nursing.
  • Minimum of five (5) years recent experience in clinical nursing or related nursing field.
  • Previous Care Management, Case Management, or Utilization Management Experience.
  • Experience with doing 30+ reviews a day.
  • Previous experience with screening criteria including Cerner, InterQual, and MCG.
  • Excellent critical thinking and communication skills.
  • Strong computer skills.
  • ACM/CCM Certification helpful.

Client Details
Address
18697 Bagley Rd, Middleburg Heights, OH 44130
City
Middleburg Heights
State
OH
Zip Code
44130

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