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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

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 ...

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

As of Aug 14, 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

Tuba City Regional - Tuba City, AZ - Medefis

Tuba City, AZ • On-site

Other

Medical, Dental, Vision, Retirement

Posted 11 days ago

Job description

RN - Utilization Review

Prime HealthCare Staffing, a national health care staffing company with over 20 years in the business, is looking for an experienced RN - Utilization Review for our customer in Tuba City, Arizona. The ideal candidate will possess a current Arizona license. This is a RN position in the Utilization Review RN Unit. You must have a Nursing License and at least 2 years of recent Utilization Review US nursing experience as a RN - Utilization Review. Prime`s team of experienced health care professionals are here to guide you through the process 24/7.

Prime Benefits

  • First Day Medical, Dental, Vision and Rx benefits
  • Housing and Meal stipends
  • 401(k) Savings plan after 90 days
  • Travel/Licensure Reimbursement
  • Competitive pay rates
  • Referral Bonus Plan
  • Assignment Bonus on select assignments (ask your recruiter for details)
  • Weekly Direct Deposit

Qualifications

  • At least 2-years total experience in your specialty
  • Current BLS and/or ACLS (AHA Preferred) and/or Specialty Certifications
  • Active Nursing License per state
  • Current Updated Resume
  • Supervisory Professional References
  • Must complete Drug Screen and Background Screen

Prime HealthCare Staffing has day and night shifts available. Submit your resume and experience the Prime difference.

Client Details Setting Hospital City Tuba City State AZ

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