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Rn Utilization Review Nurse Jobs (NOW HIRING)

Oscar Health

Utilization Review Nurse

Atlanta, GA · Remote

$35 - $45.94/hr

We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... Active, unrestricted RN licensure from the United States in [state], OR, active compact multistate ...

Oscar Health

Utilization Review Nurse

Dallas, TX · Remote

$35 - $45.94/hr

We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... Active, unrestricted RN licensure from the United States in [state], OR, active compact multistate ...

US Tech Solutions

Utilization Review Nurse

Canton, MA · On-site

$55 - $60/hr

Active, unrestricted Registered Nurse (RN) license. * Associate Degree in Nursing (ADN) required ... Utilization Management (UM) * Medical Necessity Review * Prior Authorization * Precertification

Phenom People

RN Utilization Review PRN

Paris, KY · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

PRN, RN - Utilization Review Making Communities Healthier with Comprehensive Care... You can get to know who we are and what truly makes us different by our mission, 'Making Communities Healthier'

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 ...

Oscar Health

Utilization Review Nurse

Tempe, AZ · Remote

$35 - $45.94/hr

We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... Active, unrestricted RN licensure from the United States in [state], OR, active compact multistate ...

Sedgwick

RN Utilization Review

Knoxville, TN · On-site

$63K - $65K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... RN Utilization Review As a nurse at Sedgwick, you can build a meaningful and rewarding career while advocating for patients in a nontraditional clinical setting. * Apply your RN clinical knowledge ...

St. Charles Health System

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 ...

Sedgwick

RN Utilization Review

Nashville, TN · On-site

$63K - $65K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... RN Utilization Review As a nurse at Sedgwick, you can build a meaningful and rewarding career while advocating for patients in a nontraditional clinical setting. * Apply your RN clinical knowledge ...

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Rn Utilization Review Nurse information

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

As of Aug 16, 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.

Travel Nurse RN - Utilization Review

Care Career

Fort Myers, FL • On-site

Contractor

Medical, Dental, Vision

Posted 4 days ago

Job description

Care Career is seeking a travel nurse RN Utilization Review for a travel nursing job in Fort Myers, Florida.

Job Description & Requirements
  • Specialty: Utilization Review
  • Discipline: RN
  • Start Date: 09/06/2026
  • Duration: 1 weeks
  • 36 hours per week
  • Shift: 12 hours, days
  • Employment Type: Travel
About Care Career

Care Career brings together a portfolio of leading healthcare staffing organizations, each delivering specialized talent solutions across the industry. Wherever you want to go, We Make It Happen.

With travel nursing jobs across the country, you can discover the possibilities that create the lifestyle and financial position that you have dreamed of.

Care Career is a modern, transparent staffing firm creating the ultimate community of US.


Benefits
  • Referral bonus
  • Weekly pay
  • Medical benefits
  • Continuing Education
  • Dental benefits
  • Vision benefits

Apply