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Rn Utilization Review Nurse Jobs (NOW HIRING)

UHS

Utilization Review Nurse (RN)

Augusta, GA · On-site

... Valid RN or LPN license * Must have 2 years of experience in a psychiatric health care setting, delivery of care to psychiatric and/or chemically dependent patients and utilization review EEO ...

Pride Health

Utilization Review Nurse

Manhattan, NY · On-site

$60 - $61/hr

Care Manager (RN) - Non-Patient-Facing - MLTC Location: New York, NY 10004 Schedule: Monday-Friday ... Perform utilization review and discharge planning. * Collaborate with providers and ...

AbsoluteCare

Utilization Review Nurse

New Orleans, LA · On-site

The Utilization Review Nurse ensures appropriate utilization of health services by performing ... Active Registered Nurse license by the State of Louisiana and/or the state(s) in which the nurse is ...

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

As of Sep 6, 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, 81% Full Time, 14% Part Time, 1% Temporary, and 3% Contract. Highlights an 88% Physical, 3% Hybrid, and 9% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

Travel Nurse RN - Utilization Review

Medlivo

South San Francisco, CA • On-site

Contractor

Medical, Dental, Vision, Life, Retirement

Posted 17 days ago

Job description

Medlivo is seeking a travel nurse RN Utilization Review for a travel nursing job in South San Francisco, California.

Job Description & Requirements
  • Specialty: Utilization Review
  • Discipline: RN
  • Duration: 13 weeks
  • 40 hours per week
  • Shift: 8 hours, nights
  • Employment Type: Travel

Requirements:
Current RN State License
Current BLS certification
Previous experience as a Patient Care Coordinator or in a similar RN coordination role required.

Medlivo Job ID #KAISJP00252175. Pay package is based on 8 hour shifts and 40.0 hours per week (subject to confirmation) with tax-free stipend amount to be determined.

About Medlivo


Benefits
  • Dental benefits
  • Vision benefits
  • 401k retirement plan
  • Health Care FSA
  • Life insurance
  • Sick pay
  • Holiday Pay
  • Medical benefits

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