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Sco Um Review Rn Jobs (NOW HIRING)

We Care Staffing

RN UM

Camden, NJ · On-site

$89/hr

Registered Nurse - Unit Manager (RN UM) Location: Windward Gardens Contract Duration: 04/06/26 - 06 ... Review and audit nursing documentation for accuracy and completeness * Implement and enforce ...

CommonSpirit Health

Utilization Review RN

Omaha, NE · On-site

Collaborates with facility RN Care Coordinators to ensure progression of care. Engages the second level physician reviewer, internal or external, as indicated to support the appropriate status.

CHI Health

Utilization Review RN

Omaha, NE

$33.51 - $48.58/hr

Collaborates with facility RN Care Coordinators to ensure progression of care. Engages the second level physician reviewer, internal or external, as indicated to support the appropriate status.

Astrana Health

UM Review Nurse - LVN

Monterey Park, CA · Remote

$34 - $47/hr

Astrana Health is looking for a CA-licensed Utilization Review Nurse to assist our Health Services ... Active and unrestricted LVN license in CA. * 1+ years of outpatient UM experience * Experience with ...

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How much do sco um review rn jobs pay per hour?

As of May 31, 2026, the average hourly pay for sco um review rn in the United States is $44.48, according to ZipRecruiter salary data. Most workers in this role earn between $33.65 and $51.92 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a SCO UM Review RN, and why are they important?

To thrive as a SCO UM Review RN (Senior Care Options Utilization Management Review Registered Nurse), you need a valid RN license, strong clinical assessment skills, and a solid understanding of medical necessity criteria for managed care populations. Familiarity with utilization management software, InterQual or Milliman guidelines, and electronic health records is typically required. Exceptional attention to detail, critical thinking, and effective communication are vital soft skills for collaborating with care teams and advocating for patient needs. These skills ensure accurate review processes, regulatory compliance, and optimized patient outcomes in managed care environments.

What are some common challenges faced by a SCO UM Review RN and how can they be managed effectively?

A SCO UM Review RN often faces challenges such as balancing a high volume of case reviews with the need for thorough, accurate assessments and staying updated with frequently changing regulatory requirements. Time management and strong organizational skills are crucial for managing daily responsibilities, which typically include reviewing medical records, collaborating with interdisciplinary teams, and communicating with providers and members. Building strong relationships with both clinical and non-clinical staff can help streamline workflows, while ongoing professional development ensures you remain current with best practices and compliance standards.

What are SCO UM Review RNs?

SCO UM Review RNs are registered nurses who specialize in Utilization Management (UM) review for Senior Care Options (SCO) programs. They evaluate medical records, treatment plans, and healthcare services to ensure that care provided to elderly patients is medically necessary and meets health plan guidelines. These nurses play a key role in coordinating care, preventing unnecessary services, and advocating for appropriate patient care within managed care organizations.

What is the difference between Sco Um Review Rn vs Licensed Practical Nurse?

AspectSco Um Review RnLicensed Practical Nurse
CredentialsRegistered Nurse (RN) license, possibly specialized certificationsLicensed Practical Nurse (LPN) license
Work EnvironmentHospitals, clinics, outpatient facilities, often in more complex care settingsLong-term care, nursing homes, clinics, with more routine patient care
Job ResponsibilitiesAssessments, care planning, complex patient care, medication administrationBasic patient care, vital signs, assisting RNs and physicians

Both Sco Um Review Rn and Licensed Practical Nurse roles involve patient care, but Sco Um Review Rn typically requires a higher level of education and certification, allowing for more complex responsibilities. LPNs focus on routine patient care and support roles. The choice depends on your career goals and desired scope of practice.

More about Sco Um Review Rn jobs
What states have the most Sco Um Review Rn jobs? States with the most job openings for Sco Um Review Rn jobs include:
What job categories do people searching Sco Um Review Rn jobs look for? The top searched job categories for Sco Um Review Rn jobs are:
Sco Um Review Rn jobs near you
Infographic showing various Sco Um Review Rn job openings in the United States as of May 2026, with employment types broken down into 2% As Needed, 88% Full Time, 7% Part Time, and 3% Contract. Highlights an 1% Physical, and 99% Remote job distribution, with an average salary of $92,525 per year, or $44.5 per hour.
Travel Nurse RN - Utilization Review

Travel Nurse RN - Utilization Review

Prime Staffing

Rosedale, MD

Contractor

Posted 11 days ago

Job description

Prime Staffing is seeking a travel nurse RN Utilization Review for a travel nursing job in Rosedale, Maryland.

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

About the Position
Specialty: RN – Utilization Review
Experience: 2+ years of experience in utilization review, case management, or acute care nursing
License: Active State or Compact RN License
Certifications: BLS – AHA; Certified Case Manager (CCM) preferred
Must-Have: Strong understanding of insurance guidelines, medical necessity criteria (e.g., InterQual or MCG), and discharge planning


Description: The Utilization Review RN is responsible for reviewing medical records to determine the appropriateness and medical necessity of hospital admissions and continued stays. The nurse collaborates with providers, insurance companies, and case managers to ensure compliance with coverage guidelines and supports optimal patient outcomes while managing healthcare costs.

Requirements

Required for Onboarding:

  • Active RN License
  • BLS

Prime Staffing Job ID #36524314. 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. Posted job title: RN:Utilization Review,08:00:00-16:00:00

About Prime Staffing

At Prime Staffing, we understand the importance of finding the perfect fit for both our clients and candidates. Prime Staffing utilizes a unique matchmaking approach, providing the most qualified contingent staffing to our clients, and the most competitive contracts to our workforce. Our experienced team takes the time to get to know both our clients and candidates, their needs, and preferences, to ensure that each placement is a success.

We offer a wide range of staffing services including temporary, temp-to-perm, and direct hire placements. Our extensive network of qualified candidates includes nurses, allied healthcare professionals, corporate support professionals and executives.



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