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Senior Rn Utilization Review Nurse Jobs in Appleton, WI

TEEMA Group

Registered Nurse (RN)

Oshkosh, WI · On-site

$55 - $60/hr

Registered Nurse (RN)Role Summary Are you a resilient, highly analytical Registered Nurse looking ... Prior professional experience navigating behavioral health, substance utilization programs, or ...

Eden Senior Care

MDS Coordinator

Oshkosh, WI · On-site

$80K - $90K/yr

Run Utilization Review Meetings and ensure PDPM scores and rates are validated * Review and Educate ... Must hold an active LPN or RN license in the state of Wisconsin. * Strong knowledge of the MDS ...

TEEMA Group

Registered Nurse (RN)

Green Bay, WI · On-site

$55 - $63/hr

Registered Nurse (RN)Role Summary Are you a resilient, highly analytical Registered Nurse looking ... Prior professional experience navigating behavioral health, substance utilization programs, or ...

Continuum Healthcare, LLC

Registered Nurse

Green Bay, WI · On-site

) Registered Nurse (RN) Sign on Bonus 8500 Competitive Benefits and Wages Serenity Spring Senior Living at Green Bay is a skilled nursing facility, providing clinically sophisticated sub-acute care and ...

Avina of Weyauwega

Registered Nurse (RN)

Weyauwega, WI

$38 - $45/hr

FT RN $40/hour Registered Nurse (RN) Job Benefits: * Competitive Pay * Health Insurance including ... Review medication orders for completeness of information and accuracy. * Transcribe physician ...

Manor of Fond du Lac

Registered Nurse (RN)

Weyauwega, WI · On-site

$40/hr

FT RN $40/hour Registered Nurse (RN) Job Benefits: * Competitive Pay * Health Insurance including ... Review medication orders for completeness of information and accuracy. * Transcribe physician ...

St. Paul Elders

Registered Nurse (RN)

Kaukauna, WI · On-site

Registered Nurse (RN) McCormick Assisted Living Green Bay, WI Full-time Position Summary McCormick ... Reviews charts, orders and service plans on a regular basis. * Attends resident/tenant service plan ...

Interim HealthCare

Registered Nurse (RN)

Menasha, WI · On-site

$35 - $40/hr

Review, interpret, transcribe and carry out physician orders for patients * Administer medication, operate medical equipment and maintain a safe environment A few must-haves for Registered Nurses:

Carepros, LLC

Registered Nurse

Appleton, WI · On-site

Registered Nurse (RN) The Registered Nurse (RN) is a licensed medical professional who performs ... Review and interpretation of the physician's orders. * Frequency and anticipated duration of ...

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Showing results 21-40

All JobsRn Utilization Review Nurse JobsSenior Rn Utilization Review Nurse JobsSenior Rn Utilization Review Nurse Jobs in Appleton, WI

Senior Rn Utilization Review Nurse information

See Appleton, WI salary details

$20

$41

$67

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

As of Aug 8, 2026, the average hourly pay for senior rn utilization review nurse in Appleton, WI is $41.26, according to ZipRecruiter salary data. Most workers in this role earn between $32.60 and $47.36 per hour, depending on experience, location, and employer.

What is the difference between Senior Rn Utilization Review Nurse vs Rn Case Manager?

AspectSenior Rn Utilization Review NurseRn Case Manager
CertificationsRN license, possibly UR or case management certificationRN license, often case management certification
Work EnvironmentHospitals, insurance companies, healthcare organizationsHospitals, community health, insurance providers
Primary FocusReviewing medical necessity and utilization of servicesCoordinating patient care and discharge planning
Common UsageUsed in insurance and healthcare review settingsUsed in patient care coordination and discharge planning

The Senior Rn Utilization Review Nurse primarily focuses on evaluating the necessity and appropriateness of healthcare services, often working within insurance companies or healthcare organizations. In contrast, Rn Case Managers concentrate on coordinating patient care, discharge planning, and ensuring smooth healthcare delivery. Both roles require RN licensure and relevant certifications, but their daily responsibilities and work environments differ slightly.

What does a Senior RN Utilization Review Nurse do?

A Senior RN Utilization Review Nurse is a registered nurse who evaluates the medical necessity, appropriateness, and efficiency of healthcare services provided to patients. They review patient records, apply clinical guidelines, and collaborate with healthcare providers to ensure that treatments are cost-effective and meet established standards of care. Additionally, they often mentor junior staff, participate in policy development, and help optimize resource utilization within healthcare organizations. Their work supports quality patient care while managing healthcare costs.

What are some typical challenges faced by a Senior RN Utilization Review Nurse when coordinating with multidisciplinary teams?

Senior RN Utilization Review Nurses often collaborate with physicians, case managers, and insurance representatives to ensure patients receive appropriate, cost-effective care. A common challenge is balancing clinical guidelines with payer requirements, which can sometimes lead to differing opinions on the necessity of certain treatments or services. Effective communication, strong negotiation skills, and up-to-date knowledge of regulatory standards are essential to navigate these situations successfully. Being proactive and maintaining strong professional relationships helps facilitate smoother approvals and promotes patient-centered care.

What are the key skills and qualifications needed to thrive as a Senior RN Utilization Review Nurse, and why are they important?

To thrive as a Senior RN Utilization Review Nurse, you need a strong clinical nursing background, active RN licensure, and in-depth knowledge of medical necessity criteria and healthcare regulations. Familiarity with utilization review software, electronic health records (EHRs), and certifications like CCM (Certified Case Manager) or URAC are highly beneficial. Exceptional critical thinking, attention to detail, and effective communication skills distinguish top performers in this role. These skills ensure accurate case evaluations, compliance with regulations, and optimized patient care while controlling healthcare costs.
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What job categories do people searching Senior Rn Utilization Review Nurse jobs in Appleton, WI look for? The top searched job categories for Senior Rn Utilization Review Nurse jobs in Appleton, WI are:
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Senior Rn Utilization Review Nurse jobs near you

Registered Nurse (RN)

Eden Senior Care

Oshkosh, WI • On-site

$36 - $41/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 6 days ago

Job description

Edenbrook of Oshkosh is a skilled nursing facility located in Oshkosh, Wisconsin, as a part of the Eden Senior Care network. We are recruiting positive, happy, and reliable Full-time and Part-time Registered Nurses to join our team!

Eden Senior Care, founded in 2016, is a growing Healthcare Management company, focused on managing and operating Skilled Nursing, Rehabilitation and Assisted Living communities in Minnesota, Wisconsin, Illinois, Ohio, Pennsylvania, Indiana and Alabama. Our mission with each community is to support their success by providing strong leadership, corporate support, and the resources and tools to realize their goals. Edenbrook of Oshkosh promotes and encourages the success of each of its employees and values the individual experience of its guests and their families.

Reason's to join Edenbrook Oshkosh

  • $10,000 Sign-on bonus for Full time. Prorated for part-time
  • $5,250 in yearly Tuition Reimbursement/Student Loan Repayment.
  • Employee referral bonuses.
Job Responsibilities:

  • To provide planning and delivery of direct and indirect patient care through the nursing process of assessment, planning, prevention, and evaluation.
  • Direct the day-to-day activities of the Nursing Assistants.
  • Prepare and administer medications as ordered by physician and perform other drug administration.
  • Communicate changes in patient clinical condition with physician, nursing supervisor and family.
  • Complete required record keeping upon residents' admission, discharge, transfer; chart and document per facility policy.
Qualifications:

You love working with people and handle everyday challenges with a smile!

  • Graduate or future graduate from an accredited nursing program.
  • Hold a Current State License as a Registered Nurse.
  • Ability to communicate well in both verbal and written forms.
  • Are committed to interacting professionally, and with care, toward residents, families, and other staff.
Benefits:

  • Health, Dental, and Vision benefits
  • Vacation/Holiday/Sick time
  • Tuition & Continuing Education Reimbursement Program
  • 401k with company match
  • Shift Differentials
  • Referral Bonus
We would be happy to discuss your compensation further during the Interview!

We look forward to talking with you about your passion for providing excellent care to all our guests, and the many career growth opportunities that our facility provides.

If you are chosen, you will add your name to the list of employees working together to deliver an exciting new standard of service.

Please inquire today for specific shift openings and more information.

*We are an equal opportunity employer and value diversity. All employment is decided on the basis of qualifications, merit and business need.