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Senior Rn Utilization Review Nurse Jobs in Appleton, WI

All One Staffing LLC

Registered Nurse RN

Appleton, WI · On-site

$50 - $51/hr

Currently looking for experienced Registered Nurses to fill full-time, part-time, and casual openings. Interested candidates should have an up to date TB and have reliable transportation.

All One Staffing LLC

Registered Nurse RN

Kimberly, WI · On-site

$50 - $51/hr

Currently looking for experienced Registered Nurses to fill full-time, part-time, and casual openings. Interested candidates should have an up to date TB and have reliable transportation.

Carepros, LLC

Registered Nurse

Appleton, WI · On-site

The plan shall be based on the RN's visit to the Client's home and shall include: • Review and interpretation of the physician's orders. • Frequency and anticipated duration of service. • ...

Carepros, LLC

Registered Nurse

Appleton, WI

The plan shall be based on the RN's visit to the Client's home and shall include: · Review and interpretation of the physician's orders. · Frequency and anticipated duration of service. · ...

Carepros, LLC

Registered Nurse

Appleton, WI

The plan shall be based on the RN's visit to the Client's home and shall include: · Review and interpretation of the physician's orders. · Frequency and anticipated duration of service. · ...

TEEMA

Registered Nurse (RN)

Oshkosh, WI · On-site

Registered Nurse (RN) Job ID: 88902 Location: Oshkosh, Wisconsin Overview: We are seeking a compassionate, experienced Registered Nurse (RN) to provide comprehensive nursing care within a ...

Eden Senior Care

Director of Wellness RN / LPN

Oshkosh, WI · On-site

$80K - $90K/yr

Eden Vista Oshkosh , a proud member of Vista Senior Living , is seeking a compassionate and driven Director of Wellness RN / LPN to lead our clinical team and help create an exceptional experience ...

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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 7, 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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Senior Rn Utilization Review Nurse jobs near you

Registered Nurse RN

All One Staffing LLC

Clintonville, WI • On-site

$50 - $51/hr

Full-time, Part-time

Re-posted 18 days ago

Job description

Clintonville, WIMake Your Own Schedule, Weekly Pay, and Never Mandated.Currently looking for experienced Registered Nurses to fill full-time, part-time, and casual openings. Interested candidates should have an up to date TB and have reliable transportation.Responsibilities of the Registered Nurse/RN Staff Nurse Identify patient care requirements by establishing personal rapport with potential and actual patients and other persons in a position to understand care requirements.Establish a compassionate environment by providing emotional, psychological, and spiritual support to patients, friends, and families.Promote patient's independence by establishing patient care goals; teaching patient, friends, and family to understand condition, medications, and self-care skills; answering questions.Assure quality of care by adhering to therapeutic standards; measuring health outcomes against patient care goals and standards; making or recommending necessary adjustments; following hospital and nursing division's philosophies and standards of care set by state board of nursing, state nurse practice act, and other governing agency regulations.Resolve patient problems and needs by utilizing multidisciplinary team strategies.Maintain safe and clean working environment by complying with procedures, rules, and regulations; calling for assistance from health care support personnel. Requirements of the Registered Nurse/RN Staff NurseCurrent TB Skin testCurrent CPR certificationBachelor's of Nursing from an accredited nursing facilityCurrent compact state Registered Nurse licenseAt least 1 year of healthcare experience Compensation for the Registered Nurse/RN Staff Nurse