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Senior Rn Utilization Review Nurse Jobs in Raleigh, NC

Senior Helpers

Registered Nurse - PRN

Holly Springs, NC · On-site

$33 - $38/hr

Registered Nurse - PRN / As Needed | Senior Helpers of Holly Springs • $33-$38/hr Your license. Your schedule. Your terms. If you're an RN who wants meaningful clinical work without the grind of a ...

Granville Health System

LPN/ RN

Oxford, NC · On-site

$25 - $34/hr

... utilization of the nursing process in collaboration with other health team members. The LPN or RN ... will be responsible for meeting the standards required by JCAHO, GHS, and other regulating agencies ...

Granville Health System

LPN/ RN

Oxford, NC · On-site

$25 - $34/hr

... utilization of the nursing process in collaboration with other health team members. The LPN or RN ... will be responsible for meeting the standards required by JCAHO, GHS, and other regulating agencies ...

Granville Health System

LPN/ RN

Oxford, NC · On-site

$25 - $34/hr

... utilization of the nursing process in collaboration with other health team members. The LPN or RN ... will be responsible for meeting the standards required by JCAHO, GHS, and other regulating agencies ...

IVX Health

Infusion Registered Nurse (RN)

Raleigh, NC · On-site

As a Registered Nurse at IVX Health, you'll be at the forefront of delivering personalized ... review nursing documentation, and uphold HIPAA and OSHA standards. * Optimize Clinical Workflows ...

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Senior Rn Utilization Review Nurse information

See Raleigh, NC salary details

$20

$41

$67

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

As of Jul 2, 2026, the average hourly pay for senior rn utilization review nurse in Raleigh, NC is $41.10, according to ZipRecruiter salary data. Most workers in this role earn between $32.50 and $47.21 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.

Can I make $500,000 as a nurse?

Senior Rn Utilization Review Nurses typically earn salaries ranging from $80,000 to $120,000 annually, depending on experience, location, and employer. Earning $500,000 is uncommon in this role and usually requires additional responsibilities, bonuses, or working in high-paying regions or specialized settings.

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.

How to make 150,000 as a nurse?

Senior Rn Utilization Review Nurses can earn $150,000 by gaining extensive experience, obtaining advanced certifications such as CCM or ANCC, and working in high-paying settings like hospitals or insurance companies. Increasing responsibilities, working overtime, or taking on leadership roles can also boost income in this field.

What are some typical challenges faced by Senior RN Utilization Review Nurses 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.

How to make $200,000 a year as a nurse?

Senior Rn Utilization Review Nurses can reach a $200,000 annual salary by gaining extensive experience, obtaining advanced certifications, and working in high-paying settings such as insurance companies or specialty healthcare organizations. Developing expertise in case management, health policy, and utilizing clinical judgment can also increase earning potential, often supplemented by overtime or leadership roles.

How to get into utilization review as a nurse?

To become a utilization review nurse, typically a registered nurse (RN) must have clinical experience and obtain knowledge of insurance policies and healthcare regulations. Certification in case management or utilization review, such as the Certified Case Manager (CCM) credential, can enhance job prospects. Strong analytical skills, attention to detail, and familiarity with electronic health records (EHR) systems are also important for this role.
What are the most commonly searched types of Rn Utilization Review Nurse jobs in Raleigh, NC? The most popular types of Rn Utilization Review Nurse jobs in Raleigh, NC are:
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What job categories do people searching Senior Rn Utilization Review Nurse jobs in Raleigh, NC look for? The top searched job categories for Senior Rn Utilization Review Nurse jobs in Raleigh, NC are:
What cities near Raleigh, NC are hiring for Senior Rn Utilization Review Nurse jobs? Cities near Raleigh, NC with the most Senior Rn Utilization Review Nurse job openings:
Senior Rn Utilization Review Nurse jobs near you
Infusion Registered Nurse (RN)

Infusion Registered Nurse (RN)

IVX Health

Durham, NC

Other

PTO

Posted 2 days ago

IVX Health rating

5.7

Company rating: 5.7 out of 10

Based on 6 frontline employees who took The Breakroom Quiz

Job description

Join IVX Health as a Full-time Registered Nurse!

Shift will be Tuesday - Friday, 7am - 7pm, rotating Saturdays 8am - 5pm

Join a team that's redefining infusion care and creating exceptional patient experiences.

Are you a skilled and compassionate Registered Nurse (RN) looking for an opportunity to make a meaningful impact in patient-centered infusion care? IVX Health is seeking an RN to provide high-quality, specialized infusion therapy in an outpatient setting. As a Registered Nurse at IVX Health, you'll be at the forefront of delivering personalized, compassionate care to our patients. With your expertise in infusion therapy, you'll administer treatments, monitor patient responses, and collaborate with a multi-disciplinary team to ensure the highest standard of care. Every treatment you deliver will help improve patients' lives and provide them with the support they need.

Why Join IVX Health

  • Make a Meaningful Impact - Deliver high-quality care that directly improves patients' lives and supports their families.
  • Collaborative & Supportive Team - Work alongside a dedicated, multidisciplinary team in a positive and patient-focused environment.
  • Grow Your Career - Access Continuing Education Units (CEUs), tuition reimbursement, and professional development opportunities. We cover the cost of CRNI (Certified Registered Nurse Infusion) and ONCC (Oncology Nursing Certification Corporation) certifications to support your career advancement.
  • Advanced Clinical Training - Receive ultrasound IV skills training to enhance your expertise in infusion therapy.
  • Prioritize Work-Life Balance - Enjoy flexible scheduling, ample PTO, and the ability to truly disconnect and recharge during holidays.
  • Innovative Outpatient Care - Be part of a cutting-edge healthcare model that prioritizes patient comfort, seamless care coordination, and specialized infusion therapies.

What You Will Do

  • Provide Direct Patient Care - Deliver on-site and virtual supervision while administering infusions and injections with precision.
  • Conduct Patient Assessments - Conduct patient assessments, document observations, and monitor treatment responses.
  • Educate and Support Patients - Guide patients and families through treatment expectations, potential side effects, and disease management.
  • Ensure Compliance and Quality - Maintain accurate records in the Electronic Health Record (EHR) system, review nursing documentation, and uphold HIPAA and OSHA standards.
  • Optimize Clinical Workflows - Assist with chart preparation and treatment planning to streamline patient visits.
  • Collaborate with Healthcare Teams - Work closely with referring providers and cross-functional teams to enhance care coordination.
  • Support Operations and Training - Assist in inventory management, prior authorizations, and regulatory adherence.
  • Flexibility and Adaptability - Work at multiple facilities within a designated market as needed.
  • Perform Additional Duties - Take on other responsibilities as assigned to support patient care and organizational objectives.

What We Are Looking For

  • Active and Unrestricted Registered Nurse (RN) license
  • Life Support Certifications - BLS certification required; PALS certification preferred.
  • Clinical Experience - Background in an ambulatory infusion center, outpatient specialty clinic, or similar setting is a plus.
  • Strong IV and Infusion Therapy Skills - Experience with specialty biologics, medication management, and emergency response protocols.
  • Proficiency in Clinical Documentation - Experience with EHR systems and a strong understanding of HIPAA and regulatory compliance.
  • Exceptional Communication & Collaboration - Ability to work effectively with patients, families, and multidisciplinary teams.

What IVX Health employees say

Pay

Hours and flexibility

Workplace

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