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Senior Rn Utilization Review Nurse Jobs (NOW HIRING)

Ascension

Registered Nurse Utilization Review

Baltimore, MD · On-site

$81K - $115K/yr

Utilization Management Schedule: Day-Shift | Full-Time | Monday-Friday 8:00AM-4:30PM Salary: $81 ... Registered Nurse credentialed from the Maryland Board of Nursing obtained prior to hire date or job ...

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Senior Rn Utilization Review Nurse information

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

As of Jul 21, 2026, the average hourly pay for senior 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 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.
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Senior Rn Utilization Review Nurse jobs near you
Infographic showing various Senior Rn Utilization Review Nurse job openings in the United States as of July 2026, with employment types broken down into 3% As Needed, 60% Full Time, 18% Part Time, and 19% Contract. Highlights an 99% Physical, and 1% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.
Registered Nurse - Utilization Review

Registered Nurse - Utilization Review

vTech Solution

Apple Valley, CA • On-site

Other

This job post has expired today. Applications are no longer accepted.

Job description

Weekend Requirements - UR RN 4 weekend shifts (days) in a six-week period but can be more Job Description • Start date: ASAP • Floating Expectation: No • Ratios: 1:40 • Years of experience REQ: 3-year acute medical Care Manager/UM experience performing utilization review in a hospital setting (not health plan/medical group) • First-timers accepted: Seasoned traveler is required Hardstop • Weekend REQ: minimum of 4 shift w/in a 6-week period • CA state license: Yes • Pending License accepted: Yes, but must be licensed upon start date • RTO Restrictions: No more than 7 days Hospital Highlights • Type of Facility: Acute Care Facility • Scrub Color: Business Attire

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About vTech Solution

Sourced by ZipRecruiter

vTech is a Managed IT Services firm based out of Washington DC with a primary focus on Cloud Computing and Managed Network Security.

Industry

It services

Company size

51 - 200 Employees

Headquarters location

Washington, DC, US

Year founded

2006

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