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Temporary Utilization Review Nurse Jobs in Appleton, WI

GQR Global Markets

RN Case Manager

Appleton, WI · On-site

$1.8K - $1.9K/wk

  • Medical

  • Dental

  • Vision

Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location: Appleton, Wisconsin Start Date: August 23, 2026 Profession: Registered Nurse (RN) Facility: Estimated Pay: $1847 ...

New

Eden Senior Care

MDS Coordinator

Oshkosh, WI · On-site

$80K - $90K/yr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

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 ...

Interim HealthCare

Registered Nurse (RN)

Menasha, WI · On-site

$35 - $40/hr

Per diem, block schedule, contract, temp-to-hire and direct-hire positions * Online training ... Review, interpret, transcribe and carry out physician orders for patients * Administer medication ...

Network Health WI

RN Care Manager

Menasha, WI · On-site +1

Review results from medical or behavioral tests and procedures and updates care plan to reflect ... Previous experience in case management, utilization management, insurance, or managed care ...

Network Health

RN Care Manager

Menasha, WI · On-site

Review results from medical or behavioral tests and procedures and updates care plan to reflect ... Previous experience in case management, utilization management, insurance, or managed care ...

Network Health, Inc

RN Care Manager

Menasha, WI · Remote

Review results from medical or behavioral tests and procedures and updates care plan to reflect ... Previous experience in case management, utilization management, insurance, or managed care ...

Network Health

RN Care Manager

Menasha, WI · Remote

Review results from medical or behavioral tests and procedures and updates care plan to reflect ... Previous experience in case management, utilization management, insurance, or managed care ...

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All JobsUtilization Review Nurse JobsTemporary Utilization Review Nurse JobsTemporary Utilization Review Nurse Jobs in Appleton, WI

Temporary Utilization Review Nurse information

See Appleton, WI salary details

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$41

$67

How much do temporary utilization review nurse jobs pay per hour?

As of Aug 18, 2026, the average hourly pay for temporary 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 a temporary utilization review nurse?

A Temporary Utilization Review Nurse is a registered nurse hired on a short-term basis to assess the medical necessity, appropriateness, and efficiency of healthcare services provided to patients. They review patient records, treatment plans, and insurance coverage to ensure that care meets established guidelines and is cost-effective. These nurses often work with hospitals, insurance companies, or healthcare agencies, typically filling in for permanent staff or handling increased workloads. Their goal is to promote quality care while managing healthcare resources responsibly.

How does a temporary utilization review nurse typically collaborate with other healthcare professionals to ensure proper patient care?

A Temporary Utilization Review Nurse works closely with physicians, case managers, and insurance representatives to review patient records and determine the medical necessity of treatments and services. This collaboration often involves attending interdisciplinary meetings, clarifying clinical information, and providing recommendations for care plans. The role requires effective communication skills to facilitate timely approvals and prevent unnecessary delays in patient care, all while maintaining compliance with regulatory standards. Working as part of a team, the nurse helps bridge the gap between clinical staff and administrative requirements, ensuring optimal outcomes for both patients and the organization.

What are the key skills and qualifications needed to thrive as a temporary utilization review nurse, and why are they important?

To thrive as a Temporary Utilization Review Nurse, you need a registered nursing license, strong clinical judgment, and experience in patient care or case management. Familiarity with utilization review software, electronic health records (EHRs), and knowledge of insurance regulations and medical necessity criteria are typically required. Outstanding analytical thinking, attention to detail, and effective communication skills set individuals apart in this position. These skills ensure accurate evaluation of care appropriateness, support compliance, and facilitate collaboration with healthcare providers for optimal patient outcomes.

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

AspectTemporary Utilization Review NurseCase Manager
CredentialsRN license, certification in utilization review (e.g., CURN)RN license, case management certification (e.g., CCM)
Work EnvironmentHospitals, insurance companies, healthcare facilitiesHospitals, community health, insurance companies
Employer & IndustryHealthcare providers, insurance firmsHealthcare organizations, insurance providers
Primary FocusReview medical necessity and insurance coverageCoordinate patient care and discharge planning

While both roles require nursing credentials and involve patient-related assessments, the Temporary Utilization Review Nurse primarily focuses on evaluating medical necessity for insurance purposes, whereas the Case Manager concentrates on coordinating patient care and discharge planning. Understanding these differences helps healthcare professionals and employers select the right role for their needs.

How to get into utilization review as a temporary utilization review nurse?

To become a temporary utilization review nurse, candidates typically need a registered nurse (RN) license and experience in case management or clinical review. Gaining knowledge of insurance policies, medical coding, and utilization review processes, along with familiarity with electronic health records (EHR) systems, can improve job prospects. Temporary roles often require flexibility and the ability to adapt to different healthcare settings or insurance companies.

What are the most commonly searched types of Utilization Review Nurse jobs in Appleton, WI?

The most popular types of Utilization Review Nurse jobs in Appleton, WI are:

What are popular job titles related to Temporary Utilization Review Nurse jobs in Appleton, WI?

For Temporary Utilization Review Nurse jobs in Appleton, WI, the most frequently searched job titles are:

What job categories do people searching Temporary Utilization Review Nurse jobs in Appleton, WI look for?

The top searched job categories for Temporary Utilization Review Nurse jobs in Appleton, WI are:

What cities near Appleton, WI are hiring for Temporary Utilization Review Nurse jobs?

Cities near Appleton, WI with the most Temporary Utilization Review Nurse job openings:

Temporary Utilization Review Nurse jobs near you
Infographic showing various Temporary Utilization Review Nurse job openings in Appleton, WI as of August 2026, with employment types broken down into 1% As Needed, 83% Full Time, 13% Part Time, and 3% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $85,812 per year, or $41.3 per hour.

RN Coordinator Utilization Management

Network Health, Inc

Menasha, WI

Full-time

Re-posted 14 days ago

Job description

The RN Coordinator Utilization Management to review submitted authorization requests for medical necessity, appropriateness of care and benefit eligibility. This position reviews applicable guidelines regarding payment and coverage, and makes determinations for authorization/payment.

Location: Candidates must reside in the state of Wisconsin for consideration. This position is eligible to work at your home office (reliable internet is required). Travel to the corporate office in Menasha is required occasionally for the position, including on first day. Training is required in person at our Menasha location for the first 6-8 weeks.

Hours: 1.0 FTE, 40 hours per week, 8am - 5pm Monday through Friday

Check out our 2025 Community Report to learn a little more about the difference our employees make in the communities we live and work in. As an employee, you will have the opportunity to work hard and have fun while getting paid to volunteer in your local neighborhood. You too, can be part of the team and making a difference. Apply to this position to learn more about our team.

Job Responsibilities:

  • Evaluate and process prior authorization requests/referrals submitted from contracted and non-contracted providers
  • Follow Network Health process, policies, and procedures in authorization review of all membership on a pre-service, concurrent and post-service basis. This process includes verifying eligibility and benefits, as well as documenting all utilization management communication
  • Provide education regarding utilization management activities and processes to members, caregivers, providers, and their administrative staff
  • Participate in Utilization Management auditing (i.e. Utilization Management Inter-reviewer reliability and denial files)
  • Refer all members with complex health problems and needs to Network Health Case Management to reduce medical costs while providing a higher quality of life and an ability to take charge of their diseases. This requires an extensive holistic approach to care management assessment
  • Collaborate with other NH departments to develop interdepartmental operational processes
  • Support Utilization Management department programs and goals through active participation
  • Identify and screen candidates for Case Management intervention and determines appropriate level of care from Utilization Management criteria
  • Complete assessments and plans of care including need for medication regime, treatment plans, practitioner follow-up appointments, knowledge of red flags, disease management, Advance Directives, life planning, and self-management of illness to the best of member ability
  • Evaluate cases for cost savings/quality improvement potential
  • Other duties and responsibilities as assigned

Job Requirements:

  • Bachelor of Science in Nursing, preferred
  • Associate Degree in Nursing, required
  • Current registered nurse licensure in Wisconsin required
  • Minimum of four (4) years clinical health care experience as a Registered Nurse (RN) required
  • Experience in insurance, managed care and utilization management preferred

Network Health is an Equal Opportunity Employer

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