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Trainee Rn Utilization Review Nurse Jobs (NOW HIRING)

Seh

Summary The Utilization Review Nurse screens medical records in accordance with contractual ... Current Registered Nurse license in the State of Alabama Minimum Education Preferred * Bachelor ...

Southeast Health

Utilization Review Nurse

Dothan, AL · On-site

Summary The Utilization Review Nurse screens medical records in accordance with contractual ... Current Registered Nurse license in the State of Alabama Minimum Education Preferred * Bachelor ...

Houston Methodist

At Houston Methodist, the Utilization Review Nurse (URN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and concurrent medical record review for medical ...

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$39K

$89.5K

$163K

How much do trainee rn utilization review nurse jobs pay per year?

As of Jul 22, 2026, the average yearly pay for trainee rn utilization review nurse in the United States is $89,483.00, according to ZipRecruiter salary data. Most workers in this role earn between $64,500.00 and $104,500.00 per year, depending on experience, location, and employer.

What is the difference between Trainee Rn Utilization Review Nurse vs Registered Nurse in Utilization Review?

AspectTrainee Rn Utilization Review NurseRegistered Nurse in Utilization Review
CredentialsLicensed RN, in training or early in careerLicensed RN with experience in utilization review
Work EnvironmentSupervised training setting, often in healthcare or insurance companiesIndependent review, case analysis, and decision-making in healthcare or insurance
Job ResponsibilitiesAssisting with reviews, learning policies, supporting senior staffConducting utilization reviews, making coverage decisions, ensuring compliance

The main difference is that the Trainee Rn Utilization Review Nurse is in training and gaining experience, while the Registered Nurse in Utilization Review is a fully qualified professional responsible for independent review and decision-making. The trainee role focuses on learning, whereas the registered nurse role involves applying expertise to evaluate patient care and insurance coverage.

What cities are hiring for Trainee Rn Utilization Review Nurse jobs? Cities with the most Trainee Rn Utilization Review Nurse job openings:
What are the most commonly searched types of Rn Utilization Review Nurse jobs? The most popular types of Rn Utilization Review Nurse jobs are:
What states have the most Trainee Rn Utilization Review Nurse jobs? States with the most job openings for Trainee Rn Utilization Review Nurse jobs include:
Trainee Rn Utilization Review Nurse jobs near you
Utilization Review Nurse

Utilization Review Nurse

Seh

Full-time

Posted 12 days ago

Job description

Southeast. Always the right career direction.Job Description SummaryThe Utilization Review Nurse screens medical records in accordance with contractual agreement and regulatory requirements for medical necessity on admission and continued stay in the acute care setting. The Utilization Review case manager collaborates with all components of the healthcare system, managing appropriate use of acute care to aid in the achievement of quality outcomes, fiscal responsibility, and patient satisfaction.
Job Description

Essential Functions

  • Performs admissions and continued stay reviews of all inpatients and outpatient/observation patients in a bed; at times, this may be retrospective.
  • Performs precertification on procedures ordered while patients are hospitalized.
  • Issues required Medicare/Medicaid notifications of medical necessity changes to patients while hospitalized.
  • Issues notifications of non-coverage letters to patients if received during hospital stay.
  • Documents clear billing notes into the Electronic Medical Record (EMR) payer communications navigator to avoid billing denials.
  • Performs medical necessity denial appeals.
  • Maintains a close, collaborative relationship with the medical staff to promote continuity of care and avoid delays in service.
  • Performs other duties as requested by primary manager that do not compromise moral code of conduct or protocols set in place for patient or employee safety
Supervised Positions
  • None

Qualifications

Minimum Education Required
  • Associates degree in Nursing
  • Current Registered Nurse license in the State of Alabama
Minimum Education Preferred
  • Bachelor's degree or higher in Nursing
Minimum Experience Required
  • Two (2) years acute care experience
  • Must pass Blue Cross Blue Shield Iterator Reliability Test with 90% within six (6) months of hire
Minimum Experience Preferred
  • Three (3) years acute care experience
  • One (1) year utilization review experience

Required Knowledge/ Skills/ Abilities

  • Maintain current licensure in the State of Alabama
  • Demonstrates appropriate utilization of the skills of the Registered Nurse as approved by the Alabama Board of Nursing
  • Ability to quickly adapt to changing circumstances in fast-paced environment
  • Actively accepts, understands, and practices appropriate standards of nursing practice.
  • Must demonstrate basic knowledge of discharge planning needs
  • Demonstrates advanced computer skills (ability to generate reports, graph trends).
  • Clinical knowledge and experience in the care of patients with multiple and complex diagnoses, disease process, and care needs.
  • Ability to prioritize work and meet deadlines.
  • Ability to problem solve in a proactive, creative manner, using sound judgment based on factual information and clinical knowledge.
  • Ability to develop leadership skills and to serve as a role model for clinical staff.
  • Ability to lead and actively participate in multidisciplinary teams.
  • Ability to work independently within a team structure.
  • Demonstrates responsibility for educational requirements as evidenced by reading all assigned related references, and attending all required educational meetings, or webinars, and completing annual Symplr requirements.
  • Demonstrates commitment to organizations five (5) priorities and Six Ground Rules
  • Person in this position is required to understand, agree upon and follow our Six Ground Rules:
    • No excuses.
    • We are a team.
    • Bring up your ideas.
    • Poor performance will be addressed.
    • 'That's not my job' is not acceptable
    • Manage Up.

ShiftDayShift Details8:00 am - 4:30 pm
FTE1
TypeRegular
Join one of Forbes 500 best mid-sized employers in America.Equal Employment EmployerSoutheast Health is committed to provide equal employment opportunity (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law. In addition, Southeast Health will provide reasonable accommodations for qualified individuals with disabilities.

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