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Trainee Rn Utilization Review Nurse Jobs (NOW HIRING)

Bracane Co

Utilization Review Nurse

Plano, TX · Remote

Austin area - Travis/Williamson Counties or Richardson area - Dallas/Collin Counties*** RN working ... This position is responsible for performing initial, concurrent review activities; discharge care ...

US Tech Solutions

Utilization Review Nurse

Chicago, IL · On-site

Active and unrestricted RN licensure in state of residence Questionnaire: * Do you have experience ... Do you have experience with Utilization Review? * Do you have an Active Registered Nurse License?

Magnet Medical

RN - Utilization Review

Kinston, NC · On-site

$28/hr

Travel Nursing Position Nursing Profession: RN Specialty: Utilization Review Pay Rate: $28 Shift Details: 8 hour days Job Order Details: Start Date: 07/06/2026 End Date: 10/05/2026 Duration: 13 Week ...

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Trainee Rn Utilization Review Nurse information

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$39K

$89.5K

$163K

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

As of Jun 29, 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
Registered Nurse, Utilization Review

Registered Nurse, Utilization Review

Nascentia Health

Syracuse, NY • On-site

$72K - $83K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 6 days ago

Key responsibilities

  • Assist with the review of member usage patterns for medical necessity and appropriateness.

  • Perform continuing review of medical records and supporting documentation for medical necessity.

  • Track and analyze service utilization patterns and compare to regional benchmarks.

Nascentia Health rating

7.3

Company rating: 7.3 out of 10

Based on 9 frontline employees who took The Breakroom Quiz

Job description

The Utilization Review Nurse assists the utilization review process taking on various tasks including data collection of demographic, claim and medical information; analysis; and outcomes reporting. Utilizes standards of care, evidence based practices, Medicare and Medicaid and organizational coverage guidelines to assure members receive high quality, cost efficient health care and services to meet their long term home and community based needs. Performs utilization review in accordance with all state mandated regulations.
Performance Responsibilities and Standards:
  1. Assist with the review of member usage patterns for medical necessity and appropriateness.
  2. Performs continuing review of medical records and supporting documentation for medical necessity where appropriate.
  3. Tracks and analyzes service utilization patterns monthly and compares to regional benchmarks
  4. Reviews appeals and provides notice of determination.
  5. Receives and responds to Office of Temporary and Disability Assistance (OTDA) notifications of Fair Hearings
  6. Prepares for and attends Fair Hearings.
  7. Assist with the development of coverage policy guidelines for MLTC services.
  8. Participates in interdisciplinary collaboration with professional staff.
  9. Creates and facilitates educational programs.
  10. Identifies and collaborates with UR Manager on individual cases
  11. Identifies and collaborates with UR Manager on trends in usage patterns.
  12. Process Notice of Action letters
  13. Performs concurrent, prior service authorizations and retrospective reviews
  14. Analyze per member per month (PMPM) data
  15. Other duties as assigned

Job Qualifications:
  1. Current NYS RN licensure, BSN preferred.
  2. Five or more years of home health care or long term care experience strongly preferred.
  3. Three or more years of utilization management or quality improvement experience preferred.

Professional competencies, skills and abilities:
  1. Excellent relationship management skills
  2. Demonstrated ability to problem solve complex, multifaceted situations
  3. Successfully manage conflict and negotiate a win win solution
  4. Strong organizational, prioritizing and delegation skills
  5. Abstract thinking
  6. Strong communication skills written and verbal
  7. Advocacy focused
  8. Ability to be non-judgmental
  9. Computer literacy with Microsoft office products

Physical Requirements:
  1. Speech, visual, and hearing ability sufficient to express and comprehend written and verbal communication
  2. Ability to sit 90% of the day
  3. Frequent sitting, standing, walking
  4. Pushing, pulling, reaching, kneeling
  5. Bloodborne Pathogens Exposure Determination Category: Category III

Compensation & Benefits:
Competitive Salary [This position is an S03 exempt position with a min-max rate of: $72,415-$83,922/annually] with:
  • 401K with generous Employer match
  • Medical, Dental, Vision plans
  • Tuition Reimbursement for BSN after 6 months of employment
  • Exceptional work/life balance - no rotating shifts
  • Partially funded HSA
  • Employee Recognition Platform
  • Paid Time Off, Holidays, and Extended Sick Leave
  • Short/Long term Disability
  • Employee Assistance Program (EAP)
  • Much More!!

About Nascentia Health:
Nascentia Health is leading the way in home care, post acute care and long-term community health. A healthcare system without walls, Nascentia is an innovator in the concept of healthcare, truly focused on the patient as a whole. By serving people in their homes, Nascentia Health is able to provide true holistic care. We can address immediate needs, help support positive long term medical and lifestyle choices that provide for better outcomes, leverage cutting edge in-home care technologies, and help avoid unnecessary visits to busy healthcare facilities.
Our employees are our greatest asset. They work hard every day to make our system amazing and are dedicated to our mission of being the premier home and community-based care system for the regions we serve. We want everyone to love what they do, be excited about coming to work, and take pride in being part of our team.
Nascentia Health is an Equal Opportunity Employer (EOE)
Employment is contingent upon negative results of a pre-hire drug screen

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