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Utilization Review Appeal Rn Jobs (NOW HIRING)

Orison

RN - Utilization Review

Elmhurst, NY · On-site

... appeals, and reconsiderations when applicable. * Ensure compliance with applicable healthcare ... Non-acute utilization review. Skills: RN,REGISTERED NURSE

Orison

RN - Utilization Review

Elmhurst, NY · On-site

... appeals, and reconsiderations when applicable. * Ensure compliance with applicable healthcare ... Non-acute utilization review. Skills: RN,REGISTERED NURSE

US Tech Solutions

Utilization Review Nurse

Canton, MA · On-site

$55 - $60/hr

... UM) Registered Nurse to support outpatient utilization review and prior authorization activities ... Participate in appeal reviews and provide clinical recommendations when appropriate. * Maintain ...

Schneck Medical Center

UTILIZATION REVIEW RN

Seymour, IN · On-site

Bachelors Degree in Nursing with case management certification LICENSE/CERTIFICATION Licensed RN in ... Denials Management and Appeals Equal Opportunity Employer This employer is required to notify all ...

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How much do utilization review appeal rn jobs pay per hour?

As of Sep 8, 2026, the average hourly pay for utilization review appeal rn 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.

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For Utilization Review Appeal Rn jobs, the most frequently searched job titles are:

Infographic showing various Utilization Review Appeal Rn job openings in the United States as of July 2026, with employment types broken down into 1% As Needed, 81% Full Time, 14% Part Time, 1% Temporary, and 3% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

RN Utilization Review - Patient & Family Services - Per Diem

Nashua, NH • On-site

SolutionHealth
Health Care and Social Assistance • 51 - 200 employees
Learn more about SolutionHealthexternal

Part-time

Medical, Dental, Vision, Life, Retirement

Re-posted 23 days ago

Job description

Come work at the best place to give and receive care!
Job Description:
This Role is On-Site
Who We Are:
Southern NH Medical Centers strives to keep patients on a continuous track to discharge and receive the continuity of care that our patients and their families need. Our Patient and Family Services Department is the driving force to assure communication, respect, and safety follows our patients throughout the admission phase, all the way through the discharge process. This department includes a dedicated team of Case Managers, Social Workers, and Interpreters that ensure that all care is equal, and our patient's dignity is maintained above all else.
About the Job:
The Utilization Review/Denial Specialist works with the care team to evaluate medical acuity for the appropriate level of care orders and documentation to facilitate insurance coverage, and proactively prevent denials. This specialist ensures level of care charges are applied accurately and meet compliance with CMS and commercial insurance guidelines as well as reviewing appeal options for medical necessity insurance denials
What You'll Do:
  • Assess acute medical necessity utilizing appropriate criteria.
  • Collect and trend Utilization Review data metrics.
  • Review appeal options for commercial insurance, RAC, and QIO medical necessity denials.
  • Understand and apply CMS Regulations to meet compliance

Who You Are:
  • Current NH Nursing License as a Registered Nurse.
    • ASN accepted; BSN required within 10 years of hire.
  • A minimum of 5-years' of experience as a Registered Nurse.
  • Experience in use of Interqual, Milliman or other Healthcare acute criteria preferred.

Why You'll Love Us:
  • Health, dental, prescription, and vision coverage for full-time & part-time employees
  • Short-term, long-term disability, life & pet insurance
  • Student Loan Forgiveness & Discounts
  • 403(b) Retirement savings plans
  • Continuous earned time accrual

& So much more!
Work Shift:
Per diem weekends and holiday. Other days available if staff have availability.
SolutionHealth is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, disability status, veteran status, or any other characteristic protected by law.

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