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How much do utilization review epic emr jobs pay per hour?

As of Jun 7, 2026, the average hourly pay for utilization review epic emr 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.

How much do utilization review nurses make in the US?

Utilization review nurses in the US typically earn between $65,000 and $85,000 annually, depending on experience, location, and certifications such as CCM or CPHQ. They review medical records and determine the necessity of treatments using electronic health records like Epic EMR, often working full-time in healthcare settings.

What are the key skills and qualifications needed to thrive as a Utilization Review Epic EMR Specialist, and why are they important?

To thrive as a Utilization Review Epic EMR Specialist, you need expertise in medical record review, knowledge of healthcare regulations, and a background in nursing or a related clinical field, often supported by a valid RN or healthcare degree. Proficiency with Epic EMR software, clinical documentation tools, and utilization review systems is crucial. Strong analytical thinking, attention to detail, and effective communication skills enable professionals to interpret clinical data and collaborate across teams. These skills ensure accurate case reviews, regulatory compliance, and optimized patient care processes.

What is the difference between Utilization Review Epic Emr vs Utilization Review Nurse?

AspectUtilization Review Epic EmrUtilization Review Nurse
CredentialsTypically requires RN license, Epic EMR trainingRN license, often with utilization review certification
Work EnvironmentUtilizes Epic EMR software in healthcare settingsPerforms reviews in clinical or administrative settings
Employer & IndustryHospitals, health systems using Epic EMRInsurance companies, healthcare organizations
Primary FocusManaging utilization data within Epic EMR systemAssessing medical necessity and reviewing patient cases

Utilization Review Epic Emr professionals focus on managing utilization data within the Epic EMR system, often requiring Epic training and technical skills. In contrast, Utilization Review Nurses perform clinical assessments and review patient cases to determine medical necessity, leveraging their nursing expertise. Both roles are essential in healthcare but differ in their primary functions and work environments.

How does a Utilization Review professional use Epic EMR to facilitate interdisciplinary collaboration?

Utilization Review professionals leverage Epic EMR to efficiently communicate with physicians, nurses, case managers, and other healthcare team members. By documenting reviews, recommendations, and authorization statuses directly in the EMR, they ensure transparent and timely information sharing, which is essential for coordinated patient care and discharge planning. This digital workflow helps minimize delays, supports compliance, and enhances overall patient outcomes by keeping all stakeholders informed and aligned throughout the review process.

What is a Utilization Review Epic EMR specialist?

A Utilization Review Epic EMR specialist is a healthcare professional who uses the Epic electronic medical record (EMR) system to review patient care and ensure that medical services are necessary and appropriate. They work with clinical teams to monitor documentation, compliance, and insurance requirements. Their primary goal is to optimize the use of healthcare resources while maintaining quality patient care, often interacting with insurance companies and regulatory agencies.
Infographic showing various Utilization Review Epic Emr job openings in the United States as of May 2026, with employment types broken down into 100% Full Time. Highlights an 50% In-person, and 50% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

RN - Utilization Review - Syracuse, NY - RNDS

NavitasPartners

Rochester, NY • On-site

$56.21 - $65/hr

Other

Posted 10 days ago

Job description

Job Title: RN - Utilization Review
Location: Syracuse, NY
Type: Contract | 14 Weeks
Shift & Schedule: Day Shift | Monday-Friday

Position Overview:
Navitas Healthcare, LLC is seeking RN - Utilization Review for an exciting Travel or Local job in Syracuse, NY.

Responsibilities

  • Perform utilization review and utilization management activities to ensure appropriate patient admissions and continued stays
  • Apply MCG and InterQual screening criteria to evaluate medical necessity and level of care
  • Review and analyze patient records to support appropriate hospital admissions and discharge planning
  • Collaborate with healthcare providers, payers, and regulatory agencies to ensure compliance with CMS guidelines and hospital policies
  • Communicate effectively with physicians, case management teams, and insurance companies regarding patient status and care decisions
  • Ensure proper documentation and compliance with hospital, state, and federal regulations
  • Identify and report cases of overutilization or underutilization of healthcare services
  • Support care coordination and assist in reducing avoidable hospital readmissions
  • Maintain confidentiality and adhere to professional nursing standards

Requirements

  • Active New York State RN License required
  • Current BLS Certification required
  • Minimum 1.5 years of recent acute care hospital experience within the last 2 years required
  • Strong understanding of Utilization Review, Utilization Management, or Case Management
  • Knowledge of CMS regulations and hospital admission criteria
  • Excellent communication and interpersonal skills

Preferred Qualifications

  • Experience with MCG or InterQual screening tools preferred
  • EPIC EMR experience preferred
  • Experience working with insurance payers and regulatory agencies preferred
  • Experience in large acute care hospitals or trauma centers preferred

For more details contact at hdavda@navitashealth.com or Call / Text at 516-862-1169.

About Navitas Healthcare, LLC: It is a Joint Commission Certified / WBENC and one of the fastest-growing healthcare staffing firms in the US providing Medical, Clinical and Non-Clinical services to numerous hospitals. We offer the most competitive pay for every position we cater. We understand this is a partnership. You will not be blindsided and your salary will be discussed upfront.

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