... and Utilization Review/PPS. * Meets with committee members to evaluate activities within the ... Director of Nursing (DON) * A minimum of 2-3 years' management experience * A team player with ...
Quick apply
... and Utilization Review/PPS. * Meets with committee members to evaluate activities within the ... Director of Nursing (DON) * A minimum of 2-3 years' management experience * A team player with ...
Quick apply
... and Utilization Review/PPS. * Meets with committee members to evaluate activities within the ... Director of Nursing (DON) * A minimum of 2-3 years' management experience * A team player with ...
As a Registered Nurse Clinical Manager, you will: * Oversee clinical operations for the location ... Conduct ongoing staff education based on documentation review, utilization review findings, and ...
As a Registered Nurse Clinical Manager, you will: * Oversee clinical operations for the location ... Conduct ongoing staff education based on documentation review, utilization review findings, and ...
... audits, utilization review, performance improvement, in services, workshops, and seminars ... Strives to improve nursing care through continuing education, attendance at workshops and ...
... audits, utilization review, performance improvement, in services, workshops, and seminars ... Strives to improve nursing care through continuing education, attendance at workshops and ...
As a Registered Nurse Clinical Manager , you will: * Oversee clinical operations for the location ... Conduct ongoing staff education based on documentation review, utilization review findings, and ...
As a Registered Nurse Clinical Manager , you will: * Oversee clinical operations for the location ... Conduct ongoing staff education based on documentation review, utilization review findings, and ...
As a Registered Nurse Clinical Manager , you will: * Oversee clinical operations for the location ... Conduct ongoing staff education based on documentation review, utilization review findings, and ...
As a Registered Nurse Clinical Manager , you will: * Oversee clinical operations for the location ... Conduct ongoing staff education based on documentation review, utilization review findings, and ...
As a Registered Nurse Clinical Manager , you will: * Oversee clinical operations for the location ... Conduct ongoing staff education based on documentation review, utilization review findings, and ...
As a Registered Nurse Clinical Manager , you will: * Oversee clinical operations for the location ... Conduct ongoing staff education based on documentation review, utilization review findings, and ...
As a Registered Nurse Clinical Manager , you will: * Oversee clinical operations for the location ... Conduct ongoing staff education based on documentation review, utilization review findings, and ...
As a Registered Nurse Clinical Manager , you will: * Oversee clinical operations for the location ... Conduct ongoing staff education based on documentation review, utilization review findings, and ...
Racine, WI · On-site
As a Registered Nurse Clinical Manager , you will: * Oversee clinical operations for the location ... Conduct ongoing staff education based on documentation review, utilization review findings, and ...
Racine, WI · On-site
As a Registered Nurse Clinical Manager , you will: * Oversee clinical operations for the location ... Conduct ongoing staff education based on documentation review, utilization review findings, and ...
Racine, WI · On-site
As a Registered Nurse Clinical Manager , you will: * Oversee clinical operations for the location ... Conduct ongoing staff education based on documentation review, utilization review findings, and ...
Racine, WI · On-site
As a Registered Nurse Clinical Manager , you will: * Oversee clinical operations for the location ... Conduct ongoing staff education based on documentation review, utilization review findings, and ...
As a Registered Nurse Clinical Manager , you will: * Oversee clinical operations for the location ... Conduct ongoing staff education based on documentation review, utilization review findings, and ...
As a Registered Nurse Clinical Manager , you will: * Oversee clinical operations for the location ... Conduct ongoing staff education based on documentation review, utilization review findings, and ...
... nursing, mental health, administrative, and security teams * Participate in quality assurance, peer review, and performance improvement activities * Address clinical risk management, utilization ...
... nursing, mental health, administrative, and security teams * Participate in quality assurance, peer review, and performance improvement activities * Address clinical risk management, utilization ...
Milwaukee, WI · On-site
$155/hr
... nursing, mental health, administrative, and security teams * Participate in quality assurance, peer review, and performance improvement activities * Address clinical risk management, utilization ...
Milwaukee, WI · On-site
$155/hr
... nursing, mental health, administrative, and security teams * Participate in quality assurance, peer review, and performance improvement activities * Address clinical risk management, utilization ...
Milwaukee, WI · On-site
$155/hr
... nursing, mental health, administrative, and security teams * Participate in quality assurance, peer review, and performance improvement activities * Address clinical risk management, utilization ...
New
Milwaukee, WI · On-site
$155/hr
... nursing, mental health, administrative, and security teams * Participate in quality assurance, peer review, and performance improvement activities * Address clinical risk management, utilization ...
New
Kenosha, WI · On-site +1
$90K/yr
As a registered nurse with an Illinois nursing license, you will work remotely to enhance the ... Knowledge of utilization review, quality improvement, managed care, and/or community health.
Kenosha, WI · On-site +1
$90K/yr
As a registered nurse with an Illinois nursing license, you will work remotely to enhance the ... Knowledge of utilization review, quality improvement, managed care, and/or community health.
Kenosha, WI · On-site
$90K/yr
As a registered nurse with an Illinois nursing license, you will work remotely to enhance the ... Knowledge of utilization review, quality improvement, managed care, and/or community health.
Kenosha, WI · On-site
$90K/yr
As a registered nurse with an Illinois nursing license, you will work remotely to enhance the ... Knowledge of utilization review, quality improvement, managed care, and/or community health.
Kenosha, WI · On-site
$90K/yr
As a registered nurse with an Illinois nursing license, you will work remotely to enhance the ... Knowledge of utilization review, quality improvement, managed care, and/or community health.
Kenosha, WI · On-site
$90K/yr
As a registered nurse with an Illinois nursing license, you will work remotely to enhance the ... Knowledge of utilization review, quality improvement, managed care, and/or community health.
As a registered nurse with an Illinois nursing license, you will work remotely to enhance the ... Knowledge of utilization review, quality improvement, managed care, and/or community health.
As a registered nurse with an Illinois nursing license, you will work remotely to enhance the ... Knowledge of utilization review, quality improvement, managed care, and/or community health.
Pleasant Prairie, WI · On-site
$51.50/hr
Provides medication order verification and clinical services to the nursing staff, physicians, and ... and drug utilization review. * Demonstrates the ability to access, enter and adjust patient ...
Pleasant Prairie, WI · On-site
$51.50/hr
Provides medication order verification and clinical services to the nursing staff, physicians, and ... and drug utilization review. * Demonstrates the ability to access, enter and adjust patient ...
Pleasant Prairie, WI · On-site
$33.50 - $52.50/hr
Registered Nurse - Critical Care Unit/ intensive care (RN) (ICU) Job Duties: Coordinates and administers medical and nursing care to patients utilizing the nursing process which involves: an ...
Pleasant Prairie, WI · On-site
$33.50 - $52.50/hr
Registered Nurse - Critical Care Unit/ intensive care (RN) (ICU) Job Duties: Coordinates and administers medical and nursing care to patients utilizing the nursing process which involves: an ...
Pleasant Prairie, WI · On-site
$51.50/hr
Provides medication order verification and clinical services to the nursing staff, physicians, and ... and drug utilization review. * Demonstrates the ability to access, enter and adjust patient ...
Pleasant Prairie, WI · On-site
$51.50/hr
Provides medication order verification and clinical services to the nursing staff, physicians, and ... and drug utilization review. * Demonstrates the ability to access, enter and adjust patient ...
$20.06 - $24.12
2% of jobs
$24.12 - $28.18
9% of jobs
$30.95 is the 25th percentile. Wages below this are outliers.
$28.18 - $32.23
21% of jobs
The median wage is $35.52 / hr.
$32.23 - $36.29
23% of jobs
$36.29 - $40.35
13% of jobs
$43.50 is the 75th percentile. Wages above this are outliers.
$40.35 - $44.40
10% of jobs
$44.40 - $48.46
8% of jobs
$48.46 - $52.52
5% of jobs
$52.52 - $56.58
5% of jobs
$56.58 - $60.63
2% of jobs
$60.63 - $64.69
2% of jobs
$20
$39
$64
A utilization review nurse determines the best course of treatment for a patient using preapproved policy criteria. Utilization review nurses collect and review patient records, clinical documentation, and billing information to recommend the best use of patient care resources. Their assessments help determine the length of hospital stays, the effectiveness of the care plan, and the necessity of the services administered. Utilization review nurses inform and educate patients about their options based on their insurance benefits and limitations. Utilization review nurses also assess patient care services in clinical appeals for approval or denial.
| Aspect | Utilization Review Nurse | Case Manager |
|---|---|---|
| Credentials | RN license, certification in utilization review (e.g., URAC) | RN license, case management certification (e.g., CCM) |
| Work Environment | Hospitals, insurance companies, healthcare facilities | Hospitals, insurance companies, community health settings |
| Employer & Industry Usage | Primarily in insurance and healthcare organizations for reviewing medical necessity | In healthcare and insurance for coordinating patient care and discharge planning |
Utilization Review Nurses focus on evaluating the necessity and appropriateness of medical services, often working in insurance or healthcare settings. Case Managers coordinate patient care, discharge planning, and resource management. While both roles require RN licensure and related certifications, their primary responsibilities differ: UR Nurses review medical necessity, whereas Case Managers facilitate patient care and services.
For Utilization Review Nurse jobs in Racine, WI, the most frequently searched job titles are:
The top searched job categories for Utilization Review Nurse jobs in Racine, WI are:
Cities near Racine, WI with the most Utilization Review Nurse job openings:

Full-time
Medical, Retirement, PTO
Re-posted 16 days ago
UNDER NEW OWNERSHIP
Benefits of (Director of Nursing) DON position:
Milwaukee Nursing and Rehab makes it top priority to care for seniors with the respect, compassion, and dignity they deserve. We understand that caring is what makes a community and without a sense of caring, there can be no sense of community. It is what sets us apart from any other Skilled Nursing Facility.
At Milwaukee Nursing and Rehab, our nursing staff are overly courteous, respectful and always maintain a high level of professionalism. Our primary goal is to get you back in a condition to be independent once again while maintaining a friendly environment and providing nutritionally enhanced meals.
We are looking for a Director of Nursing (DON) to care for our patients and facilitate their speedy recovery. You will also be responsible for educating them and their families on prevention and healthy habits. The ideal candidate will be a responsible and well-trained professional able to give the best nursing care with little supervision. You will be able to follow health and safety guidelines faithfully and consistently. The goal is to-promote patient’s being-by providing high quality nursing care.
Responsibilities: Director of Nursing (DON)
Requirements: Director of Nursing (DON)
Apply now to join our team as a DON and help make a real difference! Walk-ins welcome.