Participate in utilization review processes to evaluate the effectiveness of treatment plans ... Provide support in the training of nursing staff on best practices for wound management.
Participate in utilization review processes to evaluate the effectiveness of treatment plans ... Provide support in the training of nursing staff on best practices for wound management.
The Case Manager directs the utilization review of patient charts, treatment plans, and discharge planning pertaining to the quality of care and treatment criteria for patients in a specific ...
The Case Manager directs the utilization review of patient charts, treatment plans, and discharge planning pertaining to the quality of care and treatment criteria for patients in a specific ...
Participate in utilization review processes to evaluate the effectiveness of treatment plans ... Provide support in the training of nursing staff on best practices for wound management.
Participate in utilization review processes to evaluate the effectiveness of treatment plans ... Provide support in the training of nursing staff on best practices for wound management.
Participate in utilization review processes to evaluate the effectiveness of treatment plans ... Provide support in the training of nursing staff on best practices for wound management.
Participate in utilization review processes to evaluate the effectiveness of treatment plans ... Provide support in the training of nursing staff on best practices for wound management.
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
RN - Med Surg, PRN
Canton, MS · On-site
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
Quick apply
RN - Med Surg, PRN
Canton, MS · On-site
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
To act as liaison between Case Managers, Home Health nurses, Utilization Review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
To act as liaison between Case Managers, Home Health nurses, Utilization Review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
To act as liaison between Case Managers, Home Health nurses, Utilization Review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
To act as liaison between Case Managers, Home Health nurses, Utilization Review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
RN - Med Surg
Jackson, MS · On-site
To act as liaison between Case Managers, Home Health nurses, Utilization Review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
Quick apply
RN - Med Surg
Jackson, MS · On-site
To act as liaison between Case Managers, Home Health nurses, Utilization Review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
Quick apply
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
RN
Jackson, MS · On-site
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
Quick apply
RN
Jackson, MS · On-site
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
RN
Jackson, MS · On-site
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
RN
Jackson, MS · On-site
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
RN
Jackson, MS · On-site
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
Quick apply
RN
Jackson, MS · On-site
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
RN - Surgery, PRN
Canton, MS · On-site
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
Quick apply
RN - Surgery, PRN
Canton, MS · On-site
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
RN - ICU
Jackson, MS · On-site
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
Quick apply
RN - ICU
Jackson, MS · On-site
To act as liaison between case managers, home health nurses, utilization review, etc. To coordinate patient services and care. To perform job duties in accordance with the medical center's purpose.
Utilization Review Nurse information
See Ridgeland, MS salary details
$17.82 - $21.43
2% of jobs
$21.43 - $25.04
9% of jobs
$27.50 is the 25th percentile. Wages below this are outliers.
$25.04 - $28.64
21% of jobs
The median wage is $31.56 / hr.
$28.64 - $32.25
23% of jobs
$32.25 - $35.85
13% of jobs
$38.65 is the 75th percentile. Wages above this are outliers.
$35.85 - $39.46
10% of jobs
$39.46 - $43.06
8% of jobs
$43.06 - $46.67
5% of jobs
$46.67 - $50.27
5% of jobs
$50.27 - $53.88
2% of jobs
$53.88 - $57.48
2% of jobs
$17
$35
$57
How much do utilization review nurse jobs pay per hour?
As of Sep 4, 2026, the average hourly pay for utilization review nurse in Ridgeland, MS is $35.23, according to ZipRecruiter salary data. Most workers in this role earn between $27.84 and $40.48 per hour, depending on experience, location, and employer.
What does a utilization review nurse do?
A Utilization Review Nurse is responsible for evaluating the necessity, appropriateness, and efficiency of healthcare services and treatments provided to patients. They review medical records, coordinate with healthcare providers, and ensure that care meets established guidelines and insurance requirements. Their primary goal is to ensure patients receive appropriate care while helping to manage healthcare costs and prevent unnecessary procedures.
What does a utilization review nurse do?
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.
What are some typical challenges utilization review nurses face when communicating with healthcare providers and insurance companies?
Utilization Review Nurses often need to balance clinical judgment with insurance guidelines, which can lead to challenging conversations with providers who may disagree with coverage decisions. They must clearly explain the rationale behind approvals or denials and ensure all documentation is thorough and compliant. Navigating differing priorities while maintaining positive, professional relationships is key, and strong communication skills help facilitate collaboration and resolve conflicts efficiently.
What are the key skills and qualifications needed to thrive as a utilization review nurse, and why are they important?
To thrive as a Utilization Review Nurse, you need a strong background in clinical nursing, critical thinking, and knowledge of healthcare regulations, usually supported by an RN license and nursing degree. Familiarity with utilization management software, medical coding systems (like ICD-10 and CPT), and case management certifications (such as CCM or URAC) is typically required. Excellent communication, negotiation, and organizational skills help you collaborate with providers and advocate for patient care while managing complex cases. These skills ensure appropriate resource use, regulatory compliance, and high-quality patient outcomes in healthcare settings.
What is the difference between Utilization Review Nurse vs Case Manager?
| 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.
More about Utilization Review Nurse jobs
What are popular job titles related to Utilization Review Nurse jobs in Ridgeland, MS?
For Utilization Review Nurse jobs in Ridgeland, MS, the most frequently searched job titles are:
What job categories do people searching Utilization Review Nurse jobs in Ridgeland, MS look for?
The top searched job categories for Utilization Review Nurse jobs in Ridgeland, MS are:
What cities near Ridgeland, MS are hiring for Utilization Review Nurse jobs?
Cities near Ridgeland, MS with the most Utilization Review Nurse job openings:
Treatment (Wound Care) Nurse-RN - Chadwick Community Care Center
Jackson, MS
Full-time
Re-posted 11 days ago
Job description
At CommCare Corporation, we're not just another healthcare provider. We're an established, forward-thinking leader in retirement living, skilled nursing, and hospice care across Louisiana and Mississippi. Our team is driven by creativity, expertise, and a passion for caregiving, and we're looking for someone who shares these values to join us.
We're seeking the right candidate for the position of RN Treatment (Wound Care) Nurse at Chadwick Community Care Center. In this vital role, you'll ensure that our residents receive the highest level of care while collaborating with a dedicated team, providing exceptional clinical leadership and support.
What You Bring to the Table:
Essential Qualifications:
Responsibilities
- Conduct thorough assessments of patients' wounds, including history taking and physical examination.
- Develop individualized care plans based on assessment findings and patient needs.
- Perform advanced wound care procedures, including debridement and dressing changes.
- Administer IV infusions as required for wound management.
- Process specimen collections for laboratory analysis to monitor healing progress.
- Collaborate with healthcare professionals to coordinate care and ensure continuity of services.
- Participate in utilization review processes to evaluate the effectiveness of treatment plans.
- Educate patients and their families on wound care techniques and preventive measures.
- Provide support in the training of nursing staff on best practices for wound management.