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.
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.
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 - Pediatric Psych
Jackson, MS · On-site
$1.5K - $2.1K/wk
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 - Pediatric Psych
Jackson, MS · On-site
$1.5K - $2.1K/wk
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 - Emergency Department, 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 - Emergency Department, 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.
RN - OR Circulator
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 - OR Circulator
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.
RN - Pediatric Psych
Jackson, MS · On-site
$1.5K - $2.1K/wk
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 - Pediatric Psych
Jackson, MS · On-site
$1.5K - $2.1K/wk
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 - Emergency Department, 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.
RN - Emergency Department, 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.
RN - Weekender
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 - Weekender
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.
Valid RN license Preferred Qualifications: RN experience in clinical nursing with chronic disease, utilization review and/or quality management Knowledge, Skills & Abilities Knowledge, Skills, and ...
Valid RN license Preferred Qualifications: RN experience in clinical nursing with chronic disease, utilization review and/or quality management Knowledge, Skills & Abilities Knowledge, Skills, and ...
RN - Med Surg
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
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.
RN - OR
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 - OR
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 - OR
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 - OR
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 - Weekender
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.
RN - Weekender
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.
Valid RN license Preferred Qualifications: RN experience in clinical nursing with chronic disease, utilization review and/or quality management Knowledge, Skills & Abilities Knowledge, Skills, and ...
Valid RN license Preferred Qualifications: RN experience in clinical nursing with chronic disease, utilization review and/or quality management Knowledge, Skills & Abilities Knowledge, Skills, and ...
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.
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.
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 5, 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:
Job description
Description
Job Summary:
To assess, develop, implement and evaluate the nursing care and treatment for patients in an assigned clinical area. To coordinate the operations of a clinical area including patient scheduling, maintaining patient records and managing the patient admissions process. To counsel with patients and family members on treatment and conditions of patients. 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.
Responsibilities
Provides patient care by assessing, planning, implementing and evaluating treatments and interventions for patients.
Educates patients (and possibly family members) on topics such as the nature and status of patient's condition, diet and associated side effects of medication/treatments and the importance of complying with medication schedules.
Ensures the safety of patients.
Coordinates referrals to other services within and outside of immediate area or unit.
Maintains accurate patient records.
Functions as a preceptor in accordance with UMMC guidelines.
Reports patients issues or concerns to supervisor as appropriate.
Serves on at least one nursing council, hospital, or medical center committee, task force, or project team to improve patient care or work area. Demonstrates core standards of exceptional customer service.
Performs other duties as assigned.
Physical and Environmental Demands
Requires occasional exposure to unpleasant or disagreeable physical environment such as high noise level and exposure to heat and cold, occasional handling or working with potentially dangerous equipment, occasional exposure to biohazardous conditions such as risk of radiation exposure, blood borne pathogens, fumes or airborne particles, and/or toxic or caustic chemicals which mandate attention to safety considerations, occasional working hours significantly beyond regularly scheduled hours, occasional activities subject to significant volume changes of a seasonal/clinical nature, constant work produced subject to precise measures of quantity and quality, constant bending, frequent lifting and carrying more than 100 pounds, frequent climbing, frequent crawling, frequent crouching/stooping, occasional driving, occasional kneeling, constant pushing/pulling, occasional reaching, occasional sitting, constant standing, constant twisting, and constant walking. (occasional-up to 20%, frequent-from 21% to 50%, constant-51% or more)
Requirements
Education & Experience
Certifications, Licenses or Registration Required: Valid RN license
Knowledge, Skills & Abilities
Knowledge of clinical nursing care procedures and protocols. Verbal and written communication skills. Interpersonal skills. Knowledge and understanding of computer systems, tools and programs. Ability to work in a team environment.
About Healthier Mississippi Collaborative
Sourced by ZipRecruiter
Industry
Health care and social assistance
Company size
51 - 200 Employees
Headquarters location
Jackson, MS, US