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Utilization Review Rn Jobs (NOW HIRING)

LeaderStat

Travel Utilization Review Nurse

Kinston, NC · On-site

LeaderStat is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Kinston, North Carolina. & Requirements * Specialty: Utilization Review * Discipline: RN * Start ...

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Utilization Review Rn information

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How much do utilization review rn jobs pay per hour?

As of Jun 29, 2026, the average hourly pay for utilization review 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.

How does a Utilization Review RN collaborate with physicians and other healthcare professionals during the patient care review process?

A Utilization Review RN works closely with physicians, case managers, and other healthcare team members to ensure that patients receive appropriate care while adhering to regulatory and insurance guidelines. This collaboration often involves discussing clinical findings, clarifying documentation, and negotiating care plans to meet both patient needs and payer requirements. Effective communication and teamwork are essential, as Utilization Review RNs frequently serve as liaisons between clinical staff and insurance representatives to facilitate timely authorizations and prevent unnecessary delays in patient care.

How do I become a utilization review RN?

To become a utilization review RN, you typically need to hold a valid registered nurse (RN) license and have experience in clinical nursing. Additional certifications such as the Certified Professional in Healthcare Quality (CPHQ) or Utilization Review Certification (URAC) can enhance job prospects, and strong knowledge of medical coding, insurance policies, and healthcare regulations is important.

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

To thrive as a Utilization Review RN, you need a current RN license, strong clinical assessment skills, and knowledge of healthcare regulations and insurance guidelines. Familiarity with utilization management software, electronic health records (EHRs), and relevant certifications like CCM or ACM is often required. Excellent critical thinking, communication, and negotiation skills help you advocate for appropriate patient care while collaborating with providers and payers. These skills ensure cost-effective, quality care and compliance with regulatory standards in healthcare delivery.

What does an RN utilization review do?

An RN utilization review evaluates medical records and treatment plans to determine the appropriateness, necessity, and efficiency of healthcare services. They ensure compliance with insurance policies and clinical guidelines, often using electronic health records and requiring knowledge of coding and documentation standards. This role supports cost-effective patient care and involves collaboration with healthcare providers and insurance companies.

How to make $300,000 a year as a nurse?

To earn $300,000 annually as a Utilization Review RN, professionals typically need extensive experience, advanced certifications such as CCM or ANCC, and may work in high-paying settings like insurance companies or healthcare consulting firms. Increasing specialization, taking on leadership roles, or working overtime can also boost income, but reaching this level often requires a combination of skills, experience, and strategic career moves.

What is the difference between Utilization Review Rn vs Case Manager?

AspectUtilization Review RnCase Manager
CredentialsRN license, certifications in utilization reviewRN license, certifications in case management
Work EnvironmentHospitals, insurance companies, healthcare facilitiesHospitals, community agencies, insurance companies
Primary FocusReviewing medical necessity and appropriateness of careCoordinating patient care and discharge planning

Utilization Review Rns primarily focus on evaluating the necessity of medical treatments, while Case Managers coordinate patient care and discharge planning. Both roles require RN licensure and certifications, but their daily responsibilities and work environments differ slightly, with Utilization Review Rns concentrating on review processes and Case Managers on patient advocacy and care coordination.

How to make $150,000 as a nurse?

A Utilization Review RN can earn $150,000 by gaining extensive experience, obtaining certifications such as CCM or ANCC, and working in high-paying settings like insurance companies or managed care organizations. Advanced skills in case management, strong clinical knowledge, and sometimes working overtime or in leadership roles can also contribute to higher earnings.

What is a Utilization Review RN?

A Utilization Review RN is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services and treatments provided to patients. They review medical records, collaborate with healthcare teams, and ensure that patient care meets established guidelines and payer requirements. Their role helps control costs, optimize care, and support compliance with healthcare regulations. Utilization Review RNs often work in hospitals, insurance companies, or managed care organizations.
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Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in the United States as of June 2026, with employment types broken down into 2% As Needed, 58% Full Time, 3% Part Time, 1% Temporary, 35% Contract, and 1% Nights. Highlights an 90% Physical, 2% Hybrid, and 8% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

Travel Nurse RN - Utilization Review

Care Career

Hanover, MD • On-site

Contractor

Medical, Dental, Vision

Posted 10 days ago

Job description

Care Career is seeking a travel nurse RN Utilization Review for a travel nursing job in Hanover, Maryland.

Job Description & Requirements
  • Specialty: Utilization Review
  • Discipline: RN
  • Start Date: 07/20/2026
  • Duration: 13 weeks
  • 40 hours per week
  • Shift: 8 hours, days
  • Employment Type: Travel

Utilization Review Nurse (Remote)

Location: 100% Remote
Schedule: Monday–Friday | 8:00 AM–5:00 PM EST
No Call | No Weekends | No Holidays
Contract Opportunity

We are seeking an experienced Utilization Review RN for a fully remote opportunity. This is a medical review role with no direct patient care responsibilities.

Requirements:
• Active RN License
• Minimum 5 years of RN experience
• Current Utilization Review experience
• Epic EMR experience
• Proficiency with InterQual criteria
• Managed Care Utilization Review experience preferred
• Must provide own computer/equipment

Responsibilities:
• Perform medical necessity and utilization reviews for acute, sub-acute, and rehabilitation services
• Apply InterQual criteria to determine authorization of services
• Coordinate with Medical Directors regarding approvals and denials
• Initiate discharge planning and coordinate post-discharge services
• Communicate authorization decisions with providers, facilities, and members
• Maintain accurate documentation and quality standards
• Collaborate with interdisciplinary teams to ensure appropriate utilization of healthcare resources

Ideal Background:
• Utilization Review RN
• Utilization Management RN
• Concurrent Review RN
• Managed Care RN
• Health Plan RN
• Case Management RN with strong UR experience

Interested? Apply today!

Job ID: #37253770

About Care Career

Care Career brings together a portfolio of leading healthcare staffing organizations, each delivering specialized talent solutions across the industry. Wherever you want to go, We Make It Happen.

With travel nursing jobs across the country, you can discover the possibilities that create the lifestyle and financial position that you have dreamed of.

Care Career is a modern, transparent staffing firm creating the ultimate community of US.


Benefits
  • Referral bonus
  • Weekly pay
  • Medical benefits
  • Continuing Education
  • Dental benefits
  • Vision benefits

Apply