Utilization Review RN
Brentwood, TN · On-site
Utilization Review RN Are you an experienced Registered Nurse with Utilization Review experience professional looking for a new opportunity with a prestigious healthcare company? Do you want the ...
Utilization Review RN
Brentwood, TN · On-site
Utilization Review RN Are you an experienced Registered Nurse with Utilization Review experience professional looking for a new opportunity with a prestigious healthcare company? Do you want the ...
RN-Utilization Review
Memphis, TN · On-site
Utilization Review * Discharge planning * Readmission Reduction Participation * Payer Communication and denial reduction * Completes assigned goals. Specifications Experience Minimum Required * RN ...
RN-Utilization Review
Memphis, TN · On-site
Utilization Review * Discharge planning * Readmission Reduction Participation * Payer Communication and denial reduction * Completes assigned goals. Specifications Experience Minimum Required * RN ...
Utilization Review * Discharge planning * Readmission Reduction Participation * Payer Communication and denial reduction * Completes assigned goals. Specifications Experience Minimum Required * RN ...
Utilization Review * Discharge planning * Readmission Reduction Participation * Payer Communication and denial reduction * Completes assigned goals. Specifications Experience Minimum Required * RN ...
RN-Utilization Review
Memphis, TN · On-site
Utilization Review * Discharge planning * Readmission Reduction Participation * Payer Communication and denial reduction * Completes assigned goals. Specifications Experience Minimum Required * RN ...
RN-Utilization Review
Memphis, TN · On-site
Utilization Review * Discharge planning * Readmission Reduction Participation * Payer Communication and denial reduction * Completes assigned goals. Specifications Experience Minimum Required * RN ...
RN-Utilization Review PRN
Memphis, TN · On-site
Utilization Review * Discharge planning * Readmission Reduction Participation * Payer Communication and denial reduction * Completes assigned goals. Specifications Experience Minimum Required * RN ...
RN-Utilization Review PRN
Memphis, TN · On-site
Utilization Review * Discharge planning * Readmission Reduction Participation * Payer Communication and denial reduction * Completes assigned goals. Specifications Experience Minimum Required * RN ...
Utilization Review * Discharge planning * Readmission Reduction Participation * Payer Communication and denial reduction * Completes assigned goals. Specifications Experience Minimum Required * RN ...
Utilization Review * Discharge planning * Readmission Reduction Participation * Payer Communication and denial reduction * Completes assigned goals. Specifications Experience Minimum Required * RN ...
Utilization Review activities include inpatient, observation, outpatient in a bed, ambulatory ... Registered Nurse (RN) Required * Minimum 5 years experience Five (5) years' progressively ...
Utilization Review activities include inpatient, observation, outpatient in a bed, ambulatory ... Registered Nurse (RN) Required * Minimum 5 years experience Five (5) years' progressively ...
Utilization Review activities include inpatient, observation, outpatient in a bed, ambulatory ... Registered Nurse (RN) Required * Minimum 5 years experience Five (5) years' progressively ...
Utilization Review activities include inpatient, observation, outpatient in a bed, ambulatory ... Registered Nurse (RN) Required * Minimum 5 years experience Five (5) years' progressively ...
RN-Utilization Review PRN
Memphis, TN · On-site
Utilization Review * Discharge planning * Readmission Reduction Participation * Payer Communication and denial reduction * Completes assigned goals. Specifications Experience Minimum Required * RN ...
RN-Utilization Review PRN
Memphis, TN · On-site
Utilization Review * Discharge planning * Readmission Reduction Participation * Payer Communication and denial reduction * Completes assigned goals. Specifications Experience Minimum Required * RN ...
RN-Utilization Review PRN
Memphis, TN · On-site
Utilization Review * Discharge planning * Readmission Reduction Participation * Payer Communication and denial reduction * Completes assigned goals. Specifications Experience Minimum Required * RN ...
RN-Utilization Review PRN
Memphis, TN · On-site
Utilization Review * Discharge planning * Readmission Reduction Participation * Payer Communication and denial reduction * Completes assigned goals. Specifications Experience Minimum Required * RN ...
State RN License required. Experience: Three to five years of health care management. A previous background in Case Management/Utilization Review. Knowledge of accepted Nursing procedures in ...
State RN License required. Experience: Three to five years of health care management. A previous background in Case Management/Utilization Review. Knowledge of accepted Nursing procedures in ...
VP of Utilization Review
Franklin, TN · On-site +1
Clinical licensure preferred (RN, LCSW, LPC, LMFT, or comparable behavioral health licensure). Requires a minimum of seven (7) years of progressive Utilization Review leadership experience within ...
VP of Utilization Review
Franklin, TN · On-site +1
Clinical licensure preferred (RN, LCSW, LPC, LMFT, or comparable behavioral health licensure). Requires a minimum of seven (7) years of progressive Utilization Review leadership experience within ...
Clinical licensure preferred (RN, LCSW, LPC, LMFT, or comparable behavioral health licensure). Requires a minimum of seven (7) years of progressive Utilization Review leadership experience within ...
Clinical licensure preferred (RN, LCSW, LPC, LMFT, or comparable behavioral health licensure). Requires a minimum of seven (7) years of progressive Utilization Review leadership experience within ...
Current state-issued RN license. Knowledge in areas such as InterQual Level of Care Criteria and ... utilization review is preferred. * Knowledge of regulatory and payer requirements for Case ...
Current state-issued RN license. Knowledge in areas such as InterQual Level of Care Criteria and ... utilization review is preferred. * Knowledge of regulatory and payer requirements for Case ...
Current state-issued RN license. Knowledge in areas such as InterQual Level of Care Criteria and ... utilization review is preferred. * Knowledge of regulatory and payer requirements for Case ...
Quick apply
Current state-issued RN license. Knowledge in areas such as InterQual Level of Care Criteria and ... utilization review is preferred. * Knowledge of regulatory and payer requirements for Case ...
Current state-issued RN license. Knowledge in areas such as InterQual Level of Care Criteria and ... utilization review is preferred. * Knowledge of regulatory and payer requirements for Case ...
Current state-issued RN license. Knowledge in areas such as InterQual Level of Care Criteria and ... utilization review is preferred. * Knowledge of regulatory and payer requirements for Case ...
Utilization Specialist
Louisville, TN · On-site
Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides ...
Utilization Specialist
Louisville, TN · On-site
Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides ...
Utilization Specialist
Burns, TN · On-site
Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides ...
Utilization Specialist
Burns, TN · On-site
Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides ...
Utilization Specialist
Louisville, TN · On-site
Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides ...
Utilization Specialist
Louisville, TN · On-site
Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides ...
Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides ...
Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides ...
Utilization Review Rn information
See Tennessee salary details
$19.42 - $23.35
2% of jobs
$23.35 - $27.27
9% of jobs
$29.96 is the 25th percentile. Wages below this are outliers.
$27.27 - $31.20
21% of jobs
The median wage is $34.38 / hr.
$31.20 - $35.13
23% of jobs
$35.13 - $39.05
13% of jobs
$42.11 is the 75th percentile. Wages above this are outliers.
$39.05 - $42.98
10% of jobs
$42.98 - $46.91
8% of jobs
$46.91 - $50.84
5% of jobs
$50.84 - $54.76
5% of jobs
$54.76 - $58.69
2% of jobs
$58.69 - $62.62
2% of jobs
$19
$38
$62
How much do utilization review rn jobs pay per hour?
As of Jun 19, 2026, the average hourly pay for utilization review rn in Tennessee is $38.38, according to ZipRecruiter salary data. Most workers in this role earn between $30.34 and $44.09 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?
| Aspect | Utilization Review Rn | Case Manager |
|---|---|---|
| Credentials | RN license, certifications in utilization review | RN license, certifications in case management |
| Work Environment | Hospitals, insurance companies, healthcare facilities | Hospitals, community agencies, insurance companies |
| Primary Focus | Reviewing medical necessity and appropriateness of care | Coordinating 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.
What are the most commonly searched types of Utilization Review Rn jobs in Tennessee? The most popular types of Utilization Review Rn jobs in Tennessee are:
What are popular job titles related to Utilization Review Rn jobs in Tennessee? For Utilization Review Rn jobs in Tennessee, the most frequently searched job titles are:
What job categories do people searching Utilization Review Rn jobs in Tennessee look for? The top searched job categories for Utilization Review Rn jobs in Tennessee are:
- Volunteer Aetna Utilization Review Nurse
- Temporary Aetna Utilization Review Nurse
- Utilization Review
- Aetna Utilization Review Nurse
- Remote Rn Utilization Review Nurse
- Per Diem Chart Review Nurse Practitioner
- Anthem Utilization Review Nurse
- Live In Cigna Utilization Review Nurse
- Seasonal Remote Utilization Review
- Remote Aetna Utilization Review Nurse
What cities in Tennessee are hiring for Utilization Review Rn jobs? Cities in Tennessee with the most Utilization Review Rn job openings:
What are popular job titles related to Utilization Review Rn jobs in TN? For Utilization Review Rn jobs in TN, the most frequently searched job titles are:
Other
Medical, Dental, Vision
Posted 6 days ago
Job description
Company Description
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!
Job Description
Job Title: Utilization Review RN
Are you an experienced Registered Nurse with Utilization Review experience professional looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered "yes" to any of these questions - this is the position for you!
Position Summary:
As the Utilization Review RN, you would be responsible for telephonically reviewing medical information in order to determine medical necessity of continued stay according to review standards.
Hours for this Position: Monday-Friday 8:00am-5:00pm
Advantages of this Opportunity:
- Competitive salary, negotiable based on experience
- Benefits offered, Medical, Dental, and Vision
- Fun and positive work environment
- Weekly deposit options
More Insight of Daily Responsibilities:
- Ensures that services provided to eligible members are within benefit plan and appropriate contracted providers are being utilized
- Determines medical necessity and length of stay based on the consistent application of CMS criteria
- Assesses and coordinates simple discharge planning
- Identifies quality of care issues
Qualifications
What We Look For:
- RN license in the state of TN
- Bachelor's Degree in related field
- 2+ years of experience in UM, UR, pre-authorization, concurrent review, discharge planning and/or skilled nursing
Additional Information
Want More Information?
Interested in hearing more about this great opportunity? Reach out to Amanda Hammer at ahammer @healthcaresupport.com or click apply for additional details.
About Healthcare Support
Sourced by ZipRecruiter
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!Healthcare Support Staffing, Inc. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.
Industry
Recruiting and staffing services
Company size
201 - 500 Employees
Headquarters location
Maitland, FL, US
Year founded
2003