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Utilization Review Rn Jobs in Appleton, WI (NOW HIRING)

GQR Global Markets

RN Case Manager

Appleton, WI · On-site

$1.8K - $1.9K/wk

  • Medical

  • Dental

  • Vision

Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location: Appleton, Wisconsin Start Date: August 23, 2026 Profession: Registered Nurse (RN) Facility: Estimated Pay: $1847 ...

New

TEEMA Group

Registered Nurse (RN)

Oshkosh, WI · On-site

$55 - $60/hr

Registered Nurse (RN)Role Summary Are you a resilient, highly analytical Registered Nurse looking ... Prior professional experience navigating behavioral health, substance utilization programs, or ...

TEEMA Group

Registered Nurse (RN)

Green Bay, WI · On-site

$55 - $63/hr

Registered Nurse (RN)Role Summary Are you a resilient, highly analytical Registered Nurse looking ... Prior professional experience navigating behavioral health, substance utilization programs, or ...

Avina of Weyauwega

Registered Nurse (RN)

Weyauwega, WI · On-site

$38 - $45/hr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

FT RN $40/hour Registered Nurse (RN) Job Benefits: * Competitive Pay * Health Insurance including ... Review medication orders for completeness of information and accuracy. * Transcribe physician ...

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Utilization Review Rn information

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$41

$67

How much do utilization review rn jobs pay per hour?

As of Aug 17, 2026, the average hourly pay for utilization review rn in Appleton, WI is $41.26, according to ZipRecruiter salary data. Most workers in this role earn between $32.60 and $47.36 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.

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.

How to get into utilization review as a registered nurse?

To become a utilization review RN, you typically need a valid registered nurse license and experience in clinical settings. Additional certifications such as the Certified Professional in Healthcare Quality (CPHQ) or knowledge of medical coding and insurance processes can enhance your qualifications. Gaining experience in case management or health insurance companies can also improve your chances of entering the field.

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.

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 Appleton, WI?

The most popular types of Utilization Review Rn jobs in Appleton, WI are:

What are popular job titles related to Utilization Review Rn jobs in Appleton, WI?

For Utilization Review Rn jobs in Appleton, WI, the most frequently searched job titles are:

What job categories do people searching Utilization Review Rn jobs in Appleton, WI look for?

The top searched job categories for Utilization Review Rn jobs in Appleton, WI are:

What cities near Appleton, WI are hiring for Utilization Review Rn jobs?

Cities near Appleton, WI with the most Utilization Review Rn job openings:

Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Appleton, WI as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 15% Part Time, and 3% Contract. Highlights an 89% Physical, 4% Hybrid, and 7% Remote job distribution, with an average salary of $85,812 per year, or $41.3 per hour.

RN Case Manager

GQR Global Markets

Appleton, WI • On-site

$1.8K - $1.9K/wk

Other

Medical, Dental, Vision

Posted 2 days ago

New

Job description

Contract – W2 Case Management/Utilization Review Registered Nurse (RN) Job

Location: Appleton, Wisconsin Start Date: August 23, 2026 Profession: Registered Nurse (RN) Facility: Estimated Pay: $1847.59 – $1942.59 Duration: 13 weeks Specialty: Case Management/Utilization Review Shift: Day

Estimated weekly pay includes projected hourly wages and weekly meal and lodging per diems for eligible clinicians based on nationally published GSA rates. Actual weekly pay and per diems may differ from the amount shown and are subject to change during an assignment.

Benefits:

  • Day 1 Insurance
  • Cigna medical, MetLife dental and vision insurance
  • License reimbursement for new licenses needed for each assignment
  • Discounts with hotels and rental cars
  • A dedicated recruiter and support team that will help you every step of the way to ensure you start on time and have an exceptional experience
  • Referral bonus up to $700

About the Company: Finding the right role is about more than just matching skills to a job–it's about aligning with your goals, values, and the way you want to work.

As an award-winning talent partner, we support healthcare professionals through every step of that process, offering meaningful opportunities, clear guidance, and long-term partnership. From our first conversation to your first day on the job (and beyond!), we're here to help you move forward with confidence.

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