ZipRecruiter

Log In

1

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

Manor of Fond du Lac

Registered Nurse (RN)

Weyauwega, WI · On-site

$40/hr

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 ...

Interim HealthCare

Registered Nurse (RN)

Menasha, WI · On-site

$35 - $40/hr

Review, interpret, transcribe and carry out physician orders for patients * Administer medication, operate medical equipment and maintain a safe environment A few must-haves for Registered Nurses:

Carepros, LLC

Registered Nurse

Appleton, WI · On-site

The plan shall be based on the RN's visit to the Client's home and shall include: · Review and interpretation of the physician's orders. · Frequency and anticipated duration of service. · ...

Eden Senior Care

MDS Coordinator

Oshkosh, WI · On-site

$80K - $90K/yr

Run Utilization Review Meetings and ensure PDPM scores and rates are validated * Review and Educate ... Must hold an active LPN or RN license in the state of Wisconsin. * Strong knowledge of the MDS ...

Carepros, LLC

Registered Nurse

Appleton, WI

The plan shall be based on the RN's visit to the Client's home and shall include: · Review and interpretation of the physician's orders. · Frequency and anticipated duration of service. · ...

Carepros, LLC

Registered Nurse

Appleton, WI · On-site

The plan shall be based on the RN's visit to the Client's home and shall include: • Review and interpretation of the physician's orders. • Frequency and anticipated duration of service. • ...

New Perspective

Registered Nurse RN

Oneida, WI · On-site

The RN: * Has a current RN license in good standing in the state in which the community is located ... For further information, please review the Know Your Rights notice from the Department of Labor.

Carepros, LLC

Registered Nurse

Appleton, WI · On-site

The plan shall be based on the RN's visit to the Client's home and shall include: · Review and interpretation of the physician's orders. · Frequency and anticipated duration of service. · ...

Network Health WI

RN Care Manager

Menasha, WI · On-site +1

Review results from medical or behavioral tests and procedures and updates care plan to reflect ... Previous experience in case management, utilization management, insurance, or managed care ...

Network Health

RN Care Manager

Menasha, WI · On-site

Review results from medical or behavioral tests and procedures and updates care plan to reflect ... Previous experience in case management, utilization management, insurance, or managed care ...

Network Health, Inc

RN Care Manager

Menasha, WI · Remote

Review results from medical or behavioral tests and procedures and updates care plan to reflect ... Previous experience in case management, utilization management, insurance, or managed care ...

Network Health

RN Care Manager

Menasha, WI · Remote

Review results from medical or behavioral tests and procedures and updates care plan to reflect ... Previous experience in case management, utilization management, insurance, or managed care ...

previous pagenext page

Showing results 21-40

All JobsUtilization Review Rn JobsUtilization Review Rn Jobs in Appleton, WI

Utilization Review Rn information

See Appleton, WI salary details

$20

$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.

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.

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.

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 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 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.

Registered Nurse (RN)

Manor of Fond du Lac

Weyauwega, WI • On-site

$40/hr

Other

Medical, Dental, Vision, Retirement, PTO

Posted 14 days ago

Job description

FT RN $40/hour
Registered Nurse (RN) Job Benefits:
  • Competitive Pay
  • Health Insurance including Dental and Vision
  • Paid Time Off for Sick, Holiday, and Vacation Days
  • Employer Matched 401k
  • Daily Pay
  • Employee Perks Website
Registered Nurse (RN) Job Qualifications:
Must have current and active license to practice as a Registered Nurse (RN) in Wisconsin.
Registered Nurse (RN) Job Overview:
The primary purpose of the Registered Nurse (RN) is to provide quality nursing care to our residents and to supervise the day-to-day nursing functions performed by the Certified Nursing Assistants. The Registered Nurse (RN) is also responsible to coordinate all aspects of a resident's care with other disciplines in the facility. Job duties are in accordance with the current Federal and State regulations that govern the facility.
Registered Nurse (RN) Job Duties:
  • Prepare and administer medication as ordered by the physician.
  • Review medication orders for completeness of information and accuracy.
  • Transcribe physician orders.
  • Document all resident information as necessary, notifying physician and family as needed.
  • Assist in the Admission/Discharge process.
  • Complete accident/incident reports, follow up investigation process.
  • Be familiar with the care planning process and participate in care conferences, updating as needed.
  • Develop and maintain a good working rapport with all disciplines to ensure that all aspects of resident needs can be adequately maintained.
  • Should be able to deal tactfully with personnel, residents, family members, visitors, government agencies/personnel and the general public.
  • Be willing to participate in continuing education programs.

INDrn

Apply