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

Host Healthcare

RN - Neurology

Neenah, WI

$890/wk

S. with an immediate option for this RN position in Neenah, WI. Sign-up here to submit your ... Reviews FROM REAL HOST HEALTHCARE TRAVELERS: "Host is the best travel agency. We have been using ...

St. Paul Elders

RN-Nursing

Kaukauna, WI

$1K/wk

Registered Nurse | AMs, PMs, NOCs (overnight) | Part-Time This job has pay differentials for PMs ... Reviews resident medical records, orders and nursing care plans on a regular basis. * Provides ...

ThedaCare

PRN - Behavioral Health RN

Neenah, WI · On-site

Our compassionate team is comprised of Psychiatric hospitalists, RN's, CNA's, Occupational Therapists, mental health therapists, utilization specialists, and administrative professionals. This ...

St. Paul Elder Services

RN-Nursing

Kaukauna, WI · On-site

$37.50 - $44.50/hr

Registered Nurse | AMs, PMs, NOCs (overnight) | Part-Time This job has pay differentials for PMs ... Reviews resident medical records, orders and nursing care plans on a regular basis. * Provides ...

St. Paul Elder Services

RN-Nursing

Kaukauna, WI · On-site

$37.50 - $44.50/hr

Registered Nurse | AMs, PMs, NOCs (overnight) | Part-Time This job has pay differentials for PMs ... Reviews resident medical records, orders and nursing care plans on a regular basis. * Provides ...

Ascension

Registered Nurse

Appleton, WI · On-site

This position will be pre-op admission, post-op care, or PACE/PAT chart review and phone calls. * RN with at least 6 months periop experience preferred. Life at Ascension: Where purpose meets ...

Unity Hospice

Registered Nurse - Float B

Green Bay, WI · On-site

Registered Nurse - All Unity Service Areas The Registered Nurse - Float B is responsible for ... Update the plan of care as necessary and review care plans with patient and family * Respond to ...

Unity Hospice

Registered Nurse - Float B

Green Bay, WI · On-site

Registered Nurse - All Unity Service Areas The Registered Nurse - Float B is responsible for ... Update the plan of care as necessary and review care plans with patient and family * Respond to ...

Unity Hospice

Admissions Nurse (RN)

Green Bay, WI · On-site

Admissions Registered Nurse The Admissions Registered Nurse is responsible for making the initial ... Review information concerning the patient's medical background * Identify the appropriate decision ...

Unity Hospice

Admissions Nurse (RN)

Green Bay, WI

Review information concerning the patient's medical background * Identify the appropriate decision ... Current unrestricted registered nurse licensure from the State of Wisconsin * At least one year of ...

Unity Hospice

Admissions Nurse (RN)

Green Bay, WI · On-site

Admissions Registered Nurse The Admissions Registered Nurse is responsible for making the initial ... Review information concerning the patient's medical background * Identify the appropriate decision ...

Ascension

Registered Nurse

Appleton, WI

$37.86/hr

This position will be pre-op admission, post-op care, or PACE/PAT chart review and phone calls. * RN with at least 6 months periop experience preferred. Equal employment opportunity employer ...

Host Healthcare

RN - Medical-Surgical

Neenah, WI

$890/wk

S. with an immediate option for this RN position in Neenah, WI. Sign-up here to submit your ... Reviews FROM REAL HOST HEALTHCARE TRAVELERS: "Host is the best travel agency. We have been using ...

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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 Jun 11, 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.

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.
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 June 2026, with employment types broken down into 87% Full Time, 11% Part Time, and 2% Contract. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution, with an average salary of $85,812 per year, or $41.3 per hour.

RN - IV Specialist - Outpatient Infusion Center

Bellin

Green Bay, WI • On-site

Full-time

Medical, Retirement, PTO

Posted 27 days ago

Job description

Job Specifics
Location: 1580 Commanche Ave, Green Bay, WI 54313
Hours: Full Time 0.90 FTE (36 hours/week)
Work Schedule: Monday - Friday. 8 or 12 hour shifts, with an every third Saturday.
Want to learn more: Chat with Sunshine Ly at sunshine.ly@emplifyhealth.org
Job Description:
The Registered Nurse (RN) - IV Specialist maintains clinical expertise in IV therapy, the administration and management of chemotherapy and biotherapy, and utilizing an interdisciplinary, collaborative team process.
Qualifications:
  • Wisconsin RN license required: successful completion of the Oncology Nursing Society (ONS) Chemotherapy and Biotherapy Course required within 6 months of hire.
  • Bachelor of Science in Nursing (BSN) degree preferred.
  • Two years of nursing experience that includes venous access/infusion therapy experience; demonstrated clinical leadership characteristics; demonstrated utilization of TQM and research principles, critical thinking, and excellent communication skills; Infusion Therapy experience preferred.
  • Chemotherapy and biotherapy provider card must be current. Relevant Board Certification required (Vascular Access, CRNI, or OCN) within three years of employment for Oncology Service Line to include the Cancer Team/Infusion Services, OHMC Infusion, and Marinette Infusion required.
  • ACLS upon hire or within 6 months of hire.

Why Bellin Health?
With so many amazing healthcare organizations in this area, why Bellin?
Bellin Health offers a proud, local history spanning more than 100 years. Our personalized patient care model is only the beginning of what you will experience as we foster population health transformation and innovation to serve our communities. You can be part of an exciting dynamic place that offers an employee-first culture, work-life balance, and career advancement & growth opportunities. This culture allows our organization to attract elite talent, like yourself!
Additional perks include:
  • Top-notch benefits: 401(k) with matching, paid time off, competitive health insurance, wellness programs to keep you and your family healthy, tuition reimbursement, and more
  • Preventative care focused medical coverage that includes FREE visits to: Bellin primary care providers, Urgent Care & Fast Care facilities, physical therapy sessions and any labs required during these visits
  • Access to online continuing education for professional and career development
  • Empowerment: shape your work environment, encouragement to improve processes and create efficiencies, and support when seeking opportunities for growth.
  • Culture that encourages self-care and provides you with opportunities to be your best self at work and at home
  • Be a member of a passionate workforce, that feels like family and is driven to provide exceptional patient care with a strong focus on community.

We inspire your best life by relentlessly caring, learning and innovating. This is our purpose. Together with our values - belonging, respect, excellence, accountability, teamwork and humility - our pillars set our foundation and our future.
Bellin Health is an Equal Opportunity Employer.

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