1

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

... will be reviewed with you by a recruiter. Additional qualifications for this job may include ... registered nurse license or the ability to obtain one within established timelines for new ...

You will determine donor eligibility to donate plasma, management of donor adverse events, review ... Registered Nurse (RN), Nurse Practitioner (NP) or Physician Assistant (PA) Current Cardiopulmonary ...

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

RN Full-Time Days

Green Bay, WI · On-site

$40 - $50/hr

RN Full-Time Days | Willow Creek Behavioral Health | Green Bay, Wisconsin About the Job: Willow ... transcribes and reviews provider's orders ensuring all required elements are present and ...

The RN Clinical Supervisor collaborates with other clinical leaders in directing care teams to ... Reviews available patient information related to case, including home visits, to determine hospice ...

The RN Clinical Supervisor collaborates with other clinical leaders in directing care teams to ... Reviews available patient information related to case, including home visits, to determine hospice ...

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 ...

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 ...

next page

Showing results 1-20

Utilization Review Rn information

See Appleton, WI salary details

$20

$41

$67

How much do utilization review rn jobs pay per hour?

As of Jul 6, 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 to get into utilization review as a nurse?

To become a utilization review RN, candidates typically need a valid nursing license and experience in clinical settings. Additional certifications such as Certified Professional in Healthcare Quality (CPHQ) or case management credentials can enhance prospects, and familiarity with electronic health records and insurance policies is beneficial.

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 make $300,000 as a nurse?

A Utilization Review RN can earn $300,000 by gaining extensive experience, obtaining certifications such as Certified Review Officer (CRO), working in high-paying settings like insurance companies or managed care organizations, and taking on leadership or specialized roles that offer higher compensation. Advanced skills in clinical assessment, documentation, and understanding of healthcare policies can also contribute to higher earnings.

What does an RN utilization review do?

An RN utilization review evaluates medical records and treatment plans to determine the necessity, appropriateness, 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.

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 Certified Review Officer (CRO), working in high-demand settings, and possibly taking on leadership or specialized roles. Increasing your workload, working overtime, or pursuing advanced education can also contribute to higher earnings within this field.

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 cities near Appleton, WI are hiring for Utilization Review Rn jobs? Cities near Appleton, WI with the most Utilization Review Rn job openings:
Infographic showing various Utilization Review Rn job openings in Appleton, WI as of July 2026, with employment types broken down into 1% As Needed, 80% Full Time, 15% Part Time, 1% Temporary, and 3% Contract. Highlights an 91% Physical, 2% Hybrid, and 7% Remote job distribution, with an average salary of $85,812 per year, or $41.3 per hour.
Registered Nurse

Full-time

Medical, Dental, Vision, Retirement

Posted 17 days ago


United States Navy rating

6.3

Company rating: 6.3 out of 10

Based on 371 frontline employees who took The Breakroom Quiz

38th of 46 rated military and defense


Job description

Job Title: Registered Nurse (Navy Nurse Corps)
Category / Component: Officer • Both

Overview
Navy Nurse Corps officers deliver professional nursing care to service members, families, and global communities in leading edge military medical centers, hospital ships, and operational units, while advancing their education and clinical practice through generous scholarships and specialty training.

Key Responsibilities
Provide direct patient care in medical surgical, critical care, perioperative, mental health, primary care, and other nursing specialties; assess, plan, implement, and evaluate nursing care for individuals and families; function as a nurse practitioner, nurse anesthetist, or other advanced practice nurse when appropriately trained; lead and supervise nursing teams, manage patient flow and unit operations, and contribute to quality improvement and clinical education initiatives.

What to Expect
Shift based work in inpatient and outpatient settings with possible on call duties; opportunities for deployment, humanitarian missions, and shipboard assignments; rapid growth in leadership responsibility as you manage teams, coordinate complex care, and take on administrative roles; strong emphasis on continuing education, specialty certifications, and professional development.

Work Environment
Assignments at Navy and joint medical centers such as Bethesda, Portsmouth, and San Diego; billets aboard hospital ships such as USNS Comfort and USNS Mercy; potential positions on surface ships, with aviation units, and within Fleet Marine Force medical organizations; daily collaboration with physicians, other nurses, Hospital Corpsmen, and allied health professionals.

Pathways, Training & Advancement
Officer Development School followed by orientation and clinical integration at a Navy medical facility; specialty training and clinical rotations based on billet requirements and experience; career progression opportunities into advanced practice roles, nursing administration, education, research, and staff positions; access to leadership courses and Navy funded graduate education for qualified officers.
Entry through programs such as NROTC Nurse Option scholarships, the Nurse Candidate Program for nursing students, direct accession for licensed registered nurses, and Reserve accession for practicing nurses in needed specialties; specific accession paths and incentives vary based on current Navy requirements.

Qualifications
All Navy jobs require meeting general enlistment or commissioning standards, which typically include:

  • Eligibility to serve in the United States Navy, which may involve United States citizenship or other legal residency and work status, depending on the program and current law and policy
  • A high school diploma or equivalent for enlisted positions, and a bachelor’s or qualifying professional degree for officer positions
  • Meeting age limits that vary by program and are set in law and Navy policy. Some communities have more restrictive age ranges
  • Meeting medical, vision, and dental standards, including body composition and physical fitness requirements, with some jobs requiring more demanding standards
  • Meeting character and conduct standards, including background screening
  • Achieving required test scores for your program, such as the Armed Services Vocational Aptitude Battery for enlisted roles or officer qualification tests for officer programs
  • Eligibility for a security clearance when required for your rating or designator
  • Additional qualifications can include specific skills, education, licensure, or experience that are unique to a job or community and will be reviewed with you by a recruiter.

Additional qualifications for this job may include:
Bachelor of Science in Nursing from a CCNE or other nationally accredited program or enrollment in such a program for student pipelines; current and unrestricted registered nurse license or the ability to obtain one within established timelines for new graduates; United States citizenship and ability to meet age, medical, fitness, and security clearance standards for commissioning as a Navy officer.

Education
Education benefits are available through standard Navy programs such as Tuition Assistance, the Post-9/11 GI Bill, ACE-recommended college credit for Navy training, Navy COOL-funded certifications, USMAP apprenticeships, and other Navy College Program opportunities. Specific options depend on the Sailor’s status, training, and current Navy policy.

Pay, Benefits & Service
Pay, benefits, and service commitments follow standard Navy Active and/or Reserve policies for this type of role, including basic pay, allowances when eligible, health coverage, and retirement options. Exact entitlements, special pays, and service obligations depend on program, component, years of service, and current law and Navy guidance.

Incentives
Incentives such as bonuses, special pays, and loan repayment may be available at times for specific ratings or communities, but they change frequently and cannot be guaranteed. Applicants must confirm current incentives and eligibility with an official Navy recruiter or authoritative Navy source.

Notes and Disclaimers
This description is a general overview of typical duties, training, and opportunities in this community. It does not replace official Navy instructions, policies, or contracts and does not guarantee specific assignments, training, incentives, or outcomes. Actual opportunities depend on Navy needs, individual performance, screening results, and current law and policy.


What United States Navy employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom


US Navy logo

About US Navy

Sourced by ZipRecruiter

Industry

National security, national security and international affairs, public safety statistics centers and offices, guided missile and space vehicle manufacturing and public administration

Company size

10,000+ Employees

Headquarters location

Washington, DC, US

Social media