1

Utilization Review Rn Jobs in Atlantic City, NJ (NOW HIRING)

... Nurse (RN), PT, OT or SLP required * Minimum of two years experience in rehabilitation or a closely related field required. Preferred Experience * Experience in Utilization Review preferred

Registered Nurse (RN)

NJ · On-site

$35 - $49/hr

You are a Registered Nurse (RN) who operates with great attention to detail and a big heart. You ... review these with LPN or CMA assigned to the patient. * Coordinate a 30 day phone call with ...

Registered Nurse

Southampton, NJ · On-site

$50 - $55/hr

S/he will review each person's health status and medications and ensure that the program meets immediate health needs * The RN will provide assessment, planning, and implementation of medical care ...

Attention all Registered Nurses, we are calling you to partner with us as independent contractors ... Review health history, service member medical records, and medical questionnaires. * Interview ...

Attention all Registered Nurses, we are calling you to partner with us as independent contractors ... Review health history, service member medical records, and medical questionnaires. * Interview ...

Description Attention all Registered Nurses, we are calling you to partner with us as independent ... Review health history, service member medical records, and medical questionnaires. * Interview ...

Develop nursing care plans after completing patient evaluations and review of medical documents ... NJ RN License * Drug Screening * CPR/First Aid Certification * Ability to travel into community for ...

RN Case Manager

Somers Point, NJ · On-site

$42.78 - $57.02/hr

Minimum Requirements • NJ Licensed RN • Minimum 1 year experience in Care Management/Insurance ... hospital utilization management and care management • CCM • CNOR Salary - $42.78 - $57.02 ...

New

Minimum Requirements • NJ Licensed RN • Minimum 1 year experience in Care Management/Insurance ... hospital utilization management and care management • CCM • CNOR Salary - $42.78 - $57.02 ...

New

next page

Showing results 1-20

Utilization Review Rn information

See Atlantic City, NJ salary details

$21

$42

$69

How much do utilization review rn jobs pay per hour?

As of Aug 2, 2026, the average hourly pay for utilization review rn in Atlantic City, NJ is $42.48, according to ZipRecruiter salary data. Most workers in this role earn between $33.56 and $48.80 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 popular job titles related to Utilization Review Rn jobs in Atlantic City, NJ? For Utilization Review Rn jobs in Atlantic City, NJ, the most frequently searched job titles are:
What cities near Atlantic City, NJ are hiring for Utilization Review Rn jobs? Cities near Atlantic City, NJ with the most Utilization Review Rn job openings:
Infographic showing various Utilization Review Rn job openings in Atlantic City, NJ as of July 2026, with employment types broken down into 9% As Needed, 64% Full Time, 18% Part Time, and 9% Contract. Highlights an 100% In-person job distribution, with an average salary of $88,365 per year, or $42.5 per hour.

Advanced Practice Registered Nurse

Boca Recovery Center

Galloway, NJ

Full-time

Medical, Retirement, PTO

Re-posted 10 days ago


Job description

Advanced Practice Registered Nurse (APRN)

Boca Recovery Center Website

Location: On Site - Galloway NJ
Department: Medical Services
Reports to: Medical Director
Salary: Competitive, based on licensure and experience

About Boca Recovery Center

Founded in 2016, Boca Recovery Center is a nationally recognized addiction treatment provider specializing in substance use disorders and co-occurring mental health conditions. With locations in Florida, New Jersey, Indiana, and launching in Massachusetts, we deliver evidence-based clinical care in a supportive, structured environment. Our team is committed to providing trauma-informed, client-centered services that promote lasting recovery.

Position Overview

We are seeking an experienced and dedicated Advanced Practice Registered Nurse (APRN) to join our multidisciplinary medical team in Galloway, NJ. The APRN plays a key clinical role in delivering psychiatric and medical services to individuals in detox and residential treatment. This role requires clinical expertise in psychiatric evaluations, medication management, and a collaborative approach to patient care.

Requirements

Key Responsibilities

  • Provide advanced nursing expertise for the design and execution of medical and clinical activities in accordance with each patient's treatment plan.
  • Conduct psychiatric and physical assessments, medication management, and consultations within scope of APRN practice.
  • Assess and assure the appropriateness of patient admissions and ongoing care.
  • Provide after-hours on-call coverage for emergency psychiatric or medical needs.
  • Attend and contribute to interdisciplinary team meetings to coordinate patient care.
  • Deliver in-service training to staff as needed.
  • Participate in facility performance improvement and utilization review activities.
  • Conduct peer reviews and contribute to the development and evaluation of policies and procedures.
  • Assist in developing a network of community resources for post-discharge continuity of care.
  • Collaborate with executive and clinical leadership on policies related to patient care.
  • Ensure timely and accurate documentation of assessments, orders, progress notes, and discharge summaries.
  • Provide consultation to patients and their families as appropriate.
  • Maintain a current collaborative agreement and prescriptive authority with the Medical Director.
  • Provide on-site services according to facility schedule and agreement.
  • Support and comply with infection control standards and collaborate with the Infection Control Nurse.
  • Ensure compliance with state and federal regulations and Joint Commission standards.
  • Uphold all safety, risk management, and workplace policies.
  • Coordinate clinical services under the guidance of the Medical Director, Clinical Director, and Director of Nursing.

Qualifications / Required Experience

  • Licensed to practice as an APRN in the state of New Jersey.
  • Active NPI and DEA registration (X-Waiver preferred but not required).
  • Current CPR certification.
  • Maintains all state-required certifications and licenses.
  • Minimum of 2 years' experience in psychiatric or addiction treatment settings preferred.
  • Essential Knowledge, Skills & Attributes
  • Proficiency in verbal and written communication.
  • Strong knowledge of addiction, dual-diagnosis treatment, and trauma-informed care.
  • Adherence to state Board of Nursing Scope of Practice and professional Code of Ethics.
  • Understanding of Infection Control protocols and Joint Commission standards.
  • Familiarity with HIPAA, Drug-Free Workplace, Workplace Violence Prevention, and Corporate Compliance.
  • High competency in electronic health records (EHR) systems.
  • Cultural sensitivity and ethical approach to diverse patient populations.
  • Ability to respond to psychiatric crises, including suicidality and homicidality.

Benefits

Boca Recovery Center offers a comprehensive benefits package, including:

  • Health Insurance
  • Retirement Plans
  • Disability Coverage
  • Paid Time Off
  • Continuing Education & Professional Development Opportunities

Join Boca Recovery Center and make a meaningful impact through expert, compassionate care in a mission-driven environment focused on recovery and wellness.