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Utilization Review Rn Jobs in Fort Mill, SC (NOW HIRING)

Erickson

Assistant Director of Nursing, RN

Matthews, NC

$100K - $115K/yr

Participating in Wound Rounds, Operations Meetings, Utilization Review, and Performance Improvement ... Current RN nursing license with no restrictions for the state in which they operate. * Expertise in ...

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All JobsUtilization Review Rn JobsUtilization Review Rn Jobs in Fort Mill, SC

Utilization Review Rn information

See Fort Mill, SC salary details

$18

$37

$60

How much do utilization review rn jobs pay per hour?

As of Jul 16, 2026, the average hourly pay for utilization review rn in Fort Mill, SC is $37.16, according to ZipRecruiter salary data. Most workers in this role earn between $29.38 and $42.69 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 Fort Mill, SC? The most popular types of Utilization Review Rn jobs in Fort Mill, SC are:
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What job categories do people searching Utilization Review Rn jobs in Fort Mill, SC look for? The top searched job categories for Utilization Review Rn jobs in Fort Mill, SC are:
What cities near Fort Mill, SC are hiring for Utilization Review Rn jobs? Cities near Fort Mill, SC with the most Utilization Review Rn job openings:
Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Fort Mill, SC 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 $77,283 per year, or $37.2 per hour.

Registered Nurse (RN)

Always Best Care Senior Services - Matthews

Charlotte, NC

$32 - $35/hr

Per diem

Medical, Dental, Vision

Re-posted 2 days ago

Job description

Always Best Care is hiring!

Always Best Care Senior Services is seeking a (RN) Registered Nurse with strong leadership skills who can provide oversight to patient services including, assessments, supervision and discharge of all clients. The RN will participate in the orientation and the training of all clinical staff, validates skills, and develop new policies as needed.

The RN will manage clients in the Charlotte area including Matthews, Pineville, Mint Hill, Monroe, Ballantyne, and Indian Land.

***The RN needs to be available in emergencies and must have a flexible schedule throughout the week. This position is PRN.

Duties Include:

  • Conducts client in home Supervisory visits at least every 90 days and documents such findings
  • Completes client record review every 90 days
  • Validation skills of the in-home Caregivers

Schedule:

  • Day shift
  • On-call

Job Type: PRN

Pay: $32 to $35 hr

Requirements Include:

  • Current, valid Registered Nurse License with the NC Board of Nursing
  • Successful completion of a Blood and Airborne Pathogens instructor course such as the types provided by AHEC Connect, the American Heart Association and the Red Cross
  • Must have a negative criminal background check
  • Must have negative TB screen
  • Must have current and valid drivers license

Highlights:

  • Competitive pay
  • Weekly Pay
  • Flexible schedule
  • Holiday pay
  • Health, Dental, Vision and Disability Insurance
  • Mileage reimbursement and other bonuses

Apply