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Utilization Review Rn Jobs in Greenville, SC (NOW HIRING)

PACS

Director of Nursing (DON), RN

Easley, SC · On-site

... DON, RN) - Full-Time $100,000-$115,000/year + Bonus Opportunities Easley, SC Schedule: Monday ... Participate in Quality Assurance (QA), Utilization Review, and Patient Care Conferences

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How much do utilization review rn jobs pay per hour?

As of Aug 28, 2026, the average hourly pay for utilization review rn in Greenville, SC is $39.76, according to ZipRecruiter salary data. Most workers in this role earn between $31.44 and $45.67 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 case management certification can enhance job prospects, and familiarity with electronic health records (EHR) systems is often required.

What are the most commonly searched types of Utilization Review Rn jobs in Greenville, SC?

The most popular types of Utilization Review Rn jobs in Greenville, SC are:

What are popular job titles related to Utilization Review Rn jobs in Greenville, SC?

For Utilization Review Rn jobs in Greenville, SC, the most frequently searched job titles are:

What job categories do people searching Utilization Review Rn jobs in Greenville, SC look for?

The top searched job categories for Utilization Review Rn jobs in Greenville, SC are:

What cities near Greenville, SC are hiring for Utilization Review Rn jobs?

Cities near Greenville, SC with the most Utilization Review Rn job openings:

Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Greenville, SC as of August 2026, with employment types broken down into 1% As Needed, 79% Full Time, 16% Part Time, 3% Contract, and 1% Nights. Highlights an 88% Physical, 3% Hybrid, and 9% Remote job distribution, with an average salary of $82,695 per year, or $39.8 per hour.

Home Health Registered Nurse- Greenville, SC

The JAG Group

Greenville, SC • On-site

Full-time

Re-posted 15 days ago

Job description

WEEKEND: Saturday through Monday
Two Openings: Greenville and Spartanburg, SC areas
OurHome Health Nurses, RN'shave been called to care when they're needed most. As a member of our home health team, you'll support a full range of patient services to bring comfort and dignity to our clients.
What you'll do:
  • Provide in-home direct patient care according to the provider's prescribed plan of care (and nursing scope of practice) while closely monitoring progress/recovery.
  • Assess and document patient conditions and report changes as needed (vitals, blood/stool/urine, glucose, etc.)
  • Administer medication, insulin, and IV/fluids; documenting thoroughly.
  • Inspect and care for wounds, changing dressings and assisting with personal hygiene.
  • Assess patient for further injuries, infections, bedsores, etc. and deliver appropriate treatments.
  • Collaborate with providers, aides, and allied health professionals to ensure exceptional patient outcomes.

What we're looking for:
  • Education: Associate's Degree in Nursing (ADN) or Associate of Applied Science in Nursing (AAS) required;
  • Licensure: Current unrestricted license to practice as a Registered Nurse (RN) in the state associated with this position.
  • Current CPR/AED/BLS/First Aid certification.
  • Valid state-issued driver's license, automobile insurance, and reliable transportation; willingness to travel.
  • One (1) year of professional experience practicing as a Registered Nurse (RN) in a home health or similar setting; previous case management/utilization review experience preferred.

What we offer:
  • Competitive compensation, benefits, and incentives.
  • Truly flexible scheduling - a dedication to work/life balance.
  • A team environment with a focus on community service.

Call to apply today!!
Derrick Green
The JAG Group
www.thejaggroup.com
dgreen@thejaggroup.com
404-405-6465

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