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

NHC

RN Registered Nurse

Greenville, SC · On-site

Position: RN, Registered Nurse Licensure: South Carolina Registered Nurse, RN Nursing license ... For further information, please review the Know Your Rights notice from the Department of Labor.

NHC

RN Registered Nurse

Laurens, SC · On-site

Position: RN, Registered Nurse Work Schedule: 3rd Shift - 7p to 7a Job Type: Full Time Licensure ... For further information, please review the Know Your Rights notice from the Department of Labor.

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Showing results 21-40

All JobsUtilization Review Rn JobsUtilization Review Rn Jobs in Greenville, SC

Utilization Review Rn information

See Greenville, SC salary details

$20

$39

$64

How much do utilization review rn jobs pay per hour?

As of Jul 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.

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 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 July 2026, with employment types broken down into 1% As Needed, 81% Full Time, 14% Part Time, 1% Temporary, and 3% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $82,695 per year, or $39.8 per hour.
Registered Nurse (RN) - Home Health

Registered Nurse (RN) - Home Health

Spartanburg Regional Medical Center

Spartanburg, SC • On-site

Full-time

Posted 7 days ago

Spartanburg Regional Healthcare System rating

6.7

Company rating: 6.7 out of 10

Based on 117 frontline employees who took The Breakroom Quiz

532nd of 890 rated healthcare providers

Job description

Job Requirements
SIGN ON BONUS $10,000.00 Eligible Experienced RN
We are hiring a Registered Nurse to join our Home Health team!
  • Full-Time; 8:30am - 5:00pm

We are proud of our skilled, caring, trustworthy and compassionate Home Health experts. Our clinicians visit patient homes to deliver customized, physician-prescribed care after a hospital stay, illness or injury to rehabilitate and achieve optimal level of independence. Home Health is an alternative to repeated hospitalizations or an extended hospital stay. Nurses and medical professionals work closely with primary care physicians and ensure patients are receiving optimum care tailored to individual needs.
Our Registered Nurses enjoy autonomy while caring for patients in their home environment. The team works with a wide variety of cases such as: Wound Care, Cardiac, Diabetes, Endocrine, Musculosketal, Pressure Ulcers, Infusion, etc. The average length of patient care is 47 days.
The Registered Nurse provides skilled nursing services within the home care setting in accordance with the orders of a physician and under a plan of care. Through use of the nursing process, utilizes knowledge and skills at a competent level to provide direct age-specific and culturally appropriate patient care management in the homecare setting. The RN also serves as a clinical resource, participates in patient and staff education, demonstrates the use of independent nursing judgment, and serves as a preceptor. Develops and coordinates the plan of care and provides case management. Performs other duties as assigned.
Minimum Requirements
Education
  • Graduate of an approved nursing program

Experience
  • One (1) year of recent clinical nursing experience

License/Registration/Certifications
  • Current license to practice as a Registered Nurse in South Carolina
  • Valid SC driver's license with good driving record
  • CPR certification

Core Job Responsibilities
  • Responsible for continuous review of all aspects of patients on his/her caseload to include but not limited to: appropriate utilization of services; review of documentation in the medical record; maintenance of interdisciplinary communication and discharge planning.
  • Completes an initial assessment of patient and family to determine home care needs. Provides a complete physical assessment and history of current and previous illness(es) and medication reconciliation.
  • Collaborates with patients, families, and other members of the interdisciplinary care team to establish appropriate treatment plan and develop a plan of care.
  • Initiates the plan of care, makes necessary revisions as patient status, and needs change. Regularly re-evaluates patient nursing needs.
  • Initiates and facilitates interdisciplinary collaboration to enhance outcomes.
  • Initiates appropriate nursing interventions. Provides treatments as prescribed by the physician.
  • Provides health care instructions to the patient as appropriate per assessment and plan. Educates the patient and family/caregiver on self-care techniques medications, diet and other instructions as ordered.
  • Recognizes and utilizes opportunities for health counseling with patients and families/ caregivers.
  • Communicates with the physician regarding the patient's needs and reports changes in the patient's condition; communicates regularly with the interdisciplinary team; communicates with community health related persons to coordinate the plan of care; and communicates on a regular basis with manager.
  • Provides supervision of home health aides per regulatory requirements.
  • Complies with established policies and procedures.
  • Knowledge of and compliance with state, federal, and local regulations for the delivery of home care services.
  • Performs other duties as assigned.

What Spartanburg Regional Healthcare System employees say

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About Spartanburg Regional Healthcare System

Sourced by ZipRecruiter

Spartanburg Regional Healthcare System is a leader in the healthcare industry, located in Spartanburg, SC, US. As a comprehensive health system, it offers services encompassing everything from wellness, prevention, and care coordination to specific medical treatments for a wide range of diseases and health issues. Spartanburg Regional Healthcare System was founded in 1921 and has since developed a reputation for excellence and innovative care, growing to include six hospitals, 100 medical offices, 8,000 associates and more than 900 medical staff.

Industry

Recruiting and staffing services

Company size

5,001 - 10,000 Employees

Headquarters location

Spartanburg, SC, US

Year founded

1921

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