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

OVATION COMMUNITIES

Registered Nurse

Milwaukee, WI

Registered Nurse Shift: AM Location: Ovation Communities -- Jewish Home & Care Center Ovation ... Oversees, directs, reviews and evaluates work performance of nursing staff and participates in ...

Aria of Waukesha

Registered Nurse (RN) PRN

Waukesha, WI · On-site

$38 - $45/hr

Registered Nurse (RN) Job Benefits: * Competitive Pay * Health Insurance including Dental and ... Review medication orders for completeness of information and accuracy. * Transcribe physician ...

Aria of Waukesha

Registered Nurse (RN) PRN

Waukesha, WI · On-site

$38 - $45/hr

Registered Nurse (RN) Job Benefits: * Competitive Pay * Health Insurance including Dental and ... Review medication orders for completeness of information and accuracy. * Transcribe physician ...

Wellpath

Travel Registered Nurse (RN)

Milwaukee, WI · On-site

Overview The RN Travel supports patient care delivery through assessment, planning, implementation ... Maintain accurate documentation in SOAP format and review medical records * Respond to emergencies ...

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How much do utilization review rn jobs pay per hour?

As of Jun 11, 2026, the average hourly pay for utilization review rn in Milwaukee, WI is $41.62, according to ZipRecruiter salary data. Most workers in this role earn between $32.88 and $47.79 per hour, depending on experience, location, and employer.

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.

How do I become a utilization review RN?

To become a utilization review RN, you typically need to hold a valid registered nurse (RN) license and have experience in clinical nursing. Additional certifications such as the Certified Professional in Healthcare Quality (CPHQ) or Utilization Review Certification (URAC) can enhance job prospects, and strong knowledge of medical coding, insurance policies, and healthcare regulations is important.

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 does an RN utilization review do?

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

How to make $300,000 a year as a nurse?

To earn $300,000 annually as a Utilization Review RN, professionals typically need extensive experience, advanced certifications such as CCM or ANCC, and may work in high-paying settings like insurance companies or healthcare consulting firms. Increasing specialization, taking on leadership roles, or working overtime can also boost income, but reaching this level often requires a combination of skills, experience, and strategic career moves.

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 CCM or ANCC, and working in high-paying settings like insurance companies or managed care organizations. Advanced skills in case management, strong clinical knowledge, and sometimes working overtime or in leadership roles can also contribute to higher earnings.

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.
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Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Milwaukee, WI as of June 2026, with employment types broken down into 75% Full Time, 21% Part Time, 2% Contract, and 2% Nights. Highlights an 92% In-person, and 8% Remote job distribution, with an average salary of $86,573 per year, or $41.6 per hour.
Registered Nurse

Registered Nurse

OVATION COMMUNITIES

Milwaukee, WI

Other

Posted 22 days ago

Job description

Registered Nurse 
Shift: AM
Location: Ovation Communities — Jewish Home & Care Center 

Ovation Communities is seeking a Registered Nurse to provide prescribed medial treatment, medication and personal care services to nursing home residents to meet individual spiritual, physical, emotional and social needs consistent with the plan of care, Standard Nursing practice, scope of gerontological nursing procedures and all applicable regulations, codes, policies and procedures.

Key Responsibilities:

  • Supervises all nursing activities delegated by the supervisor and/or Nurse Manager during the assigned shift
  • Oversees, directs, reviews and evaluates work performance of nursing staff and participates in Quality Assurance or educational activities on assigned shift to determine and ensure conformance with current State and Federal regulations
  • Administers and documents medication, treatments, etc. within the parameters of the RN licensure and according to the care plan.  Reports any changes to the manager or supervisor.
  • Reports significant changes in resident’s condition immediately to the manager/supervisor and notifies appropriate people as directed
  • Assists with obtaining, transcribing and following through with physicians’ orders.
  • Orders, properly stores, administers and records medications and treatment supplies and notes their results

Learn More:

For a full list of benefits and perks, please visit our careers page.

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