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

Avina of Kenosha

RN NOC Nurse

Kenosha, WI

$42 - $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 ...

Avina of Kenosha

RN NOC Nurse

Kenosha, WI

$42 - $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 ...

Apply Early

The Manor of Kenosha

RN NOC Nurse

Kenosha, WI · On-site

$42 - $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 ...

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

$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 ...

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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 ...

Avina of Kenosha

Registered Nurse (RN) PM Shift

Kenosha, WI · On-site

$42 - $45/hr

SIGN ON BONUS $20,000 OVER 2 YEARS Registered Nurse (RN) Job Benefits: * Competitive Pay * Health ... Review medication orders for completeness of information and accuracy. * Transcribe physician ...

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All JobsUtilization Review Rn JobsUtilization Review Rn Jobs in Milwaukee, WI

Utilization Review Rn information

See Milwaukee, WI salary details

$21

$41

$67

How much do utilization review rn jobs pay per hour?

As of Jul 6, 2026, the average hourly pay for utilization review rn in Milwaukee, WI is $41.66, according to ZipRecruiter salary data. Most workers in this role earn between $32.93 and $47.84 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 Milwaukee, WI? For Utilization Review Rn jobs in Milwaukee, WI, the most frequently searched job titles are:
What job categories do people searching Utilization Review Rn jobs in Milwaukee, WI look for? The top searched job categories for Utilization Review Rn jobs in Milwaukee, WI are:
What cities near Milwaukee, WI are hiring for Utilization Review Rn jobs? Cities near Milwaukee, WI with the most Utilization Review Rn job openings:
Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Milwaukee, WI as of July 2026, with employment types broken down into 1% As Needed, 75% Full Time, 18% Part Time, 4% Temporary, and 2% Contract. Highlights an 91% Physical, 2% Hybrid, and 7% Remote job distribution, with an average salary of $86,649 per year, or $41.7 per hour.

Director of Nursing (DON)

Milwaukee Nursing and Rehab

Wauwatosa, WI

Full-time

Posted 4 days ago

Job description

Great Benefits and Pay Package!

Skilled Nursing Experience Required

 

We are looking for a Director of Nursing (DON) to care for our skilled nursing facility to help facilitate the speedy recovery of our residents. You will also be responsible for educating them and their families on prevention and healthy habits. The ideal candidate will be a responsible and well-trained professional, with experience as an ADON or DON in Wisconsin SNFs, and able to give the best nursing care with little supervision. 

Responsibilities: Director of Nursing (DON)

  • Ensures that nursing interventions meet the personal, physical and cognitive needs of each patient/resident as well as maximize his/her self care capacities, identity, independence, choice and opportunity for social interaction.
  • Monitors the outcomes of nursing service activity by evaluating the performance of nursing staff, ensuring compliance with all facility and regulatory agency standards, policies and procedures, coordinating facility committees and monitoring the effective and efficient use of budgeted resources (personnel, supplies, equipment).
  • Assumes full responsibility for the operation and management of the facility in the temporary absence of the Facility Administrator or as directed by the Administrator.
  • Develops short and long-range plans for the nursing department that are compatible with those of the facility.
  • Assists in recruiting and selects nursing service employees appropriate to facility need and budgetary guidelines.
  • Works in establishing and facilitating effective employer/employee relations.
  • Maintains adequate staffing ratios and levels of preparation to meet the needs of patients/residents.
  • Participates in the selection of patients/residents to be admitted by evaluating the level and amount of care required by prospective patients/residents in relation to existing nursing capabilities.
  • Actively maintains cohesive public and professional relationships with patients/residents, families, physicians and the community.
  • Incorporates nursing philosophy, standards and objectives into the evaluation process for staff and nursing services and ensures that the philosophy, objectives and standards of the nursing department are an integral part of the orientation and education of nursing service personnel.
  • Coordinates requirements and cooperates with all other departments in providing a favorable physical, social and emotional environment for all patients/residents.
  • Serves on Quality Improvement and Safety Committees that include Patient/Resident Standards of Care, Pharmaceutical Services, Infection Control, Safety and Utilization Review/PPS.
  • Meets with committee members to evaluate activities within the facility and to identify opportunities for continuous improvement in nursing operations.

Requirements: Director of Nursing (DON)

  • A minimum of 2-3 years’ management experience
  • A team player with excellent communication and interpersonal skills
  • Outstanding organizational and multi-tasking skills
  • Valid RN nursing license in the state of Wisconsin

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