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Utilization Review Rn Jobs in New York, NY (NOW HIRING)

CareConnect

Utilization Review RN

Greenvale, NY · On-site

Reviews and coordinates prospective, concurrent and retrospective activities related to utilization ... Bachelor's Degree in Nursing, preferred. Must be enrolled in an accredited program within 24 months ...

CareConnect

Utilization Review RN

Greenvale, NY · On-site

Reviews and coordinates prospective, concurrent and retrospective activities related to utilization ... Bachelor's Degree in Nursing, preferred. Must be enrolled in an accredited program within 24 months ...

Jacobi Medical Center

RN - Utilization Review

Bronx, NY · On-site

$2.4K/wk

Details Client Name Jacobi Medical Center - NYCHH Job Type Travel Offering Nursing Profession RN Specialty Utilization Review Job ID 18960406 Weekly Pay $2440.59 Shift Details Shift 5x8 Days ...

Pride Health

Utilization Review Nurse

Manhattan, NY · On-site

$60 - $61/hr

Care Manager (RN) - Non-Patient-Facing - MLTC Location: New York, NY - Hybrid Schedule: Monday ... Perform utilization review and discharge planning. * Collaborate with providers and ...

New

Brookdale Associates

Be Seen First

Clinical Review Nurse

Manhattan, NY · Remote

$55 - $60/hr

Active, unrestricted Registered Nurse NY State (RN) license (required). * Strong knowledge of CMS criteria, Medicaid guidelines, and managed care appeal processes. * Experience in utilization review ...

GQR Global Markets

RN Case Manager

Mount Vernon, NY · On-site

$2.8K - $2.9K/wk

Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location: Mount Vernon, New York Start Date: August 3, 2026 Profession: Registered Nurse (RN) Facility: Estimated Pay: $2840 ...

GQR Global Markets

RN Case Manager

Bronx, NY · On-site

$3.0K - $3.1K/wk

Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location: West Bronx, New York Start Date: July 4, 2026 Profession: Registered Nurse (RN) Facility: Short Term Acute Care ...

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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 New York, NY is $46.40, according to ZipRecruiter salary data. Most workers in this role earn between $36.68 and $53.27 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 New York, NY?

The most popular types of Utilization Review Rn jobs in New York, NY are:

What are popular job titles related to Utilization Review Rn jobs in New York, NY?

For Utilization Review Rn jobs in New York, NY, the most frequently searched job titles are:

What job categories do people searching Utilization Review Rn jobs in New York, NY look for?

The top searched job categories for Utilization Review Rn jobs in New York, NY are:

What cities near New York, NY are hiring for Utilization Review Rn jobs?

Cities near New York, NY with the most Utilization Review Rn job openings:

Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in New York, NY as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 13% Part Time, 3% Contract, and 1% Nights. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $96,952 per year, or $46.6 per hour.

Utilization Review (UR) Registered Nurse RN

Voca Healthcare

Elmhurst, NY

$72.09/hr

Contractor

Posted yesterday

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Job description

We are looking for a Travel Utilization Review RN for a great Travel nursing job in Elmhurst, NY.

This Utilization Review Travel nursing job pays for 40 hours a week for 8 weeks. With Wanderly you can compare Travel nurse salary from leading Travel nurse agencies in the United States.

With Wanderly you can chat and apply to any agency with Wanderly’s Universal Application, below are the details of this Travel Nursing Job including the Travel nurse salary:

  • Specialty: Utilization Review RN
  • Travel Utilization Review (UR) Registered Nurse : Elmhurst, NY
  • Travel Nurse Salary: $2884/Week
  • Start Date: September 14, 2026
  • Travel Nursing Job Assignment Length: 8 weeks
  • Travel Nurse Hours: 40 hours per week
  • Shift: 8 hours, day

PK-19030015

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