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Utilization Review Rn Jobs in Raleigh, NC (NOW HIRING)

AMSURG

Pre Admin Nurse RN

Clayton, NC · On-site

Support efficient room turnover and appropriate utilization of supplies Documentation, Safety ... For further information, please review the Know Your Rights notice from the Department of Labor.

Granville Health System

LPN/ RN

Oxford, NC · On-site

$25 - $34/hr

... utilization of the nursing process in collaboration with other health team members. The LPN or RN ... will be responsible for meeting the standards required by JCAHO, GHS, and other regulating agencies ...

Granville Health System

LPN/ RN

Oxford, NC

$25 - $34/hr

... utilization of the nursing process in collaboration with other health team members. The LPN or RN ... will be responsible for meeting the standards required by JCAHO, GHS, and other regulating agencies ...

Granville Health System

LPN/ RN

Oxford, NC

$25 - $34/hr

... utilization of the nursing process in collaboration with other health team members. The LPN or RN ... will be responsible for meeting the standards required by JCAHO, GHS, and other regulating agencies ...

Amsurg

PRN Endoscopy Registered Nurse (RN)

Clayton, NC · On-site

Support efficient room turnover and appropriate utilization of supplies Documentation, Safety ... Current Registered Nurse (RN) license * Basic Life Support (BLS) required * Advanced Cardiac Life ...

AMSURG

PRN Endoscopy Registered Nurse (RN)

Clayton, NC · On-site

Support efficient room turnover and appropriate utilization of supplies Documentation, Safety ... Current Registered Nurse (RN) license * Basic Life Support (BLS) required * Advanced Cardiac Life ...

Duke University

Registered Nurse

Durham, NC · On-site

Review and interpret treatment orders and protocols. * Coordinate communication with external ... Promote effective utilization of clinical resources and equipment. * Support infection prevention ...

Duke University

Registered Nurse

Durham, NC

Review and interpret treatment orders and protocols. * Coordinate communication with external ... Promote effective utilization of clinical resources and equipment. * Support infection prevention ...

AMSURG

Pre Admin Nurse RN

Clayton, NC

Support efficient room turnover and appropriate utilization of supplies Documentation, Safety ... Current Registered Nurse (RN) license * Basic Life Support (BLS) required * Advanced Cardiac Life ...

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Utilization Review Rn information

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How much do utilization review rn jobs pay per hour?

As of Aug 23, 2026, the average hourly pay for utilization review rn in Raleigh, NC is $41.10, according to ZipRecruiter salary data. Most workers in this role earn between $32.50 and $47.21 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 Raleigh, NC?

The most popular types of Utilization Review Rn jobs in Raleigh, NC are:

What are popular job titles related to Utilization Review Rn jobs in Raleigh, NC?

For Utilization Review Rn jobs in Raleigh, NC, the most frequently searched job titles are:

What job categories do people searching Utilization Review Rn jobs in Raleigh, NC look for?

The top searched job categories for Utilization Review Rn jobs in Raleigh, NC are:

What cities near Raleigh, NC are hiring for Utilization Review Rn jobs?

Cities near Raleigh, NC with the most Utilization Review Rn job openings:

Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Raleigh, NC as of August 2026, with employment types broken down into 8% As Needed, 65% Full Time, 8% Part Time, 5% Temporary, and 14% Contract. Highlights an 86% In-person, and 14% Remote job distribution, with an average salary of $85,486 per year, or $41.1 per hour.

PRN Endoscopy Registered Nurse (RN)

AMSURG

Clayton, NC • On-site

Part-time

Re-posted 18 days ago

AmSurg rating

6.2

Company rating: 6.2 out of 10

Based on 24 frontline employees who took The Breakroom Quiz

Job description

PRN Endoscopy Registered Nurse (RN)
Location: Clayton Endoscopy Center - Clayton, NC
Position Type: PRN / As-Needed
About the Role
Clayton Endoscopy Center is seeking a PRN Endoscopy Registered Nurse (RN) to provide safe, efficient, and compassionate care to patients undergoing endoscopic procedures. This role is ideal for experienced nurses looking for flexible, as-needed scheduling in a focused outpatient procedural setting.
Under the direction of the Nurse Manager, the PRN RN delivers professional, direct patient care throughout the endoscopy process. The nurse utilizes the nursing process to assess patients, develop and implement individualized plans of care, monitor outcomes, and adjust care as needed to ensure optimal patient safety and satisfaction.
What You'll Do
Direct Patient Care
  • Provide nursing care across the endoscopy continuum, including pre-procedure, intra-procedure, and post-procedure phases
  • Assess, monitor, and document patient status in accordance with policies and procedures
  • Verify patient identity, procedure, and physician using approved safety and time-out protocols
  • Explain procedures and plans of care, providing comfort, reassurance, and patient education
  • Maintain patient privacy, dignity, and patient rights at all times
  • Administer medications per physician orders and document appropriately
  • Monitor for and report abnormal findings or complications to the physician and anesthesia provider
  • Monitor patients during recovery from anesthesia and prepare patients for safe discharge

Procedural & Clinical Support
  • Prepare procedure rooms, equipment, instruments, and supplies based on patient and physician needs
  • Assist with safe patient positioning and continuous monitoring during procedures
  • Support physicians and the procedural care team in the endoscopy suite
  • Handle, label, and log tissue specimens accurately according to policy and procedure
  • Ensure instruments and equipment meet high-level disinfection and sterilization requirements
  • Support efficient room turnover and appropriate utilization of supplies

Documentation, Safety & Compliance
  • Accurately document patient care and procedural details in the medical record
  • Follow all Center policies, procedures, and regulatory requirements
  • Adhere to infection prevention practices, aseptic technique, and sterile processes
  • Participate in patient safety initiatives and quality improvement efforts
  • Communicate safety concerns and clinical variances appropriately
  • Perform other duties as assigned

What We're Looking For
  • Strong clinical judgment and attention to detail
  • Ability to work efficiently and independently in a procedural environment
  • Excellent communication and teamwork skills
  • Commitment to patient safety, quality outcomes, and compassionate care
  • Flexibility and reliability for PRN scheduling needs

Qualifications
  • Current Registered Nurse (RN) license
  • Basic Life Support (BLS) required
  • Advanced Cardiac Life Support (ACLS) preferred
  • Prior experience in endoscopy, GI, procedural, surgical, PACU, or perioperative nursing preferred

Why Join Clayton Endoscopy Center (PRN)
  • Flexible, as-needed scheduling
  • Daytime procedural environment
  • No inpatient or overnight responsibilities
  • Supportive, team-based culture
  • Opportunity to maintain work-life balance while utilizing specialized nursing skills

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

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