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Utilization Review Rn Jobs in Syracuse, NY (NOW HIRING)

HAN Staff

RN - Utilization Review

Syracuse, NY · On-site

Benefits We Offer: * Comprehensive health, prescription, dental, vision, life, and disability plans * Competitive pay rates * Referral opportunities ? Refer a friend & Cash in! * Travel reimbursement ...

Auburn Community Hospital

UR RN

Auburn, NY · On-site

$50/hr

UR RN's primary responsibility is to facilitate, in collaboration with the health care team, the ... Prior Utilization Review/Case Management or Healthcare role is preferred. * Ability to multitask ...

Auburn Community Hospital

UR RN

Auburn, NY · On-site

$50/hr

UR RN's primary responsibility is to facilitate, in collaboration with the health care team, the ... Prior Utilization Review/Case Management or Healthcare role is preferred. * Ability to multitask ...

Auburn Community Hospital

UR RN

Auburn, NY

$50/hr

UR RN's primary responsibility is to facilitate, in collaboration with the health care team, the ... Prior Utilization Review/Case Management or Healthcare role is preferred. * Ability to multitask ...

Auburn Community Hospital

UR RN

Auburn, NY

$50/hr

UR RN's primary responsibility is to facilitate, in collaboration with the health care team, the ... Prior Utilization Review/Case Management or Healthcare role is preferred. * Ability to multitask ...

RN

Hospital at Home, Registered Nurse

Syracuse, NY

$75K - $87K/yr

... utilization of advanced medical equipment. * Engage in tasks involving catheter insertion and care ... Nursing: License and current registration as a Registered Professional Nurse in New York State

RN

Hospital at Home, Registered Nurse

Syracuse, NY

$75K - $87K/yr

... utilization of advanced medical equipment. * Engage in tasks involving catheter insertion and care ... Nursing: License and current registration as a Registered Professional Nurse in New York State

RN

Hospital at Home, Registered Nurse

Syracuse, NY · On-site

$75K - $87K/yr

... utilization of advanced medical equipment. * Engage in tasks involving catheter insertion and care ... Nursing: License and current registration as a Registered Professional Nurse in New York State

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All JobsUtilization Review Rn JobsUtilization Review Rn Jobs in Syracuse, NY

Utilization Review Rn information

See Syracuse, NY salary details

$21

$41

$68

How much do utilization review rn jobs pay per hour?

As of Jul 30, 2026, the average hourly pay for utilization review rn in Syracuse, NY is $41.78, according to ZipRecruiter salary data. Most workers in this role earn between $33.03 and $47.98 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 Syracuse, NY? The most popular types of Utilization Review Rn jobs in Syracuse, NY are:
What are popular job titles related to Utilization Review Rn jobs in Syracuse, NY? For Utilization Review Rn jobs in Syracuse, NY, the most frequently searched job titles are:
What job categories do people searching Utilization Review Rn jobs in Syracuse, NY look for? The top searched job categories for Utilization Review Rn jobs in Syracuse, NY are:
What cities near Syracuse, NY are hiring for Utilization Review Rn jobs? Cities near Syracuse, NY with the most Utilization Review Rn job openings:
Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Syracuse, NY as of July 2026, with employment types broken down into 1% As Needed, 75% Full Time, 20% Part Time, 1% Temporary, and 3% Contract. Highlights an 89% Physical, 4% Hybrid, and 7% Remote job distribution, with an average salary of $86,893 per year, or $41.8 per hour.

Utilization Review Nurse

Healthcare Support Staffing

Syracuse, NY

Other

Re-posted 8 days ago

Job description

Company Description

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!


Interested in being considered? 

IF IS JOB OPPORTUNITY IS FOR YOU, GIVE ME A CALL AT 321-574-6926 


Job Description

Day to Day Responsibilities:

Conducts utilization management activities in accordance with Utilization Management policies and procedures. Responds to calls, conducts certification reviews, facilitates the discharge planning and referral process and coordinates denials with physician advisors for all assigned programs.

Receives prospective & concurrent requests for service. Coordinates certification reviews for pre-admission, continued stay and retroactive reviews. Interprets and applies clinical information to make delivery decisions and determine appropriate level of care for utilization review activities. (50%)

Follows departmental policies & procedures for review, determination & notification. Ensures day to day UM processes are conducted in accordance with NCQA, URAC and other regulatory standards. (15%)

Maintains effective interactions/communication w/ outside providers to assure appropriate delivery of service to members. (10%)

Reviews requests for medical necessity (referring cases to medical director that require additional expertise). Coordinate denials with physician advisors (10%)

Documents all activities per APS policies and procedures. (15%)

Work Environment / Physical Demands:

Work is performed in a professional office setting, business casual dress environment.

Working extended hours may be required as needed.

IF IS JOB OPPORTUNITY IS FOR YOU, GIVE ME A CALL AT 321-574-6926 ASAP! 


Qualifications

RN License in NY with 2 years of experience

Computer literate. This includes simultaneous use of multiple programs and applications; navigating varied file formats; performing copy/paste, save, and update information in multiple formats.

Utilization Review Experience, the nurse can come from a Hospital, Home Health, or Managed Care company/ health plan

Additional Information

Hello!

My name is Krishna Gapuz and I am a Recruiting Consultant with Healthcare Support. I specialize in the placement of medical professionals nationwide (both clinical and non-clinical). We just had an amazing opportunity become available for a Utilization Review RN right in Syracuse, NY (Zip Code 13202). They are looking to start a qualified candidate as quickly as possible (pending hire requirements). This is an amazing opportunity for a Monday - Friday 8:00a.m.-6:00p.m. job with a stable, prestigious company (This Company is one of the leading providers of Healthcare in your area!) 

If you would like to be considered for this opportunity please respond to this Email as soon (today) as possible! (or you're more than welcome to call me at my office 321-574-6926.   

If you opt to respond to this Email, please include:

  1. Why did you leave your last position and how long ago (or why are you looking to leave your current position)?
  2. How much were you last making (hourly)?
  3. If offered, how soon could you start?


Healthcare Support logo

About Healthcare Support

Sourced by ZipRecruiter

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!Healthcare Support Staffing, Inc. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.

Industry

Recruiting and staffing services

Company size

201 - 500 Employees

Headquarters location

Maitland, FL, US

Year founded

2003

Social media

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