Registered Nurse (RN), Utilization Review (UR) Salary

With just below two-thirds of Utilization Review Registered Nurses in the United States reporting more than 10 years of experience, the field is heavily weighted toward experienced professionals. Average pay for Utilization Review Registered Nurses is $68K annually and can range from $52K on the lower end to $89K per year near the higher end. Residence is the biggest factor affecting pay for this group, followed by the specific employer and years of experience. Most workers in this position report high levels of job satisfaction. Most report receiving medical coverage from their employers and a strong majority collect dental insurance. The numbers in this rundown were provided by PayScale's salary survey participants.
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$52,351 - $86,625
$52K
$68K
$87K
MEDIAN: $68,222
10%
50%
90%

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$24.82 - $43.90
$25
$32
$44
MEDIAN: $31.79
10%
50%
90%

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National Salary Data (?
XAll compensation data shown are gross 10th to 90th percentile ranges. Take the PayScale Survey to find out how location influences pay for this job.
)
$0$30K$60K$90K
Salary
$52,351 - $86,625  
   
Bonus
$511 - $9,658  
Profit Sharing
$989  
Total Pay (?
XTotal Pay combines base annual salary or hourly wage, bonuses, profit sharing, tips, commissions, overtime pay and other forms of cash earnings, as applicable for this job. It does not include equity (stock) compensation, cash value of retirement benefits, or the value of other non-cash benefits (e.g. healthcare).
)
$52,470 - $89,342  
Country: United States | Currency: USD | Updated: 4 May 2017 | Individuals Reporting: 383
National Hourly Rate Data (?
XAll compensation data shown are gross 10th to 90th percentile ranges. Take the PayScale Survey to find out how location influences pay for this job.
)
$0$21$42$63
Hourly Rate
$24.82 - $43.90  
   
Overtime
$34.28 - $62.28  
National Annualized Data (?
XAll compensation data shown are gross 10th to 90th percentile ranges. Take the PayScale Survey to find out how location influences pay for this job.
)
$0$50K$100K$150K
Bonus
$511 - $9,658  
   
Profit Sharing
$989  
Total Pay (?
XTotal Pay combines base annual salary or hourly wage, bonuses, profit sharing, tips, commissions, overtime pay and other forms of cash earnings, as applicable for this job. It does not include equity (stock) compensation, cash value of retirement benefits, or the value of other non-cash benefits (e.g. healthcare).
)
$52,470 - $89,342  
Country: United States | Currency: USD | Updated: 4 May 2017 | Individuals Reporting: 309

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Job Description for Registered Nurse (RN), Utilization Review (UR)

The primary responsibility of the utilization review nurse is to review medical records and prepare clinical appeals (when appropriate) on medical necessity, level of care, length of stay, and authorization denials for hospitalized patients. An understanding of the severity of an array illnesses, intensity of service, and care coordination needs are key, as the nurse must integrate clinical knowledge with billing knowledge to review, evaluate, and appeal clinical denials related to the care provided to the hospitalized patient. The utilization review nurse works with the multidisciplinary team to assess and improve the denial management, documentation, and appeals process of such findings.

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Registered Nurse (RN), Utilization Review (UR) Tasks

  • Analyze information gathered by investigation, and report findings and recommendations.
  • Modify patient treatment plans as indicated by patients' responses or case history.
  • Audit and analyze patient records to ensure quality patient care and appropriateness of services.
  • Interview or correspond with physicians to correct errors or omissions and to investigate questionable claims.

Registered Nurse (RN), Utilization Review (UR) Job Listings

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Popular Employer Salaries for Registered Nurse (RN), Utilization Review (UR)


UnitedHealth Group, United Healthcare Group, Aetna, Inc., Humana, Inc., and Anthem are among the top companies that take on many Utilization Review Registered Nurses. Heading up the field in terms of compensation, Anthem offers the most; Utilization Review Registered Nurses earn $74K on average there.

Popular Skills for Registered Nurse (RN), Utilization Review (UR)


Survey takers working as Utilization Review Registered Nurses report using a large range of professional skills. Most notably, skills in Emergency Room, Pediatrics, Medicine / Surgery, and Hospice are correlated to pay that is above average. Skills that pay less than market rate include Home Health/Home Care, Labor & Delivery, Birthing, and Geriatrics. Most people familiar with Case Management also know Acute Care and Medicine / Surgery.

Pay by Experience Level for Registered Nurse (RN), Utilization Review (UR)

Pay by Experience for a Registered Nurse (RN), Utilization Review (UR) has a positive trend. An entry-level Registered Nurse (RN), Utilization Review (UR) with less than 5 years of experience can expect to earn an average total compensation of $63,000 based on 175 salaries provided by anonymous users. Average total compensation includes tips, bonus, and overtime pay. A Registered Nurse (RN), Utilization Review (UR) with mid-career experience which includes employees with 5 to 10 years of experience can expect to earn an average total compensation of $65,000 based on 157 salaries. An experienced Registered Nurse (RN), Utilization Review (UR) which includes employees with 10 to 20 years of experience can expect to earn an average total compensation of $68,000 based on 246 salaries. A Registered Nurse (RN), Utilization Review (UR) with late-career experience which includes employees with greater than 20 years of experience can expect to earn an average total compensation of $71,000 based on 233 salaries.

Pay Difference by Location

National Average: $67,820

Larger city markers indicate a job is popular in that location.

For Utilization Review Registered Nurses, Washington, New York, and Philadelphia, three eastern American cities, are home to the highest salaries in the country, all offering a rate above the national average. The smallest paychecks in the market, 17 percent south of the national average, can be found in Raleigh. A couple other locations with smaller-than-average paychecks include Columbus and Richmond (6 percent lower).

Related Job Salaries

Key Stats for Registered Nurse (RN), Utilization Review (UR)

Gender

Female
96 %
Male
4 %

Job Satisfaction

Extremely satisfied
Rated 5 out of 5
based on 78 votes.
Less than 1 year
2%
1-4 years
18%
5-9 years
16%
10-19 years
29%
20 years or more
35%
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Location:
Years in Fields/Career:
United States (change)

Experience Affects Registered Nurse (RN), Utilization Review (UR) Salaries

▲5%

▼0%

National Average
$68,000

▼4%

▼7%

Skills That Affect Registered Nurse (RN), Utilization Review (UR) Salaries


Pediatrics
▲2%

Utilization Review (UR)
▼0%

Case Management
▼0%

Medicine / Surgery
▼0%

Hospice
▼0%

National Average
$68,000

▼1%


▼2%

▼6%

Labor & Delivery, Birthing
▼7%

Home Health/Home Care
▼9%

Job Satisfaction

Extremely satisfied
Rated 5 out of 5
based on 78 votes.

Gender

Female
96 %
Male
4 %

Years of Experience

Less than 1 year
2%
1-4 years
18%
5-9 years
16%
10-19 years
29%
20 years or more
35%

Common Health Benefits

medical benefits
Medical: 81%
dental benefits
Dental: 70%
vision benefits
Vision: 64%
no benefits
None: 16%
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