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

Slightly less than two-thirds of Utilization Review Registered Nurses in the United States are seasoned employees who have more than 10 years of experience in the field. Pay ranges from $52K to $90K per year, and the average comes out to $68K annually. Geography is the biggest factor affecting pay for this group, followed by the specific employer and tenure. For the most part, Utilization Review Registered Nurses enjoy their work and report high levels of job satisfaction. Most report receiving medical coverage from their employers and the larger part collect dental insurance. Figures cited in this summary are based on replies to PayScale's salary questionnaire.
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$51,575 - $86,820
$52K
$68K
$87K
MEDIAN: $67,990
10%
50%
90%

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$24.66 - $44.61
$25
$32
$45
MEDIAN: $31.51
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$31K$62K$93K
Salary
$51,575 - $86,820  
   
Bonus
$375.00 - $9,500  
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).
)
$51,873 - $90,161  
Country: United States | Currency: USD | Updated: 18 Jan 2017 | Individuals Reporting: 380
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
$24.66 - $44.61  
   
Overtime
$33.47 - $61.35  
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
$375.00 - $9,500  
   
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).
)
$51,873 - $90,161  
Country: United States | Currency: USD | Updated: 18 Jan 2017 | Individuals Reporting: 307

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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)


Utilization Review Registered Nurses fill the offices of leading firms UnitedHealth Group, United Healthcare Group, Aetna, Inc., Humana, Inc., and Anthem. Utilization Review Registered Nurses flock to Anthem for generous paychecks, where average earnings of $74K lead the pack in compensation.

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 Pediatrics, Hospice, Case Management, and Intensive Care Unit (ICU) are correlated to pay that is above average. Skills that are correlated to lower pay, on the other hand, include Home Health/Home Care, Labor & Delivery, Birthing, and Geriatrics. Those educated in Case Management tend to be well versed in Acute Care and Medicine / Surgery.

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

Median of all compensation (including tips, bonus, and overtime) by years of experience.


Utilization Review Registered Nurses with more experience do not necessarily bring home bigger paychecks. In fact, experience in this field tends to impact compensation minimally. People who have worked for fewer than five years earn around $63K, and folks with five to 10 years of experience see a modestly higher median of $65K. The average pay reported by folks with 10 to 20 years of experience is around $68K. As Utilization Review Registered Nurses reach more than two decades on the job, compensation remains commensurate with experience; the average pay in this group is $71K.

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 74 votes.
Less than 1 year
2%
1-4 years
17%
5-9 years
18%
10-19 years
27%
20 years or more
36%
Location:
Years in Fields/Career:
United States (change)

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

▲6%

▲1%

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%

Intensive Care Unit (ICU)
▼0%

Emergency Room (ER)
▼0%

Hospice
▼0%

National Average
$68,000


▼2%

▼3%

▼6%

Labor & Delivery, Birthing
▼7%

Home Health/Home Care
▼9%

Job Satisfaction

Extremely satisfied
Rated 5 out of 5
based on 74 votes.

Gender

Female
96 %
Male
4 %

Years of Experience

Less than 1 year
2%
1-4 years
17%
5-9 years
18%
10-19 years
27%
20 years or more
36%

Common Health Benefits

medical benefits
Medical: 81%
dental benefits
Dental: 70%
vision benefits
Vision: 62%
dental benefits
None: 16%
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