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

Utilization Review Registered Nurses in the United States earn an average of $64K per year, and top pay can be found in New York, where the average is $79K. This report is based on responses to the PayScale salary survey.
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$50,275 - $81,688
(Median)
$50K
$64K
$82K
MEDIAN: $63,751
10%
50%
90%

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$23.54 - $41.44
(Median)
$24
$31
$41
MEDIAN: $30
10%
50%
90%

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National Salary Data (?
XAll compensation data shown are gross, national 10th to 90th percentile ranges. Pay can vary greatly by location. To view local data, take the PayScale survey.
)
$0$29K$58K$87K
Salary
$50,275 - $81,688  
   
Bonus
$0.00 - $4,909  
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).
)
$50,270 - $85,206  
Country: United States | Currency: USD | Updated: 2 Jul 2015 | Individuals Reporting: 521
National Hourly Rate Data (?
XAll compensation data shown are gross, national 10th to 90th percentile ranges. Pay can vary greatly by location. To view local data, take the PayScale survey.
)
$0$20$40$60
Hourly Rate
$23.54 - $41.44  
   
Overtime
$0.00 - $59.27  
National Annualized Data (?
XAll compensation data shown are gross, national 10th to 90th percentile ranges. Pay can vary greatly by location. To view local data, take the PayScale survey.
)
$0$50K$100K$150K
Bonus
$0.00 - $4,909  
   
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).
)
$50,270 - $85,206  
Country: United States | Currency: USD | Updated: 2 Jul 2015 | Individuals Reporting: 445
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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

  • 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.
  • Analyze information gathered by investigation, and report findings and recommendations.
  • Modify patient treatment plans as indicated by patients' responses or case history.

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

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


For Utilization Review Registered Nurses, comfortable salaries can be found at Aetna, Inc.; in fact, median earnings sit around $70K, the highest in the area.

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


Utilization Review Registered Nurses seem to require a rather large skill set. Most notably, skills in Pediatrics, Utilization Review, Intensive Care Unit, and Case Management are correlated to pay that is above average. Skills that seem to negatively impact pay include Psychiatric and Home Health/Home Care. The majority of those who know Case Management also know 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.


Experience does not seem to be a strong driver of pay increase in this role. People who have worked for fewer than five years earn around $62K, and folks with five to 10 years of experience see a modestly higher median of $63K. Utilization Review Registered Nurses bring in $65K after working for 10 to 20 years. 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 $69K.

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



National Average
$64,000



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

Pediatrics
up arrow 6%

Utilization Review (UR)
up arrow 4%

Case Management
up arrow 2%

Intensive Care Unit (ICU)
up arrow 2%

Medicine / Surgery
up arrow 1%

Acute Care
0%

Geriatrics
0%

Emergency Room (ER)
0%

National Average
$64,000

Hospice
up arrow 3%

Labor & Delivery, Birthing
up arrow 3%

Home Health/Home Care
up arrow 3%


Job Satisfaction

Extremely satisfied
Rated 5 out of 5
based on 116 votes.

Gender

Female
95 %
Male
5 %

Years of Experience

Less than 1 year
2%
1-4 years
17%
5-9 years
17%
10-19 years
30%
20 years or more
33%

Common Health Benefits

medical benefits Medical: 81% dental benefits Dental: 70%
vision benefits Vision: 58% employee benefits None: 16%
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