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

Utilization Review Registered Nurses in the United States are often veterans in their line of work, with just below two-thirds bringing more than 10 years of experience to the table. Salaries slide in at $65K per year on average but can range from $51K to $85K per year. While the company and tenure impact pay for this group, location is the most influential factor. Job satisfaction is high and work is enjoyable for most Utilization Review Registered Nurses. A fair number enjoy medical while the greater part get dental coverage. Vision coverage is also available to more than half. This snapshot results from replies to PayScale's salary survey.
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$50,675 - $82,906
(Median)
$51K
$65K
$83K
MEDIAN: $65,022
10%
50%
90%

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$24.03 - $41.24
(Median)
$24
$31
$41
MEDIAN: $30
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$29K$58K$87K
Salary
$50,675 - $82,906  
   
Bonus
$0.00 - $5,072  
Profit Sharing
$102.50  
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).
)
$50,811 - $85,422  
Country: United States | Currency: USD | Updated: 12 Jan 2016 | Individuals Reporting: 576
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$20$40$60
Hourly Rate
$24.03 - $41.24  
   
Overtime
$0.00 - $59.47  
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
$0.00 - $5,072  
   
Profit Sharing
$102.50  
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).
)
$50,811 - $85,422  
Country: United States | Currency: USD | Updated: 12 Jan 2016 | Individuals Reporting: 460
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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)


UnitedHealth Group, Humana, Inc., United Healthcare Group, Aetna, Inc., and Centene Corporation are leaders in the field that employ a large number of Utilization Review Registered Nurses. Although UnitedHealth Group offers the highest salaries (median pay is $72K), survey participants reported a rather limited pay range of $64K to $77K.

Not only do salaries lack room to grow — pay ranges from $45K to just $67K — but Humana, Inc. offers the lowest pay in town to boot, with a median paycheck of $58K.

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


Survey results imply that Utilization Review Registered Nurses deploy a substantial tool kit of skills at work. 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, Home Health/Home Care, and Labor & Delivery, Birthing. Those familiar with Case Management also tend to 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.


For Utilization Review Registered Nurses, experience does not seem to be a major factor in determining pay. Relatively untried employees who have fewer than five years of experience earn around $62K on average. People who have worked for five to 10 years can expect a higher median salary of $64K. For Utilization Review Registered Nurses, 10 to 20 years of experience on the job amounts to an average salary of $65K. Veterans who have worked for more than two decades do tend to make the most in the end; the median pay for this group is $69K.

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



National Average
$65,000



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

Utilization Review (UR)
up arrow 3%

Intensive Care Unit (ICU)
up arrow 3%

Pediatrics
up arrow 3%

Case Management
up arrow 1%

Medicine / Surgery
up arrow 1%

National Average
$65,000

Acute Care
up arrow 1%

Emergency Room (ER)
up arrow 1%

Geriatrics
up arrow 2%

Hospice
up arrow 3%

Labor & Delivery, Birthing
up arrow 3%

Home Health/Home Care
up arrow 5%


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: 80%
dental benefits
Dental: 70%
medical benefits
Vision: 58%
dental benefits
None: 17%
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