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

The majority of Utilization Review Registered Nurses in the United States — just under two-thirds — boast more than 10 years of experience in their profession. Salaries stretch from $51K to $85K per year, and the median is $65K per year. Geographic location is the main element affecting pay for this group — the company and years of experience are driving factors as well. A fair number report receiving medical coverage from their employers and the larger part collect dental insurance. Most Utilization Review Registered Nurses report high levels of job satisfaction. The figures in this rundown are based on the results of PayScale's salary questionnaire.
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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)


Many Utilization Review Registered Nurses can be found at UnitedHealth Group, Humana, Inc., United Healthcare Group, Aetna, Inc., and Centene Corporation, firms that are at the top of the field. Pay for Utilization Review Registered Nurses is best at UnitedHealth Group, which offers a median salary of $72K. However, the highest reported salaries don't seem to be much higher than the lowest ones; the pay range here runs from $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)


Utilization Review Registered Nurses report using a deep pool of skills on the job. Most notably, skills in Pediatrics, Utilization Review, Intensive Care Unit, and Case Management are correlated to pay that is above average. At the other end of the pay range are skills like Psychiatric, Home Health/Home Care, and Labor & Delivery, Birthing. For most people, competency in Case Management indicates knowledge of 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 do not generally earn higher incomes from more experience in the field. The average inexperienced worker earns $62K, and someone who has worked for five to 10 years can expect a bigger median salary of $64K. Utilization Review Registered Nurses bring in $65K after working for 10 to 20 years. Utilization Review Registered Nurses who have acquired more than two decades of experience generally do see greater compensation; their average income is approximately $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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