The average salary for a Utilization Review Nurse is $66,494 per year. Pay for this job does not change much by experience, with the most experienced earning only a bit more than the least.

$49,102 - $82,214
(Median)
$49K
$66K
$82K
MEDIAN: $66,493
10%
50%
90%

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$20.18 - $36.08
(Median)
$20
$28
$36
MEDIAN: $27.00
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$28K$56K$84K
Salary
$49,102 - $82,214  
   
Bonus
$1,000 - $7,000  
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).
)
$45,316 - $81,133  
Country: United States | Currency: USD | Updated: 28 Oct 2016 | Individuals Reporting: 180
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$90$180$270
Hourly Rate
$20.18 - $36.08  
   
Overtime
$29.36 - $256.34  
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$180K$360K$540K
Bonus
$1,000 - $7,000  
   
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).
)
$45,316 - $81,133  
Country: United States | Currency: USD | Updated: 28 Oct 2016 | Individuals Reporting: 106
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Job Description for Utilization Review Nurse

In the complex world of modern healthcare and the companies which manage patients' services, a utilization review nurse plays an important role. Hospitals and insurance providers employ these nurses to help determine if treatments which are underway or sought for authorization fall within the coverage parameters of a patient's insurance. Utilization review is one of the main ways health care providers and insurance companies control costs for the patients they serve.

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Utilization Review Nurse 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 Utilization Review Nurse

Popular Skills for Utilization Review Nurse

Pay by Experience Level for Utilization Review Nurse

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

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Experience Affects Utilization Review Nurse Salaries




National Average
$64,000


Skills That Affect Utilization Review Nurse Salaries

Medicine / Surgery
up arrow 4%

Utilization Management (UM)
up arrow 4%

Case Management
up arrow 3%

Acute Care
up arrow 2%

National Average
$64,000

Utilization Review (UR)
up arrow 1%

Geriatrics
up arrow 4%

Job Satisfaction

Highly satisfied
Rated 4 out of 5
based on 21 votes.

Gender

Female
91 %
Male
9 %

Years of Experience

Less than 1 year
5%
1-4 years
34%
5-9 years
22%
10-19 years
23%
20 years or more
16%

Common Health Benefits

medical benefits
Medical: 88%
dental benefits
Dental: 82%
medical benefits
Vision: 77%
dental benefits
None: 9%
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