Registered Nurse (RN) – Utilization Review

Job overview

The Registered Nurse (RN) – Utilization Review role is listed in East Elmhurst, NY. The posting describes a 13-week assignment and gives travel pay of $2,550–$2,630 per week or local pay of $69–$73 per hour. The role reviews non-acute healthcare services and clinical records against established criteria. The nurse evaluates medical necessity, appropriateness, and compliance to support informed utilization review decisions. The work includes identifying documentation gaps, collaborating with providers and care management teams, communicating decisions or requests for information, and maintaining accurate records.

What you'll do

• Review healthcare services and medical records
• assess medical necessity and appropriateness
• compare clinical documentation with established criteria and guidelines
• identify gaps or inconsistencies
• collaborate with providers, care management teams, and other healthcare professionals
• communicate review decisions and requests for additional clinical information
• document review activities
• ensure compliance with organizational, regulatory, and payer requirements.

What we're looking for

Skills & competencies

registered nurse (rn)

utilization review

medical necessity review

clinical documentation

medical record review

care management

new york state rn license

aha bls

east elmhurst ny

13-week assignment

travel pay $2,550–$2,630 per week

local pay $69–$73 per hour

Work arrangement

• Weekend coverage required

Benefits & perks

• The posting states that this position does not offer additional benefits.

Why this role

Requires at least one year of non-acute utilization review experience, an active New York State RN license, AHA BLS certification, and primary source verification. The posting states that no additional benefits are offered.

About the employer

Compu-Vision - Northeast is hiring for this role. Industry: Direct Health and Medical Insurance Carriers. Sector: 52.