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Utilization review nurse vs nurse clinician

The differences between utilization review nurses and nurse clinicians can be seen in a few details. Each job has different responsibilities and duties. It typically takes 1-2 years to become both a utilization review nurse and a nurse clinician. Additionally, a utilization review nurse has an average salary of $65,425, which is higher than the $65,159 average annual salary of a nurse clinician.

The top three skills for a utilization review nurse include medical necessity, patients and acute care. The most important skills for a nurse clinician are patients, patient education, and CPR.

Utilization review nurse vs nurse clinician overview

Utilization Review NurseNurse Clinician
Yearly salary$65,425$65,159
Hourly rate$31.45$31.33
Growth rate6%6%
Number of jobs29,776596,073
Job satisfaction--
Most common degreeBachelor's Degree, 43%Bachelor's Degree, 59%
Average age4444
Years of experience22

What does a utilization review nurse do?

The primary role of an Utilization Review Nurse is to analyze the condition of each patient carefully and decide if the patient still needs to stay in the hospital or be sent home. They deal with patients' relatives, doctors, and people from insurance companies.

What does a nurse clinician do?

A nurse clinician is a health expert who provides care and assistance to patients in hospitals, clinics, or similar establishments. Among their responsibilities include preparing equipment and documents, administering medication, monitoring the patient's condition, maintaining charts, and regularly reporting to physicians. In some establishments, they may also perform administrative support tasks such as answering calls and correspondence, preparing and processing documents, and organizing records. Moreover, a nurse clinician must maintain an active communication line with fellow medical staff to provide optimal services to patients.

Utilization review nurse vs nurse clinician salary

Utilization review nurses and nurse clinicians have different pay scales, as shown below.

Utilization Review NurseNurse Clinician
Average salary$65,425$65,159
Salary rangeBetween $47,000 And $89,000Between $48,000 And $88,000
Highest paying CityAlameda, CANew York, NY
Highest paying stateRhode IslandNew York
Best paying companyMolina HealthcareHealthpoint
Best paying industryHealth CareEducation

Differences between utilization review nurse and nurse clinician education

There are a few differences between a utilization review nurse and a nurse clinician in terms of educational background:

Utilization Review NurseNurse Clinician
Most common degreeBachelor's Degree, 43%Bachelor's Degree, 59%
Most common majorNursingNursing
Most common collegeDuke UniversityDuke University

Utilization review nurse vs nurse clinician demographics

Here are the differences between utilization review nurses' and nurse clinicians' demographics:

Utilization Review NurseNurse Clinician
Average age4444
Gender ratioMale, 8.5% Female, 91.5%Male, 10.9% Female, 89.1%
Race ratioBlack or African American, 12.0% Unknown, 4.3% Hispanic or Latino, 9.1% Asian, 8.9% White, 65.3% American Indian and Alaska Native, 0.4%Black or African American, 12.1% Unknown, 4.2% Hispanic or Latino, 8.8% Asian, 9.6% White, 64.7% American Indian and Alaska Native, 0.4%
LGBT Percentage9%9%

Differences between utilization review nurse and nurse clinician duties and responsibilities

Utilization review nurse example responsibilities.

  • Monitor patients' status during surgery (circulate in operating room) and manage patients in PACU.
  • Case management for acute patients refer to LTC
  • Advise insurance carriers on recommend reimbursement for charges following automate bill audit utilizing ICD-9 and CPT codes.
  • Provide caregiver oversight relate to care, medication administration and emergency situations.
  • Identify inappropriate utilization of services/settings through the application of establish clinical criteria using InterQual and CMS guidelines for medical necessity.
  • Direct contact with IPA providers.
  • Show more

Nurse clinician example responsibilities.

  • Manage patient pain relief and sedation by providing pharmacological and non-pharmacological intervention, monitor patient response and record care plans accordingly.
  • Provide high level nursing care for ER step down and ICU patients prior to transfer to critical care units.
  • Instruct ACLS and BLS classes.
  • Specialize care for telemetry and orthopedic patients.
  • Provide specialized nursing care to ICU medical cardiac patient populations.
  • Provide education regarding care of surgical patients as part of orientation to orienting telemetry nurses.
  • Show more

Utilization review nurse vs nurse clinician skills

Common utilization review nurse skills
  • Medical Necessity, 9%
  • Patients, 7%
  • Acute Care, 7%
  • Discharge Planning, 7%
  • Utilization Management, 6%
  • Utilization Review, 6%
Common nurse clinician skills
  • Patients, 33%
  • Patient Education, 5%
  • CPR, 5%
  • Emergency Situations, 5%
  • Patient Outcomes, 3%
  • Educational Programs, 3%

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