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Case Manager Utilization Review Nurse Jobs in Renton, WA

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Case Manager Utilization Review Nurse information

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$21

$53

$90

How much do case manager utilization review nurse jobs pay per hour?

As of Aug 27, 2026, the average hourly pay for case manager utilization review nurse in Renton, WA is $53.47, according to ZipRecruiter salary data. Most workers in this role earn between $39.76 and $64.62 per hour, depending on experience, location, and employer.

What is a case manager utilization review nurse?

A Case Manager Utilization Review Nurse is a registered nurse who evaluates the medical necessity, appropriateness, and efficiency of healthcare services provided to patients. They review patient records, coordinate with healthcare providers, and ensure that treatments meet established guidelines and insurance requirements. Their goal is to optimize patient outcomes while controlling healthcare costs and ensuring compliance with regulations. These nurses also help facilitate communication between patients, providers, and payers to support effective care management.

How does a case manager utilization review nurse typically collaborate with physicians and other healthcare providers?

Case Manager Utilization Review Nurses regularly work with physicians, social workers, and other healthcare professionals to ensure patients receive appropriate care while managing resource utilization. They often participate in interdisciplinary team meetings to discuss care plans, review patient progress, and address any barriers to discharge. Building strong communication channels and maintaining up-to-date clinical knowledge are essential, as nurses must advocate for patients while also supporting evidence-based practices and regulatory compliance. This collaborative environment helps streamline patient care and optimize outcomes.

What are the key skills and qualifications needed to thrive as a case manager utilization review nurse, and why are they important?

To excel as a Case Manager Utilization Review Nurse, you need a solid background in nursing, strong clinical assessment skills, and a valid RN license, often with case management certification. Familiarity with utilization review software, electronic health record (EHR) systems, and knowledge of insurance and regulatory guidelines is essential. Exceptional communication, critical thinking, and negotiation abilities set top performers apart in this role. These qualifications ensure effective patient advocacy, cost-effective care, and compliance with healthcare standards.

What is the difference between Case Manager Utilization Review Nurse vs Case Manager?

AspectCase Manager Utilization Review NurseCase Manager
CredentialsRN license, certification in utilization review (e.g., URAC)RN license, case management certification (e.g., CCM)
Work EnvironmentHospitals, insurance companies, healthcare facilitiesHospitals, community health, insurance providers
Primary FocusReviewing medical necessity and appropriateness of careCoordinating patient care and discharge planning

While both roles involve patient care coordination, the Case Manager Utilization Review Nurse primarily focuses on reviewing medical necessity and insurance approvals, whereas the Case Manager handles broader patient care coordination and discharge planning. Both roles require nursing credentials and are vital in healthcare settings, but their specific responsibilities differ.

What are popular job titles related to Case Manager Utilization Review Nurse jobs in Renton, WA?

For Case Manager Utilization Review Nurse jobs in Renton, WA, the most frequently searched job titles are:

What job categories do people searching Case Manager Utilization Review Nurse jobs in Renton, WA look for?

The top searched job categories for Case Manager Utilization Review Nurse jobs in Renton, WA are:

What cities near Renton, WA are hiring for Case Manager Utilization Review Nurse jobs?

Cities near Renton, WA with the most Case Manager Utilization Review Nurse job openings:

Case Manager Utilization Review Nurse jobs near you
Infographic showing various Case Manager Utilization Review Nurse job openings in Renton, WA as of July 2026, with employment types broken down into 1% As Needed, 80% Full Time, 16% Part Time, and 3% Contract. Highlights an 88% Physical, 3% Hybrid, and 9% Remote job distribution, with an average salary of $111,210 per year, or $53.5 per hour.

RN - Care Manager Utilization Review

MLee Medical Employment

Vashon, WA • On-site

Other

Medical, Dental, Vision, Retirement

Re-posted 26 days ago

Job description

Join a dynamic healthcare team in the Pacific Northwest as a Registered Nurse Care Manager specializing in Utilization Review. This role involves coordinating care and managing the utilization of services for patients in acute and post-acute skilled care settings. You will collaborate closely with interdisciplinary teams both inside and outside the organization to enhance patient outcomes and ensure cost-effective care.
Job Summary
As a vital member of the care team, you will continuously assess the appropriateness and timeliness of care levels, ensuring resources are used efficiently. Your daily activities include rounding with patients, conducting assessments, and facilitating smooth transitions from hospital to home or other care facilities. You will also identify and resolve discharge barriers, provide clear documentation, and support peer-to-peer reviews for concurrent denials.
Education and Experience

  • Minimum of 2 years of Registered Nursing experience in acute care or care management/utilization review.
  • Current RN license valid in the region or multistate license.
  • BLS certification is required.
  • Bachelor's degree in Nursing and Care Manager Certification are preferred.
Skills and Abilities
  • Strong organizational and prioritization skills.
  • Excellent written and verbal communication tailored to diverse audiences.
  • Proficiency with technology and software, including intermediate to advanced Microsoft Office skills.
  • Ability to maintain confidentiality and accurate documentation.
  • Demonstrated teamwork, collaboration, and customer service skills in fast-paced environments.
  • Independent problem-solving and sound judgment to complete tasks effectively.

Work Environment and Benefits
This full-time exempt position offers a supportive work environment with opportunities for professional growth. Benefits include competitive compensation, comprehensive medical, dental, and vision coverage, retirement plans with employer contributions, tuition reimbursement, employee wellness programs, and more. The location provides access to numerous outdoor recreational activities such as hiking, kayaking, fishing, and cultural experiences in the Pacific Northwest region.
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About McCall and Lee

Sourced by ZipRecruiter

McCall and Lee is a well-known and reputable company, headquartered in Austin, Texas, United States. Operating in the healthcare industry, their primary services center around professional recruiting and executive search. They cater to the needs of various levels of medical practitioners and executive positions for healthcare establishments. McCall and Lee is founded on the premise of filling healthcare vacancies with the most suitable and competent professionals to ensure top-quality medical service delivery. Their core value revolves around integrity, excellence, commitment, and customer satisfaction.

Industry

Recruiting and staffing services and human resources consulting services

Company size

11 - 50 Employees

Headquarters location

Austin, TX, US

Social media

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