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Case Manager Utilization Review Nurse Jobs in Rochester, MN

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Case Manager Utilization Review Nurse information

See Rochester, MN salary details

$19

$48

$81

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

As of Aug 2, 2026, the average hourly pay for case manager utilization review nurse in Rochester, MN is $48.32, according to ZipRecruiter salary data. Most workers in this role earn between $35.91 and $58.41 per hour, depending on experience, location, and employer.

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.

How do Case Manager Utilization Review Nurses 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 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.

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 are popular job titles related to Case Manager Utilization Review Nurse jobs in Rochester, MN? For Case Manager Utilization Review Nurse jobs in Rochester, MN, the most frequently searched job titles are:
What job categories do people searching Case Manager Utilization Review Nurse jobs in Rochester, MN look for? The top searched job categories for Case Manager Utilization Review Nurse jobs in Rochester, MN are:
What cities near Rochester, MN are hiring for Case Manager Utilization Review Nurse jobs? Cities near Rochester, MN with the most Case Manager Utilization Review Nurse job openings:
Infographic showing various Case Manager Utilization Review Nurse job openings in Rochester, MN as of July 2026, with employment types broken down into 1% As Needed, 79% Full Time, 17% Part Time, and 3% Contract. Highlights an 88% Physical, 3% Hybrid, and 9% Remote job distribution, with an average salary of $100,499 per year, or $48.3 per hour.

Registered Nurse - Case Manager Transitional Planning - RN

Mayo Clinic

Rochester, MN • On-site

Full-time

Medical, Dental, Vision, Retirement

Re-posted 9 days ago


Mayo Clinic rating

7.8

Company rating: 7.8 out of 10

Based on 693 frontline employees who took The Breakroom Quiz

130th of 887 rated healthcare providers


Job description


The Registered Nurse (RN) Case Manager works within an interdisciplinary team to facilitate the patient plan of care throughout the continuum of care by ensuring appropriate utilization management, care coordination, resource utilization, and clinical documentation. The RN Case Manager will function within the Mayo Clinical Nursing Professional Practice Model, which includes accountability for assessing, planning, implementing, evaluating, and communicating the patient care plan progression. The RN Case Manager utilizes the principles of mutual respect, patient/family advocacy and provides leadership within the team of internal partners and outside agencies to facilitate best practices that achieve quality clinical, financial, and patient satisfaction outcomes. The RN Case Manager provides leadership through education on case management/utilization management concepts, committee work, research, and community involvement. The RN Case Manager bridges communication between providers, patients and families, members of the interdisciplinary team, and outside agencies to assure high-quality care that meets the patient's needs and is delivered in a cost-effective and timely manner. The ANA Nursing: Scope and Standards of Practice and Code of Ethics provide a basis for the practice of the RN. The American Case Manager Association Standards of Practice and Scope of Services for Health Care Delivery System Case Management and Transitions of Care Professionals (2013) are reflected.
For New Graduate Nurses: Please apply through the Nurse Residency Program posting, which is specifically designed to support New Graduate RNs. Visit the Nurse Residency webpage for program details including current and upcoming application windows. Within the Nurse Residency application process, you may indicate work units and specialties of interest. If selected to move forward, you will meet with a Nursing Placement Coordinator who will help you explore Mayo Clinic opportunities that are best aligned with your current and future professional goals. Together, we'll identify a work area that provides an excellent foundation for your nursing career.
This role is eligible for TN sponsorship. Successful sponsorship will require state licensure and completion of the VisaScreen or equivalent certification.
Qualifications
Graduate of an accredited, or those in the candidacy process, baccalaureate nursing program, as recognized by the Accreditation Commission for Education in Nursing (ACEN), Commission on Collegiate Nursing Education (CCNE), National League for Nursing Commission for Nursing Education Accreditation (NLN CNEA). One year of RN experience is required. If graduated from a nursing program that was not accredited by ACEN,CCNE, and NLN CNEA, at least one year of RN experience in an applicable care setting is required. If graduation did not occur within the last two years, one year of RN experience in an applicable care setting is required or, effective October 1st, 2017 one year of current LPN experience at Mayo Clinic is required.
Additional Qualifications:
3 years of recent acute medical/surgical hospital nursing preferred. 1 year of Case Management experience preferred. Certification (CCM or ACM-RN) preferred.
Internal applicants are required to attach their three most recent performance appraisals.
License or Certification:
Current RN license by applicable state requirements.
Basic Cardiac Life Support for healthcare providers- BCLS - certificate of course completion required and must not expire within 3 months after start date. A scanned copy of the certificate of completion or transcripts, including your full name, must be attached to your profile to be considered.
We will only accept certificates of course completion from the following providers:
• American Heart Association (Title: BLS for Healthcare Providers or BLS Provider)
• Red Cross (Title: CPR/AED for Professional Rescuers and Health Care Providers or BLS for Healthcare Providers)
Additional specialty certification/training as required by the work area.
About Us
Why Mayo Clinic
Mayo Clinic is top-ranked in more specialties than any other care provider according to U.S. News & World Report. As we work together to put the needs of the patient first, we are also dedicated to our employees, investing in competitive compensation and comprehensive benefit plans - to take care of you and your family, now and in the future. And with continuing education and advancement opportunities at every turn, you can build a long, successful career with Mayo Clinic.
Benefits Highlights
  • Medical: Multiple plan options.
  • Dental: Delta Dental or reimbursement account for flexible coverage.
  • Vision: Affordable plan with national network.
  • Pre-Tax Savings: HSA and FSAs for eligible expenses.
  • Retirement: Competitive retirement package to secure your future.

About the Team
Just as our reputation has spread beyond our Minnesota roots, so have our locations. Today, our employees are located at our three major campuses in Phoenix/Scottsdale, Arizona, Jacksonville, Florida, Rochester, Minnesota, and at Mayo Clinic Health System campuses throughout Midwestern communities, and at our international locations. Each Mayo Clinic location is a special place where our employees thrive in both their work and personal lives. Learn more about what each unique Mayo Clinic campus has to offer, and where your best fit is.
Equal Opportunity
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, protected veteran status or disability status. Learn more about the "EOE is the Law". Mayo Clinic participates in E-Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization.

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About Mayo Clinic

Sourced by ZipRecruiter

Mayo Clinic is the largest integrated, not-for-profit medical group practice in the world. We're building the future, one where the best possible care is available to everyone — and more people can heal at home. Our relentless research turns into earlier diagnoses and new cures. That's how we inspire hope in those who need it most. At Mayo Clinic, experts work together to solve the most challenging unmet needs of patients. Our history of innovation dates back almost 150 years, when brothers Will and Charlie Mayo pioneered an integrated, team-based approach to medicine. Today, that trailblazing spirit drives innovations like Mayo Clinic Platform — which powers new technologies to change how care is delivered to all.

Industry

Hospitals

Company size

10,000+ Employees

Headquarters location

Rochester, MN, US

Year founded

1919