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Medical Review Rn Jobs (NOW HIRING)

Utilization Review RN

Portland, OR · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Oregon Registered Nurse License * Five (5) years Clinical experience in an acute adult medical/surgical care setting, OR Five (5) years Current Utilization Review or Case Management experience.

Utilization Review RN

Houston, TX · On-site

$41.14 - $61.20/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Utilization Review RN Inspired by faith. Driven by innovation. Powered by humankindness ... Every day, you will meticulously review medical records, authorize services, and prepare cases for ...

Travel Utilization Review RN

Tuba City, AZ · On-site

$2.2K - $2.3K/wk

  • Medical

  • Dental

  • Vision

Utilization Review * Discipline: RN * Start Date: 09/07/2026 * Duration: 13 weeks * 36 hours per ... Cigna medical, MetLife dental and vision insurance * License reimbursement for new licenses needed ...

Travel Utilization Review RN

Tuba City, AZ · On-site

$2.2K - $2.3K/wk

  • Medical

  • Dental

  • Vision

  • Retirement

Utilization Review * Discipline: RN * Start Date: 09/07/2026 * Duration: 13 weeks * 36 hours per week * Shift: 12 hours * Employment Type: Travel Utilization Review RN - Case Management | Tuba City ...

Medical Review Nurse (RN)

Long Beach, CA · Remote

$29.05 - $56.64/hr

... medical necessity review and/or coding experience, or equivalent combination of relevant education and experience. Registered Nurse (RN). License must be active and unrestricted in state of practice.

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Remote Utilization Review RN

Detroit, MI · Remote

$35 - $39/hr

  • Medical

  • Dental

  • Vision

  • PTO

Utilization Review RN Contract Duration: 12+ months Job Location: 100% REMOTE License Requirements ... Health Insurance (Medical, Dental and Vision) * 9 Days of Paid Time Off * All equipment provided by ...

RN - Utilization Review MedWave Healthcare Staffing is currently seeking a Utilization Review RN for a travel assignment in Tuba City, Arizona. The candidate that will best match this position will ...

Showing results 21-40

Medical Review RN information

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$24

$44

$70

How much do medical review rn jobs pay per hour?

As of Aug 17, 2026, the average hourly pay for medical review rn in the United States is $44.91, according to ZipRecruiter salary data. Most workers in this role earn between $34.38 and $53.37 per hour, depending on experience, location, and employer.

What is a Medical Review RN?

A Medical Review RN is a registered nurse who specializes in reviewing medical records and claims to ensure they meet established guidelines and standards. These nurses often work for insurance companies, government agencies, or healthcare organizations, evaluating the necessity, appropriateness, and efficiency of healthcare services provided to patients. Their role may include determining medical necessity, performing utilization reviews, and supporting appeals or audits. They use their clinical knowledge to interpret complex medical information and collaborate with healthcare providers to support accurate decision-making.

How does a Medical Review RN collaborate with other healthcare professionals during the review process?

A Medical Review RN often works closely with physicians, case managers, and insurance representatives to ensure that medical claims and treatment plans meet regulatory and clinical guidelines. Collaboration may involve participating in interdisciplinary meetings, discussing complex cases, and providing clinical expertise to support utilization management decisions. Effective communication and teamwork are essential, as you'll need to relay findings, request additional information, and sometimes clarify medical necessity with providers. This collaborative environment helps ensure quality care for patients while maintaining compliance with payer policies.

What are the key skills and qualifications needed to thrive as a Medical Review RN, and why are they important?

To thrive as a Medical Review RN, you need a strong clinical background, critical thinking skills, and an active RN license, often supported by experience in case management or utilization review. Familiarity with medical coding, claims management software, and knowledge of regulatory guidelines such as Medicare and Medicaid are typically required. Strong attention to detail, excellent written communication, and the ability to work independently are essential soft skills for this role. These competencies ensure accurate and compliant medical record reviews, which are critical for proper claims adjudication and regulatory adherence.
More about Medical Review RN jobs

What cities are hiring for Medical Review Rn jobs?

Cities with the most Medical Review Rn job openings:

What states have the most Medical Review Rn jobs?

States with the most job openings for Medical Review Rn jobs include:

Infographic showing various Medical Review Rn job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 15% Part Time, and 6% Contract. Highlights an 96% Physical, 1% Hybrid, and 3% Remote job distribution, with an average salary of $93,419 per year, or $44.9 per hour.

Utilization Review RN

Providence Service

Portland, OR • On-site

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 5 days ago


Modivcare rating

6.6

Company rating: 6.6 out of 10

Based on 47 frontline employees who took The Breakroom Quiz

569th of 887 rated healthcare providers


Job description

Description

Utilization Review RN at Providence Health Plaza. Utilization Management covers 7 days/week, including holidays.

This posting is not for a specific job vacancy. It serves to establish a place for current or future interested applicants to apply for Utilization Review RN at Providence Oregon Regional Shared Services (Providence Health Plaza) in Portland, OR. We may not have openings for each of these categories today, but the organization offers on-call, part time and full-time opportunities for day shift.

The RN Coordinator-Utilization Review supports the care of the patient through assessment, planning, implementation and evaluation of appropriate services and resources to maximize optimum outcomes. This position works collaboratively with the multiple disciplines, both internal and external to the organization, in effecting quality and cost-effective management of the patient care along the continuum.

Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence Oregon Regional Shared Services and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.

Required Qualifications:

  • Bachelor's Degree Nursing, OR Associates Degree and 2 or more years of related experience in lieu of a Bachelor's Degree

  • Upon hire: Oregon Registered Nurse License

  • Five (5) years Clinical experience in an acute adult medical/surgical care setting, OR Five (5) years Current Utilization Review or Case Management experience.

  • Demonstrated clinical expertise and experience related to a wide variety of patient populations and care delivery models.

Why Join Providence?

Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.

About Providence

At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.

Posted are the minimum and the maximum wage rates on the wage range for this position. The successful candidate's placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits.

Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.

About the Team

Providence has been serving the Pacific Northwest since 1856 when Mother Joseph of the Sacred Heart and four other Sisters of Providence arrived in Vancouver, Washington Territory. As the largest healthcare system and largest private employer in Oregon, Providence is located in areas ranging from the Columbia Gorge to the wine country to sunny southern Oregon to charming coastal communities to the urban setting of Portland.

Our award-winning and comprehensive medical centers are known for outstanding programs in cancer, cardiology, neurosciences, orthopedics, women's services, emergency and trauma care, pediatrics and neonatal intensive care. Our not-for-profit network also provides a full spectrum of care with leading-edge diagnostics and treatment, outpatient health centers, physician groups and clinics, numerous outreach programs, and hospice and home care.

Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.

Requsition ID: 439934
Company: Providence Jobs
Job Category: Health Information Management
Job Function: Revenue Cycle
Job Schedule: Part time
Job Shift: Multiple shifts available
Career Track: Nursing
Department: 5016 RS UTILIZATION MGMT
Address: OR Portland 4400 NE Halsey St
Work Location: Providence Health Plaza (HR) Bldg 1-Portland
Workplace Type: Hybrid
Pay Range: $50.14 - $77.83
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.


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