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Navihealth Utilization Review Jobs (NOW HIRING)

Reviews discharge planning forms for completeness, timing, and conformity to policy and guidelines ... They will also use a similar system as NaviHealth utilized by the State to approve all post-acute ...

Reviews discharge planning forms for completeness, timing, and conformity to policy and guidelines ... They will also use a similar system as NaviHealth utilized by the State to approve all post-acute ...

Navihealth Utilization Review information

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$21

$42

$68

How much do navihealth utilization review jobs pay per hour?

As of Sep 4, 2026, the average hourly pay for navihealth utilization review in the United States is $42.28, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 per hour, depending on experience, location, and employer.

What is a Navihealth Utilization Review?

A Navihealth Utilization Review job involves assessing patients' medical needs to ensure they receive appropriate levels of care while managing healthcare costs. Professionals in this role review clinical documentation, apply established guidelines, and collaborate with healthcare providers and insurance companies. Their goal is to determine medical necessity, ensure compliance with policies, and facilitate appropriate care transitions. This position requires strong clinical knowledge, critical thinking skills, and familiarity with utilization management principles.

What does a Navihealth Utilization Review do?

In a Navihealth Utilization Review role, your day usually involves reviewing patient cases, evaluating clinical documentation, and collaborating with hospital and post-acute care providers to ensure patients transition safely and appropriately. You may also participate in interdisciplinary team meetings, document reviews in electronic platforms, and interact with payers to discuss coverage or authorization decisions. Much of the work is independent and computer-based, though frequent communication with patients, families, and clinicians is typical. This role is well-suited for those who enjoy a balance of clinical judgment and administrative responsibilities in a fast-paced, outcomes-focused environment.

What are the key skills and qualifications needed for a Navihealth Utilization Review?

To thrive as a Navihealth Utilization Review professional, you need a clinical background such as RN or LCSW licensure, thorough knowledge of care management, and experience with utilization review processes. Familiarity with electronic medical records (EMR) systems, Navihealth's proprietary platforms, and utilization review software is highly beneficial, as well as relevant certifications like CCM (Certified Case Manager). Strong critical thinking, organizational skills, and effective communication are key soft skills for collaborating with healthcare teams and patients. These skills are crucial for ensuring patients receive appropriate care while meeting regulatory, payer, and organizational guidelines.

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Infographic showing various Navihealth Utilization Review job openings in the United States as of August 2026, with employment types broken down into 85% Full Time, 4% Part Time, and 11% Contract. Highlights an 75% In-person, and 25% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

Travel RN Case Manager

American Traveler

Baltimore, MD • On-site

Contractor

Medical, Dental, Vision, Life, Retirement

Re-posted 15 days ago


Key responsibilities

  • Coordinate care for adult patients from triage through discharge, including transition planning to post-acute settings.

  • Proactively communicate with payors to secure approval of treatment plans and required resources.

  • Collaborate with multidisciplinary teams, patients, and families to ensure safe and effective care transitions.


Job description

American Traveler is seeking a travel nurse RN Case Management for a travel nursing job in Baltimore, Maryland.

Job Description & Requirements
  • Specialty: Case Management
  • Discipline: RN
  • Start Date: ASAP
  • Duration: 13 weeks
  • 40 hours per week
  • Shift: 8 hours, days
  • Employment Type: Travel
Assignment Overview
  • Shift: Days, 5x8hrs
  • Hours: 40 hrs/wk
  • Start Date: Aug 17, 2026
  • Length: 13 weeks
  • Openings: 1
Description

American Traveler is seeking an experienced RN Case Manager for an adult inpatient case management role at a large academic medical center, requiring active RN licensure and current inpatient case management experience.

Details
  • Adult Medicine/Surgery inpatient case management unit at a large academic medical center (500+ bed facility)
  • Day shift schedule: 8:30 AM – 5:00 PM, five 8-hour shifts per week
  • No weekend, holiday, or on-call requirements
  • Uses Epic EMR and post-acute facility referral platforms such as NaviHealth or Allscripts
  • Caseload involves adult patients from triage through care coordination and safe transition to post-acute settings
Requirements
  • Active MD or Compact RN license currently in hand
  • Minimum 2 years of RN experience required
  • Current inpatient case management experience required
  • Experience in a 500+ bed facility required
  • Certifications required: BLS/CPR (must be current and active)
  • Proficiency with Epic EMR and post-acute referral platforms (e.g., NaviHealth or Allscripts) required
  • SSN and DOB required for consideration
  • One professional reference required for consideration
Additional Information
  • Coordinates care for a select caseload of adult patients from triage through discharge, including transition planning to post-acute settings such as nursing facilities, acute inpatient rehab, or community resources
  • Proactively communicates with payors to secure approval of treatment plans and required resources
  • Collaborates with multidisciplinary teams, patients, and patient families to ensure safe and effective care transitions
  • Maintains and enters patient information across departmental systems in accordance with operational guidelines
  • Local candidates are accepted at the same rate as travelers
  • Medication administration testing is not required for this role

American Traveler Job ID #P-734327. Pay package is based on 8 hour shifts and 40.0 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: Travel RN - Case Management/Utilization Review - Case Management

About American Traveler

With over 25 years of experience, American Traveler has established a reputation for outstanding customer service. Our team ensures a smooth, worry-free experience for those starting on or expanding their travel nursing and allied careers.

With thousands of travel nursing and allied jobs nationwide, our attentive and approachable recruiters find positions that align perfectly with your career aspirations and personal requirements.

American Traveler offers exceptional benefits, including premium medical, dental, vision and life insurance beginning day one of your assignment, generous 401(k) match, substantial housing stipends, and more. Additionally, with 24/7 support and access to our in-house clinicians, you are assured confidence and comfort throughout your assignment.

With our team behind you, you can relax and enjoy a rewarding travel career.


American Traveler logo

About American Traveler

Sourced by ZipRecruiter

With over 20 years of success in healthcare staffing, American Traveler has established a reputation for outstanding customer service. Our full-service agency has earned top ratings from healthcare professionals in every specialty and setting. We offer travel assignments in the most sought-after locations and facilities in the country. We staff major medical centers, prestigious university teaching facilities, Magnet facilities, regional community hospitals, outpatient centers, rehab centers, skilled nursing facilities and more. With our expert team behind you every step of the way, you can enjoy a rewarding travel career that exceeds your expectations. With over 20 years of experience, American Traveler has established a reputation for outstanding customer service. With our team behind you, you can relax and enjoy a rewarding travel career.

Industry

Recruiting and staffing services

Company size

501 - 1,000 Employees

Headquarters location

Boca Raton, FL, US

Year founded

1999