ZipRecruiter

Log In

1

Rn Utilization Management Jobs (NOW HIRING)

Sagility

RN Utilization Management Reviewer

Concord, NC · Remote

$35 - $40/hr

Job title: RN Utilization Management Reviewer We are currently hiring a talented RN, Utilization Management Reviewer. This role will be responsible in day-to-day timely clinical and service ...

Sagility

RN Utilization Management Reviewer

Concord, NC · Remote

$35 - $40/hr

Job title: RN Utilization Management Reviewer We are currently hiring a talented RN, Utilization Management Reviewer. This role will be responsible in day-to-day timely clinical and service ...

Sagility LLC

RN Utilization Management Reviewer

$35 - $40/hr

Job title: RN Utilization Management Reviewer We are currently hiring a talented RN, Utilization Management Reviewer. This role will be responsible in day-to-day timely clinical and service ...

Covenant Health

RN UTILIZATION MGMT I

Knoxville, TN · On-site

Registered Nurse Utilization Management Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health is the region's top-performing healthcare network with 10 hospitals ...

talent4health

RN - Utilization Review

Cleveland, OH · On-site

$2.2K/wk

... Offering Nursing Profession RN Specialty Utilization Review Job ID 18807560 Job Title RN - ... Previous Care Management, Case Management, or Utilization Management Experience. * Experience with ...

previous pagenext page

Showing results 21-40

All JobsRn Utilization Management Jobs

RN Utilization Management information

See salary details

$39K

$89.5K

$163K

How much do rn utilization management jobs pay per year?

As of Aug 10, 2026, the average yearly pay for rn utilization management in the United States is $89,483.00, according to ZipRecruiter salary data. Most workers in this role earn between $64,500.00 and $104,500.00 per year, depending on experience, location, and employer.

How does an RN Utilization Management typically collaborate with physicians and other healthcare team members?

RN Utilization Management professionals work closely with physicians, case managers, and insurance representatives to ensure patients receive appropriate, high-quality care while managing healthcare costs. They review patient records, communicate clinical findings, and may participate in interdisciplinary meetings to discuss care plans and discharge needs. Building strong relationships and maintaining open lines of communication with the care team is essential for timely authorizations and effective care coordination. This collaborative approach helps optimize patient outcomes and resource utilization.

What skills and qualifications are needed to thrive as an RN Utilization Management?

To thrive as an RN Utilization Management Nurse, you need a current RN license, strong clinical assessment skills, and experience in care coordination or case management. Familiarity with utilization review tools, electronic health records, and knowledge of insurance guidelines or InterQual/MCG criteria are typically required. Exceptional communication, critical thinking, and negotiation skills help facilitate collaboration among providers, payers, and patients. These abilities are crucial for ensuring appropriate resource use, compliance with regulations, and optimal patient outcomes.

How to get into utilization management as an RN?

To become an RN in utilization management, gain experience as a registered nurse, often in case management or clinical roles, and obtain knowledge of insurance policies and healthcare regulations. Certifications such as Certified Case Manager (CCM) or Certified Professional in Healthcare Quality (CPHQ) can enhance prospects. Strong communication skills and familiarity with electronic health records (EHR) systems are also beneficial.

What is the difference between Rn Utilization Management vs Rn Case Management?

AspectRn Utilization ManagementRn Case Management
CertificationsRN license, possibly certifications in utilization reviewRN license, case management certification often preferred
Work EnvironmentUtilization review departments, insurance companies, hospitalsCommunity clinics, hospitals, insurance companies
Primary FocusReviewing medical necessity and appropriateness of servicesCoordinating patient care and discharge planning

Both roles require an RN license, but Rn Utilization Management focuses on reviewing the necessity of services, while Rn Case Management emphasizes coordinating patient care. Understanding these differences helps professionals choose the right career path and employers.

What does a utilization management registered nurse do?

A utilization management registered nurse reviews patient cases to determine the necessity, appropriateness, and efficiency of healthcare services and treatments. They analyze medical records, collaborate with healthcare providers, and ensure compliance with insurance and regulatory guidelines, often using electronic health records and clinical judgment. Certification in case management or utilization review is commonly required for this role.

What is an RN Utilization Management?

RN Utilization Management nurses are registered nurses who specialize in reviewing healthcare services to ensure patients receive appropriate and cost-effective care. They evaluate the necessity, efficiency, and quality of medical treatments and procedures, often working with insurance companies, hospitals, or healthcare organizations. Their responsibilities include reviewing patient records, coordinating with clinical staff, making coverage recommendations, and ensuring compliance with healthcare regulations. This role helps manage healthcare costs while maintaining high standards of patient care.
More about RN Utilization Management jobs
What cities are hiring for Rn Utilization Management jobs? Cities with the most Rn Utilization Management job openings:
What states have the most Rn Utilization Management jobs? States with the most job openings for Rn Utilization Management jobs include:
What job categories do people searching Rn Utilization Management jobs look for? The top searched job categories for Rn Utilization Management jobs are:
RN Utilization Management jobs near you
Infographic showing various Rn Utilization Management job openings in the United States as of August 2026, with employment types broken down into 83% Full Time, 13% Part Time, 1% Temporary, and 3% Contract. Highlights an 88% Physical, 2% Hybrid, and 10% Remote job distribution, with an average salary of $89,483 per year, or $43 per hour.

Travel Nurse RN - Utilization Review

Encode INC

Middleburg Heights, OH • On-site

$65/hr

Contractor

Medical, Dental, Vision, Life, Retirement

Posted 11 days ago

Job description

Encode INC is seeking a travel nurse RN Utilization Review for a travel nursing job in Middleburg Heights, Ohio.

Job Description & Requirements
  • Specialty: Utilization Review
  • Discipline: RN
  • Start Date: 08/24/2026
  • Duration: 12 weeks
  • 40 hours per week
  • Shift: 8 hours, days
  • Employment Type: Travel

Urgent Hiring – Utilization Management (UM) Registered Nurse
 

Location: Southwest General Health Center – Middleburg Heights, OH
Position: Utilization Management (UM) RN / Utilization Specialist
Schedule: Full-Time | 40 Hours/Week | Monday–Friday | 8:00 AM – 4:30 PM + Every 3rd Weekend
Pay Rate: $65 per hour and $2600 per week.
 

Position Overview:
 

We are actively seeking an experienced Utilization Management Registered Nurse (UM RN) to join the team at Southwest General Health Center. This is an on-site opportunity for a highly skilled RN with extensive Utilization Review and Case Management experience who can work efficiently in a fast-paced acute care environment.
 

Responsibilities:

  • Perform 25–30 utilization reviews per day while ensuring timely and accurate documentation.
  • Review medical necessity using InterQual and MCG Criteria.
  • Complete utilization reviews utilizing standardized documentation templates.
  • Collaborate with physicians, case managers, and interdisciplinary teams regarding patient status and level of care.
  • Ensure compliance with payer guidelines, regulatory standards, and hospital policies.
  • Utilize Cerner EMR for documentation and patient review activities.
  • Participate in weekend coverage on a rotating schedule (every 3rd weekend).

Minimum Qualifications:

  • Active Registered Nurse (RN) License.
  • Minimum 5 years of recent RN experience.
  • 2–3 years of recent Utilization Management/Utilization Review or Case Management experience.
  • Case Managers with strong Utilization Management experience will be considered.
  • Previous travel assignment experience is required.
  • Hands-on experience with:
    • Cerner EMR
    • InterQual
    • MCG Criteria
    • Standardized Templates
  • Ability to independently complete 25–30 reviews per day.
  • Must be available to work 100% onsite (Remote work is not available).

Preferred Qualifications:

  • ACM (Accredited Case Manager) or CCM (Certified Case Manager) Certification.

Why Apply?

  • Competitive pay rates.
  • Immediate interview opportunities.
  • Work with a respected healthcare organization.
  • Long-term assignment with a stable schedule.
  • Opportunity to make an impact in patient care and resource management.

📩 We're actively interviewing and submitting qualified candidates. Apply today if you meet the requirements or know someone who would be a great fit!

About Encode INC
At Encode, we empower organizations and individuals through innovative, human-centric workforce and technology solutions. With decades of experience and a proven track record, we deliver more than just healthcare staffing, we provide integrated, strategic support across industries, with particular strength in federal and government contracts.
Benefits
  • 401k retirement plan
  • Vision benefits
  • Dental benefits
  • Referral bonus
  • Life insurance
  • Medical benefits

Apply