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Rn Utilization Management Jobs in Delaware (NOW HIRING)

Vivian Health

RN Case Manager in Newark, DE

Newark, DE · On-site

$41.28 - $66.05/hr

RN Case Manager - Day Shift - Sign-on Bonus RN Case Manager - Day Shift M-F (Hours: 8a-4:30p with ... Utilization Management - Reviews patient status for appropriateness and anticipated payer coverage.

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Rn Utilization Management information

See Delaware salary details

$39K

$89.6K

$163.1K

How much do rn utilization management jobs pay per year?

As of Aug 18, 2026, the average yearly pay for rn utilization management in Delaware is $89,560.00, according to ZipRecruiter salary data. Most workers in this role earn between $64,600.00 and $104,600.00 per year, depending on experience, location, and employer.

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.

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 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 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.

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 healthcare policies and insurance processes. 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 are popular job titles related to Rn Utilization Management jobs in Delaware?

For Rn Utilization Management jobs in Delaware, the most frequently searched job titles are:

What job categories do people searching Rn Utilization Management jobs in Delaware look for?

The top searched job categories for Rn Utilization Management jobs in Delaware are:

What cities in Delaware are hiring for Rn Utilization Management jobs?

Cities in Delaware with the most Rn Utilization Management job openings:

Rn Utilization Management jobs near you
Infographic showing various Rn Utilization Management job openings in Delaware as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 15% Part Time, and 2% Contract. Highlights an 86% Physical, 3% Hybrid, and 11% Remote job distribution, with an average salary of $89,560 per year, or $43.1 per hour.

LPN - Shift Date: 01/26/2026 - 01/26/2026

Care Coordination Services LLC

Seaford, DE • On-site

$34 - $39/hr

Full-time

Re-posted 10 days ago

Job description

Job Description POSITION TITLE: Licensed Practical Nurse (LPN) DEPARTMENT: Nursing REPORTS TO: RN Nursing Supervisor/Unit Manager/Center Nurse Executive POSITION SUMMARY: Under the direction of a Registered Nurse (RN), the Licensed Practical Nurse delivers efficient and effective nursing care while achieving positive clinical outcomes and patient/family satisfaction. He/she operates within the scope of practice defined by the State Nurse Practice Act. The LPN contributes to nursing assessments and care planning, provides direct patient care, and supervises patient care provided by unlicensed staff.

RESPONSIBILITIES/ACCOUNTABILITIES: Patient Evaluation: Collects, reports and documents objective and subjective data. Observes conditions and reports changes in condition to RN. Care Planning: Contributes to establishing individualized patient goals.

Assists in developing interventions to achieve goals. Implements the plan of care. Evaluates effectiveness of interventions to achieve patient goals and minimize re-hospitalizations.

Participate in review and revision of care plans. Provision of Direct Patient Care: Administers medications and performs treatments per physician orders. Communicates pertinent data to RN and/or physician.

Documents accurately and thoroughly. Consults and seeks guidance from the RN as necessary. At the direction of the RN, participates in Utilization Management or Interdisciplinary Care Management Meeting to facilitate appropriate discharge planning: Communicates team's recommendations for discharge to the attending physician, patient, and family.

Prepares patient/family for discharge including patient and family education. Monitors patient care provided by unlicensed staff: Assigns duties as specified by State Nurse Practice Act, Genesis policy, and staff training. Communicates patient information with unlicensed staff during and between shifts.

Monitors, evaluates and follows up on assigned responsibilities of unlicensed staff. Ensures that assigned tasks are performed in accordance with policies and procedures. Uses Point Click Care (PCC) according to the Business Processes.

Performs drug count when beginning and ending shift and whenever necessary. Assists physician in rounds and examination of patients, as needed. Participates in shift-to-shift communication between incoming and outgoing nursing staff.

Collaborates and coordinates with other departments to provide timely effective care consistent with individual's needs, choices, and preferences. Contributes to an environment that is respectful, team-oriented, and responsive to the concerns of staff, patients, and families. Enhances nursing practice by attending all mandated in-service programs.

Assists with the orientation of newly hired nursing staff. Promotes a culture of safety to ensure a healthy practice and living environment. Maintains confidentiality and protects sensitive Protected Health Information (PHI) at all times.

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