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Utilization Management Nurse Jobs in Alberta (NOW HIRING)

Passport Health

Nurse Practitioner (NP)

Calgary, AB · On-site

CA$60 - CA$65/hr

This is a temporary, part-time position reporting to the Regional Nurse Manager. Role ... utilization of guidelines to recommend appropriate vaccination and preventive medication. These ...

Passport Health

Nurse Practitioner (NP)

Edmonton, AB · On-site

CA$60 - CA$65/hr

This is a temporary, part-time position reporting to the Regional Nurse Manager. Role ... utilization of guidelines to recommend appropriate vaccination and preventive medication. These ...

Passport Health

Nurse Practitioner (NP)

Edmonton, AB · On-site

CA$60 - CA$65/hr

This is a temporary, part-time position reporting to the Regional Nurse Manager. Role ... utilization of guidelines to recommend appropriate vaccination and preventive medication. These ...

Passport Health

Nurse Practitioner (NP)

Calgary, AB · On-site

CA$60 - CA$65/hr

This is a temporary, part-time position reporting to the Regional Nurse Manager. Role ... utilization of guidelines to recommend appropriate vaccination and preventive medication. These ...

Rochester Regional Health

CA$75K - CA$105K/yr

Program Manager- Registered Nurse Department: Program Manager - Moore Place Location: Demay, 100 ... Guides assigned areas in the utilization of recognized improvement tools, data analysis, and ...

Rochester Regional Health

CA$38.66 - CA$51.91/hr

Completes at least one clinical research utilization (CRU) form for submission to Nursing Research Department utilizing a research article from the last 5 years from research performed in the United ...

Rochester Regional Health

CA$38.66 - CA$51.91/hr

Completes at least one clinical research utilization (CRU) form for submission to Nursing Research Department utilizing a research article from the last 5 years from research performed in the United ...

Rochester Regional Health

CA$38.66 - CA$51.91/hr

Completes at least one clinical research utilization (CRU) form for submission to Nursing Research Department utilizing a research article from the last 5 years from research performed in the United ...

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All JobsUtilization Management Nurse JobsUtilization Management Nurse Jobs in Alberta

Utilization Management Nurse information

See Alberta salary details

$25

$39

$56

How much do utilization management nurse jobs pay per hour?

As of Aug 29, 2026, the average hourly pay for utilization management nurse in Alberta is $39.29, according to ZipRecruiter salary data. Most workers in this role earn between $32.69 and $43.03 per hour, depending on experience, location, and employer.

What is a utilization management nurse?

A Utilization Management Nurse is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services provided to patients. They review medical records and treatment plans to ensure that care meets established guidelines and is cost-effective. Utilization Management Nurses work with healthcare providers, insurance companies, and patients to coordinate care and prevent unnecessary procedures or hospitalizations. Their goal is to support high-quality patient care while managing healthcare costs.

What does a utilization management nurse do?

A utilization management nurse ensures that healthcare services are administered appropriately. Their job responsibilities include working in a hospital, health practice, or other clinical setting reviewing patient clinical records, drafting clinical appeals, and overseeing staff members. The qualifications for a utilization management nurse include a nursing degree and a registered nursing license. Most people in this job also have career experience in case management and utilization review.

What are the key skills and qualifications needed to thrive as a utilization management nurse?

To thrive as a Utilization Management Nurse, you need a registered nursing license, strong clinical judgment, and experience in case management or utilization review. Familiarity with medical management software, InterQual or Milliman guidelines, and insurance authorization processes is typically required. Excellent analytical thinking, communication, and negotiation skills help you coordinate with providers and advocate for patients. These competencies ensure appropriate resource use, compliance with regulations, and optimal patient outcomes.

What are some common challenges a utilization management nurse faces when coordinating care between providers and insurance companies?

A Utilization Management Nurse often navigates the challenge of balancing patient advocacy with insurance guidelines, ensuring that care recommendations meet both clinical standards and payer requirements. Communicating complex medical information to both providers and insurance representatives can be demanding, especially when there are disagreements about coverage or medical necessity. Additionally, staying updated on changing policies and maintaining thorough documentation under tight deadlines are frequent aspects of the role. Strong collaboration skills and attention to detail are essential for success in this position.

What is the difference between Utilization Management Nurse vs Case Manager?

AspectUtilization Management NurseCase Manager
CredentialsRN license, certifications in utilization reviewRN license, case management certification often preferred
Work EnvironmentInsurance companies, healthcare organizations, utilization review departmentsHospitals, community health agencies, insurance companies
Primary FocusReviewing medical necessity and appropriateness of servicesCoordinating patient care and discharge planning

Utilization Management Nurses primarily focus on reviewing medical necessity and approving healthcare services, while Case Managers coordinate patient care and facilitate discharge planning. Both roles require RN licensure and work within healthcare or insurance settings, but their core responsibilities differ in scope and focus.

More about Utilization Management Nurse jobs

What are popular job titles related to Utilization Management Nurse jobs in Alberta?

For Utilization Management Nurse jobs in Alberta, the most frequently searched job titles are:

What job categories do people searching Utilization Management Nurse jobs in Alberta look for?

The top searched job categories for Utilization Management Nurse jobs in Alberta are:

What are popular job titles related to Utilization Management Nurse jobs in AB?

For Utilization Management Nurse jobs in AB, the most frequently searched job titles are:

Utilization Management Nurse jobs near you
Infographic showing various Utilization Management Nurse job openings in Alberta as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 16% Part Time, and 2% Contract. Highlights an 82% Physical, 3% Hybrid, and 15% Remote job distribution, with an average salary of $81,730 per year, or $39.3 per hour.

Manager, RAI Program & Clinical Education (MGR-CP57-001) - Corporate Office

Calgary, AB • On-site

Bethany Care Society
1 - 5K employees
Learn more about Bethany Care Societyexternal

Full-time

Posted 7 days ago

Job description

About The Role:

The Manager, RAI Program & Clinical Education provides strategic and operational leadership for Bethany Care Society's Resident Assessment Instrument (RAI) program and Clinical Education function. The position is accountable for organizational competency governance, mandatory education systems, clinical practice readiness, RAI data integrity, education compliance monitoring, and workforce capability development across Bethany communities.
Working within the Integrated Quality Management (IQM) System, the Manager ensures alignment between regulatory requirements, accreditation standards, practice standards, organizational priorities, and workforce development strategies. The role leads Clinical Educators and RAI Assessors and works collaboratively with Operations, Quality, Human Resources, and organizational leaders to advance quality care, resident safety, and workforce effectiveness.

What You Will Do:

Clinical Education Leadership

  • Lead corporate clinical education strategy and annual planning.

  • Establish mandatory education requirements and governance processes.

  • Oversee competency frameworks and practice-readiness initiatives.

  • Direct educator deployment and workload prioritization.

  • Monitor education effectiveness and compliance.

RAI Program Leadership

  • Provide operational and organizational leadership for the RAI-MDS system.

  • Ensure assessment accuracy, timeliness, and data quality.

  • Support interpretation and utilization of RAI indicators.

  • Lead RAI quality assurance and continuous improvement activities.

  • Coordinate RAI education and competency oversight.

Accreditation and Regulatory Compliance

  • Lead education and RAI readiness activities associated with CARF, CCHSS, continuing care legislation, and other regulatory requirements.

  • Coordinate evidence collection and documentation.

  • Monitor relevant compliance risks and implement corrective actions.

Leadership and People Management

  • Directly supervise Clinical Educators and RAI-Team Lead (Coordinator), RAI Assessors.

  • Provide coaching, performance management, staff development, and workforce planning.

  • Manage resource allocation across multiple sites.

Quality Improvement and Data Integration

  • Utilize RAI, quality, incident, audit, and accreditation findings to establish learning priorities.

  • Collaborate with Quality and Operations leaders to support continuous improvement initiatives.

Strategic Partnerships and Governance

  • Participate in organizational committees and governance activities.

  • Work closely with the Director Quality, Executive Director, Research & Innovation, Clinical Operations leadership, Human Resources,

What You Bring:

  • Post-secondary degree in nursing

  • Training in Adult learning or equivalent combination of education and directly relevant experience may be considered.

  • Minimum 3 to 5 years of relevant experience in nursing management, nursing assessment experience in a regulated healthcare or continuing care environment.

  • Experience supporting multi-site work, committees, healthcare practice education, policy/process implementation, and process improvement strongly preferred.

  • Experience working with document management systems, LMS, policy platforms, SharePoint / Microsoft 365, or comparable systems preferred.

  • Strong organizational and coordination skills with excellent follow-through.

  • Strong writing skills, including ability to prepare concise summaries, status reports, and working documents.

  • Ability to manage multiple streams of work in a structured and disciplined manner.

  • Strong attention to detail, especially with version control, records organization, and action tracking.

  • Comfort working with trackers, spreadsheets, meeting records, and draft planning documents.

  • Strong interpersonal skills and ability to work effectively across teams without direct authority.

  • Proficiency in Word, Excel, Outlook, Teams, and file management within Microsoft 365.

Position Information:

Location:

Calgary, Alberta

Site:

Corporate Office

Site Address:

100, 2915 - 26th Avenue SE, Calgary AB, T2B 2W6

Classification:

Manager, RAI Program & Clinical Education (MGR-CP57-001) - Corporate Office

FTE:

1.00

Non- Union/Union:

Department/Unit:

Research & Innovation - CMS

Time Type:

Full time

Position Type:

Permanent

Shift & Hours of Work:

Days (0800-1615)

Shift per Cycle:

Monday to Friday

Position Start Date:

2026-08-24

Position End Date:

All applicants are thanked for their interest. Only those selected to move forward will be contacted.
Bethany Care Society is an equal opportunity employer.
Successful candidates will be required to obtain a Criminal Background Check and provide proof of all mandatory immunizations.
Bethany Care Society complies with the Personal Information Protection and Electronic Documents Act (PIPEDA). By forwarding your resume to Bethany you are consenting to the collection and use of your personal information for this job competition. Your information will be kept strictly confidential.

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