ZipRecruiter

Log In

1

Utilization Management Nurse Jobs in Rochester, MN

Blue Stone Therapy

Rehab Director

Spring Valley, MN · On-site

$29 - $56/hr

Lead daily therapy department operations, including staffing, scheduling, and utilization ... Ability to manage staffing, scheduling, and operational performance * Experience in skilled nursing ...

Blue Stone Therapy

Rehab Director

Spring Valley, MN

$29 - $56/hr

Lead daily therapy department operations, including staffing, scheduling, and utilization ... Ability to manage staffing, scheduling, and operational performance * Experience in skilled nursing ...

Blue Stone Therapy

Rehab Director

Spring Valley, MN · On-site

$29 - $56/hr

Lead daily therapy department operations, including staffing, scheduling, and utilization ... Ability to manage staffing, scheduling, and operational performance * Experience in skilled nursing ...

next page

Showing results 1-20

People also search for

All JobsUtilization Management Nurse JobsUtilization Management Nurse Jobs in Rochester, MN

Utilization Management Nurse information

See Rochester, MN salary details

$39.6K

$91K

$165.7K

How much do utilization management nurse jobs pay per year?

As of May 30, 2026, the average yearly pay for utilization management nurse in Rochester, MN is $90,959.00, according to ZipRecruiter salary data. Most workers in this role earn between $65,600.00 and $106,200.00 per year, depending on experience, location, and employer.

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, and why are they important?

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 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 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 Rochester, MN? For Utilization Management Nurse jobs in Rochester, MN, the most frequently searched job titles are:
What job categories do people searching Utilization Management Nurse jobs in Rochester, MN look for? The top searched job categories for Utilization Management Nurse jobs in Rochester, MN are:
What cities near Rochester, MN are hiring for Utilization Management Nurse jobs? Cities near Rochester, MN with the most Utilization Management Nurse job openings:
Utilization Management Nurse jobs near you
Rehab Director

Rehab Director

Blue Stone Therapy

Spring Valley, MN • On-site

$29 - $56/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 10 days ago

Blue Stone Therapy rating

4.2

Company rating: 4.2 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

Job description

Description:

Blue Stone Therapy is proud to be certified as a Great Place to Work®


Since 2009, Blue Stone Therapy has partnered with skilled nursing and senior living communities across the Midwest to deliver individualized, high-quality physical, occupational, and speech therapy services. We are committed to strong clinical standards, operational consistency, and long-term partnerships that support meaningful patient outcomes.


Rehab Director - Spring Valley, MN

Blue Stone Therapy is seeking a Rehab Director (RD) to oversee rehabilitation services at Spring Valley Care Center in Spring Valley, MN.


This leadership role is responsible for the daily operations, clinical oversight, staffing strategy, and overall performance of the rehabilitation department within a skilled nursing facility (SNF) or post-acute setting. The Rehab Director ensures the delivery of high-quality therapy services while driving operational efficiency, regulatory compliance, team engagement, and measurable patient outcomes.


This position provides direct patient care as needed and is accountable for achieving productivity and utilization standards.


$5,000 sign-on bonus available for eligible full-time candidates.


What You’ll Do

  • Lead daily therapy department operations, including staffing, scheduling, and utilization management
  • Provide clinical oversight related to case management, care planning, and appropriate therapy delivery
  • Support onboarding, coaching, accountability, and performance management of therapy team members
  • Maintain productivity standards while providing direct patient care as required
  • Ensure compliance with company policies, regulatory standards, and facility requirements
  • Collaborate with facility leadership and regional operations partners to support performance goals
  • Promote program development and quality improvement initiatives
  • Foster a positive, team-centered culture aligned with Blue Stone Therapy’s purpose and core values
Requirements:

What You Bring

  • Graduate of an accredited program in Physical Therapy, Occupational Therapy, Speech Language Pathology, Physical Therapy Assistant, or Occupational Therapy Assistant
  • Current therapy license (PT, OT, SLP, PTA, or COTA) or eligibility for licensure in applicable state
  • Minimum of one (1) year of clinical experience in a therapy services role
  • Strong leadership, organizational, and communication skills
  • Ability to manage staffing, scheduling, and operational performance
  • Experience in skilled nursing or post-acute rehabilitation preferred
  • Experience with NetHealth or electronic medical record systems preferred

Why Blue Stone Therapy?

We believe strong leadership drives strong outcomes. Our Rehab Directors are supported by regional leadership while empowered to build engaged teams, strengthen facility partnerships, and drive performance. We provide operational support, clear expectations, and a collaborative environment where leaders can focus on delivering quality care and measurable results.

We invest in professional growth, operational support, and long-term partnerships that allow our leaders to focus on performance and patient success.


Benefits

  • Medical, Dental, and Vision insurance
  • Flexible Spending Account (FSA) and Health Savings Account (HSA) options
  • 401(k) with employer contribution
  • Employee Assistance Program (EAP)
  • Paid Time Off (PTO) and paid holidays
  • And more

Benefits are subject to eligibility requirements and the terms of applicable plans or programs.


Blue Stone Therapy is an Equal Opportunity Employer