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Utilization Review Case Manager Jobs in Oregon (NOW HIRING)

Providence Service

Utilization Review RN

Portland, OR · On-site

Five (5) years Clinical experience in an acute adult medical/surgical care setting, OR Five (5) years Current Utilization Review or Case Management experience. * Demonstrated clinical expertise and ...

St. Charles Health System

RN Utilization Review

Bend, OR · On-site

$48.30 - $72.45/hr

Utilization Management DATE LAST REVIEWED: November 2024 OUR VISION: Creating America's healthiest ... CCM), Case Management Nurse-Board Certified (CMGT-BC:ANCC). EXPERIENCE Required : Three (3) three ...

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All JobsUtilization Review Case JobsUtilization Review Case Manager JobsUtilization Review Case Manager Jobs in Oregon

Utilization Review Case Manager information

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How much do utilization review case manager jobs pay per hour?

As of Aug 29, 2026, the average hourly pay for utilization review case manager in Oregon is $38.58, according to ZipRecruiter salary data. Most workers in this role earn between $31.25 and $40.67 per hour, depending on experience, location, and employer.

What is a utilization review case manager?

A Utilization Review Case Manager is a healthcare professional responsible for evaluating the necessity, appropriateness, and efficiency of medical treatments and services provided to patients. They review clinical information, coordinate with providers and insurance companies, and ensure that patient care aligns with established guidelines and policies. Their goal is to optimize patient outcomes while managing healthcare costs and ensuring compliance with regulations.

What are some common challenges utilization review case managers face when coordinating care across multiple departments?

Utilization Review Case Managers often navigate complex communication between physicians, nursing staff, insurance providers, and patients to ensure appropriate care and resource use. Balancing timely authorizations with evolving patient needs and varying documentation standards can be challenging. Additionally, staying current with changing regulations and payer requirements requires ongoing learning and adaptability. Building strong collaborative relationships and maintaining clear, concise documentation are key strategies for overcoming these hurdles.

What are the key skills and qualifications needed to thrive as a utilization review case manager, and why are they important?

To thrive as a Utilization Review Case Manager, you need a clinical background such as an RN or LCSW license, strong knowledge of medical necessity criteria, and experience with case management. Familiarity with utilization management software, electronic health records (EHRs), and knowledge of regulatory guidelines like Medicare and Medicaid are essential. Excellent communication, critical thinking, and negotiation skills help facilitate collaboration between patients, providers, and payers. These skills ensure appropriate resource use, compliance with regulations, and high-quality patient care.

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

AspectUtilization Review Case ManagerUtilization Review Nurse
CredentialsTypically requires a nursing license or relevant healthcare certificationRegistered Nurse (RN) license is required
Work EnvironmentOffice-based, insurance companies, healthcare organizationsHospital, clinic, insurance review departments
Primary FocusReviewing medical necessity, coordinating care, managing casesAssessing medical records, clinical review, patient care evaluation

Both roles involve healthcare review and require nursing credentials, but the Utilization Review Case Manager often focuses on coordinating care and managing cases, while the Utilization Review Nurse emphasizes clinical assessment and review of medical records. Understanding these differences helps in choosing the right career path or job search focus.

What are popular job titles related to Utilization Review Case Manager jobs in Oregon?

For Utilization Review Case Manager jobs in Oregon, the most frequently searched job titles are:

What job categories do people searching Utilization Review Case Manager jobs in Oregon look for?

The top searched job categories for Utilization Review Case Manager jobs in Oregon are:

Utilization Review Case Manager jobs near you
Infographic showing various Utilization Review Case Manager job openings in Oregon as of August 2026, with employment types broken down into 57% Full Time, and 43% Contract. Highlights an 100% In-person job distribution, with an average salary of $80,239 per year, or $38.6 per hour.

Travel Nurse RN - Utilization Review

Medlivo

Hillsboro, OR • On-site

Contractor

Medical, Dental, Vision, Life, Retirement

Posted 9 days ago

Job description

Medlivo is seeking a travel nurse RN Utilization Review for a travel nursing job in Hillsboro, Oregon.

Job Description & Requirements
  • Specialty: Utilization Review
  • Discipline: RN
  • Duration: 13 weeks
  • 40 hours per week
  • Shift: 8 hours, days
  • Employment Type: Travel

Requirements:
- Active Oregon RN or Washington RN license, or Compact RN license
- BLS
- Minimum 1 year of Case Manager or Patient Care Coordinator (PCC) experience
- EPIC experience
- Experience with Medicare and Medicaid
- Previous Kaiser Permanente experience preferred

Medlivo Job ID #KAISJP00253838. Pay package is based on 8 hour shifts and 40 hours per week (subject to confirmation) with tax-free stipend amount to be determined.

About Medlivo


Benefits
  • Dental benefits
  • Vision benefits
  • 401k retirement plan
  • Health Care FSA
  • Life insurance
  • Sick pay
  • Holiday Pay
  • Medical benefits

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