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Utilization Review Nurse Jobs in Remote, OR (NOW HIRING)

Aviva Health

Clinical Quality Manager

Roseburg, OR · On-site

$38.83 - $61.85/hr

This individual will review data, evaluate trends, and compare with benchmark measures. The ... Identify and prioritize key quality and utilization initiatives critical for the success of ...

Aviva Health

Clinical Quality Manager

Roseburg, OR · On-site

$38.83 - $61.85/hr

This individual will review data, evaluate trends, and compare with benchmark measures. The ... Identify and prioritize key quality and utilization initiatives critical for the success of ...

GLC On-The-Go

Travel Behavioral Health RN

Coos Bay, OR · On-site

$1.9K - $2.0K/wk

Discipline: RN * Start Date: 09/29/2026 * Duration: 13 weeks * 36 hours per week * Shift: 12 hours ... Apply now and start your rewarding journey with GLC - a recruiter will connect quickly to review ...

Volare Health, LLC

Registered Nurse (RN)

Roseburg, OR · On-site

$48 - $49.25/hr

Registered Nurse (RN) Location: Rose Haven Nursing Center - Roseburg, OR Pay: $48.00/HR - $49.25/HR (based on licensed experience) PRN Schedules Available - shifts are not guaranteed Rose Haven ...

Volare Health LLC

Registered Nurse (RN)

Roseburg, OR · On-site

$48 - $49.25/hr

Registered Nurse (RN) Location: Rose Haven Nursing Center - Roseburg, OR Pay: $48.00/HR - $49.25/HR (based on licensed experience PRN Schedules Available - shifts are not guaranteed Rose Haven ...

Volare Health LLC

Registered Nurse (RN)

Roseburg, OR · On-site

$48 - $49.25/hr

Registered Nurse (RN) Location: Rose Haven Nursing Center - Roseburg, OR Pay: $48.00/HR - $49.25/HR (based on licensed experience PRN Schedules Available - shifts are not guaranteed Rose Haven ...

Volare Health LLC

Registered Nurse (RN)

Roseburg, OR

$48 - $49.25/hr

Registered Nurse (RN) Location: Rose Haven Nursing Center - Roseburg, OR Pay: $48.00/HR - $49.25/HR (based on licensed experience PRN Schedules Available - shifts are not guaranteed Rose Haven ...

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Showing results 21-40

All JobsUtilization Review Nurse JobsUtilization Review Nurse Jobs in Remote, OR

Utilization Review Nurse information

See Remote, OR salary details

$21

$42

$68

How much do utilization review nurse jobs pay per hour?

As of Sep 6, 2026, the average hourly pay for utilization review nurse in Remote, OR is $42.24, according to ZipRecruiter salary data. Most workers in this role earn between $33.37 and $48.51 per hour, depending on experience, location, and employer.

What does a utilization review nurse do?

A Utilization Review Nurse is responsible for evaluating the necessity, appropriateness, and efficiency of healthcare services and treatments provided to patients. They review medical records, coordinate with healthcare providers, and ensure that care meets established guidelines and insurance requirements. Their primary goal is to ensure patients receive appropriate care while helping to manage healthcare costs and prevent unnecessary procedures.

What does a utilization review nurse do?

A utilization review nurse determines the best course of treatment for a patient using preapproved policy criteria. Utilization review nurses collect and review patient records, clinical documentation, and billing information to recommend the best use of patient care resources. Their assessments help determine the length of hospital stays, the effectiveness of the care plan, and the necessity of the services administered. Utilization review nurses inform and educate patients about their options based on their insurance benefits and limitations. Utilization review nurses also assess patient care services in clinical appeals for approval or denial.

What are some typical challenges utilization review nurses face when communicating with healthcare providers and insurance companies?

Utilization Review Nurses often need to balance clinical judgment with insurance guidelines, which can lead to challenging conversations with providers who may disagree with coverage decisions. They must clearly explain the rationale behind approvals or denials and ensure all documentation is thorough and compliant. Navigating differing priorities while maintaining positive, professional relationships is key, and strong communication skills help facilitate collaboration and resolve conflicts efficiently.

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

To thrive as a Utilization Review Nurse, you need a strong background in clinical nursing, critical thinking, and knowledge of healthcare regulations, usually supported by an RN license and nursing degree. Familiarity with utilization management software, medical coding systems (like ICD-10 and CPT), and case management certifications (such as CCM or URAC) is typically required. Excellent communication, negotiation, and organizational skills help you collaborate with providers and advocate for patient care while managing complex cases. These skills ensure appropriate resource use, regulatory compliance, and high-quality patient outcomes in healthcare settings.

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

AspectUtilization Review NurseCase Manager
CredentialsRN license, certification in utilization review (e.g., URAC)RN license, case management certification (e.g., CCM)
Work EnvironmentHospitals, insurance companies, healthcare facilitiesHospitals, insurance companies, community health settings
Employer & Industry UsagePrimarily in insurance and healthcare organizations for reviewing medical necessityIn healthcare and insurance for coordinating patient care and discharge planning

Utilization Review Nurses focus on evaluating the necessity and appropriateness of medical services, often working in insurance or healthcare settings. Case Managers coordinate patient care, discharge planning, and resource management. While both roles require RN licensure and related certifications, their primary responsibilities differ: UR Nurses review medical necessity, whereas Case Managers facilitate patient care and services.

More about Utilization Review Nurse jobs

What are the most commonly searched types of Utilization Review Nurse jobs in Remote, OR?

The most popular types of Utilization Review Nurse jobs in Remote, OR are:

What are popular job titles related to Utilization Review Nurse jobs in Remote, OR?

For Utilization Review Nurse jobs in Remote, OR, the most frequently searched job titles are:

What job categories do people searching Utilization Review Nurse jobs in Remote, OR look for?

The top searched job categories for Utilization Review Nurse jobs in Remote, OR are:

What cities near Remote, OR are hiring for Utilization Review Nurse jobs?

Cities near Remote, OR with the most Utilization Review Nurse job openings:

Utilization Review Nurse jobs near you
Infographic showing various Utilization Review Nurse job openings in Remote, OR as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 13% Part Time, 3% Contract, and 1% Nights. Highlights an 72% Physical, 2% Hybrid, and 26% Remote job distribution, with an average salary of $87,860 per year, or $42.2 per hour.

Registered Nurse (RN)

Evergreen Family Medicine

Roseburg, OR • On-site

$39.30 - $50.92/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 13 days ago

Job description

Registered Nurse (RN)
Evergreen Family Medicine is committed to providing excellent care for your family with clinics in Roseburg, Sutherlin and Myrtle Creek Oregon. Evergreen Family Medicine serves outpatient needs, including Urgent Care, Family Practice, Women's Health, and Occupational Health.
Evergreen Family Medicine is a Drug Free Workplace. All candidates that are offered employment will be required to pass a pre-employment drug screen and background check.
Job Summary:
Fast-paced Family Practice Clinic seeking a Registered Nurse (RN) to be a key player in our commitment to giving patients the best experience possible, while we provide them with the highest quality patient care in our area.
Responsibilities and Duties:
  • Ability to communicate effectively, both orally and in writing.
  • Administer first-aid treatment and life-support care to sick or injured persons as directed by provider or by signed protocol.
  • Obtain patient's vital signs, medical history, and medications to determine the circumstances of their HPI and to administer emergency treatment if indicated.
  • Contributes to assessing patient needs by collecting data, communicating, and recording data accurately in accordance with policy and procedure.
  • Assesses the nature and extent of illness or injury to establish and prioritize medical procedures.
  • Observes records and reports to provider the patient's condition or injury. Conveys the treatment provided if performed under protocol delegation and reports any adverse reactions to drugs or treatment.
  • Administers drugs, orally or by injection and performs intravenous procedures under a provider's supervision and delegation in accordance with OSBN guidelines for LPNs & RNs
  • Sets up and assists for procedures such as pap/pelvic exams, lacerations repairs, I&D abscess, toenail removal, nasal cautery, etc. in accordance with one's personal scope of practice, under a provider's direction, delegation and/or supervision.
  • Performs procedures such as suture removal, ear lavage, phlebotomy, splinting, wound care, urinary catheter placement / change ace wrap application, etc. in accordance with one's scope of practice, under a provider's direction, delegation and/or supervision.
  • Performs in house lab procedures such as strep, mono, hemoccult, urine HCG, UA dips, etc. in accordance with one's scope of practice, under a provider's direction, delegation and/or supervision.
  • Assists and cares for others by providing personal assistance, medical attention, emotional support, or other personal care to others such as coworkers and patients.
  • Gathers pertinent information by observing, receiving, and requesting information from all relevant sources such as pharmacy, PCP, specialty offices, ED notes and family members.
  • Must understand how to operate maneuver and navigate, mechanized equipment such as EKG, AED, ZOLL, bladder-scanner, ultrasound etc.
  • Ensure equipment is maintained in a safe and clean manner and that cleaning and controls are performed per manufacturers guidelines to ensure accurate results.
  • Must seek to understand and perform all essential duties and skills performed by MA's in the Family Practice setting.
  • Learns all internal flow systems to sustain a smooth, timely flow of patients throughout their visit to expedite patient care.
  • Maintains a clean, neat, and safe work environment for patients and staff in accordance with the standards put forth by EFM policy.
  • Demonstrates understanding of prescription control and prescription refill procedures. Accurately and completely document known allergies in EHR.
  • Participates and promotes the economical utilization of supplies.
  • Minimizes non-productive time and fills slow periods with activities that meet the future needs of EFM i.e., stocking, copying, organizing, cleaning, etc.
  • Assists and supports the clinic providers by being a presence on the floor who can intervene and correct patient care issues that are presented by the providers.
  • Develops constructive and cooperative working relationships with other staff and other EFM departments by encouraging and building mutual trust, respect, and cooperation.
  • Understands that it is the certificate holder or licensees' responsibility to work within the parameters of the certificate holder or licensees' legal scope of practice.
  • Triages, prioritizes, and executes emergent patient interventions by direct care or by delegation.
  • All additional tasks assigned by manager.

Essential Functions:
  • Customer and Personal Service - Must possess knowledge of principles and processes that enables EFM to provide exceptional patient care and personal services. This includes a patient needs assessment via triage, meeting quality standards for services and striving to exceed the patients' expectations daily.
  • Critical Thinking - Uses logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.
  • Organizing, Planning, and Prioritizing Work - Develops specific goals and plans to prioritize, organize, and accomplish work.
  • Making Decisions and Solving Problems - Analyzes information and evaluates results to problem solve by choosing the best solution.
  • Medical Knowledge - Must possess the abilities and techniques needed to treat human injuries, diseases, and deformities within one's scope of practice. This includes symptoms, treatment alternatives, drug properties and interactions and preventive health-care measures.
  • Communicating with Supervisors, Peers, or Subordinates - Disseminates appropriate information to supervisors, co-workers, and others by telephone, in written form, email or in person.
  • Public Safety and Security - Must possess knowledge of relevant equipment, policies, procedures, and strategies to promote effective local, state, or national security operations for the protection of people, data, property and institutions. Must possess knowledge of OSHA regulations and internal protocols in the event of a disaster or threat. Maintains confidentiality in accordance with HIPPA regulations and EFM policies.
  • Performing for or Working Directly with the Public - Demonstrates excellent interpersonal skills with patients either in person, by portal or via telephone.
  • Establishing and Maintaining Interpersonal Relationships - Develops constructive and cooperative working relationships with others and maintains them over time.
  • Developing and Building Teams - Encourages and builds mutual trust, respect, and cooperation among team members.
  • Accurately document/recording information - Timely and accurately enters, transcribes, records, stores and maintains information in written or electronic form.

Qualifications and Skills:
  • Graduated from an accredited Nursing school
  • Valid RN license and BLS certificate.
  • 2-5 years' experience in a Medical Setting
  • Ability to communicate effectively, both orally and in writing
  • Administer medications accordingly as directed by the provider
  • Assess patient needs and document accurately
  • Set priorities for nursing action in a sequence according to patient needs
  • Communicate with the provider and other nurses and team members to ensure the patients well being
  • Teach patient appropriate health information and share written informational material
  • Maintain a clean, neat, and safe work environment for patients and staff according to policy and procedures
  • Participate in economical utilization of supplies • Ensure equipment is maintained in a safe and clean manner
  • Minimize non-productive time and fill slow periods with activities that will enable you to prepare to meet the future needs of EFM

Physical requirements:
  • Required to work evening and weekend shifts
  • The employee is frequently required to walk; use hands and fingers, handle, or feel; and reach forward with hands and arms.
  • The employee is occasionally required to sit and stoop, kneel, or crouch.
  • Must be able to withstand physical and emotional stress.
  • This job requires standing or walking 60% of the time; sitting 30%; and lifting up to 35 lbs 10% of the time.

Our culture and values are every employee's responsibility: The needs of our patient come first S.P.I.R.I.T
  • Stewardship
  • Patient & Population Focused Health Care
  • Integrity
  • Respect
  • Innovation
  • Teamwork

Benefits:
  • Health, Dental, Vision benefits
  • Life Insurance
  • 401k with a company match up to 6%
  • Paid Time Off

Apply