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Utilization Review Rn Jobs in Iowa (NOW HIRING)

ePATHUSA Inc

Medical Review Nurse

Clive, IA · Remote

$80K - $90K/yr

Seeking Registered Nurse for fully remote role to perform complex medical record and claim reviews ... utilization/practice guidelines, clinical review judgment and when appropriate, monitor for ...

Imh

RN Ambulatory Care Manager

Nevada, IA

$40.39 - $60.96/hr

The RN Ambulatory Care Manager I delivers comprehensive ambulatory care management services to ... Demonstrated experience in case management, utilization review, or discharge planning. Physical ...

UnityPoint Health

RN Care Manager

Waterloo, IA · On-site

Overview RN Care Manager Allen Hospital Full-time, Monday-Friday 8a-4:30pm 6 weekends/year and one ... Maintains knowledge of utilization management criteria and communicates with Utilization Review ...

UnityPoint Health

RN Care Manager

Waterloo, IA · On-site

Overview RN Care Manager Allen Hospital Full-time, Monday-Friday 8a-4:30pm 6 weekends/year and one ... Maintains knowledge of utilization management criteria and communicates with Utilization Review ...

UnityPoint Health

RN Care Manager

Waterloo, IA

RN Care Manager Allen Hospital Full-time, Monday-Friday 8a-4:30pm 6 weekends/year and one holiday ... Maintains knowledge of utilization management criteria and communicates with Utilization Review ...

UnityPoint Health

RN Care Manager

Waterloo, IA

RN Care Manager Allen Hospital Full-time, Monday-Friday 8a-4:30pm 6 weekends/year and one holiday ... Maintains knowledge of utilization management criteria and communicates with Utilization Review ...

UnityPoint Health

RN-Psych Home Care

Cedar Rapids, IA

$1.7K - $2.4K/wk

Responsible for case coordination of patients and insurance precertification/utilization review ... Current licensure in good standing to practice as a Registered Nurse in [type in State]. * Must ...

UnityPoint Health

RN-Psych Home Care

Cedar Rapids, IA · On-site

$1.7K - $2.4K/wk

Responsible for case coordination of patients and insurance precertification/utilization review ... Current licensure in good standing to practice as a Registered Nurse in [type in State]. * Must ...

UnityPoint Health

RN-Psych Home Care

Cedar Rapids, IA · On-site

$1.7K - $2.4K/wk

Responsible for case coordination of patients and insurance precertification/utilization review ... Current licensure in good standing to practice as a Registered Nurse in [type in State]. * Must ...

UnityPoint Health

RN-Psych Home Care

Cedar Rapids, IA

$1.7K - $2.4K/wk

Responsible for case coordination of patients and insurance precertification/utilization review ... Current licensure in good standing to practice as a Registered Nurse in [type in State]. * Must ...

Trinityhealth

RN Care Coordination

Davenport, IA

Certification in Case Management, Professional Utilization Review or Managed Care; DRG/CPT knowledge; Interqual Admission/Continued Stay criteria knowledge * Licensure/Registration: Registered Nurse ...

UnityPoint Health

RN-Psych Home Care

Cedar Rapids, IA · On-site

$1.7K - $2.4K/wk

Responsible for case coordination of patients and insurance precertification/utilization review ... Current licensure in good standing to practice as a Registered Nurse in [type in State]. * Must ...

Trinity Health

RN Care Coordination

Davenport, IA · On-site

Certification in Case Management, Professional Utilization Review or Managed Care; DRG/CPT knowledge; Interqual Admission/Continued Stay criteria knowledge * Licensure/Registration: Registered Nurse ...

Trinity Health

RN Care Coordination

Davenport, IA · On-site

Certification in Case Management, Professional Utilization Review or Managed Care; DRG/CPT knowledge; Interqual Admission/Continued Stay criteria knowledge * Licensure/Registration: Registered Nurse ...

UnityPoint Health

RN-Psych Home Care

Cedar Rapids, IA

$1.7K - $2.4K/wk

Responsible for case coordination of patients and insurance precertification/utilization review ... Current licensure in good standing to practice as a Registered Nurse in [type in State]. * Must ...

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Showing results 1-20

All JobsUtilization Review Rn JobsUtilization Review Rn Jobs in Iowa

Utilization Review Rn information

See Iowa salary details

$20

$39

$64

How much do utilization review rn jobs pay per hour?

As of Jun 21, 2026, the average hourly pay for utilization review rn in Iowa is $39.71, according to ZipRecruiter salary data. Most workers in this role earn between $31.39 and $45.62 per hour, depending on experience, location, and employer.

How does a Utilization Review RN collaborate with physicians and other healthcare professionals during the patient care review process?

A Utilization Review RN works closely with physicians, case managers, and other healthcare team members to ensure that patients receive appropriate care while adhering to regulatory and insurance guidelines. This collaboration often involves discussing clinical findings, clarifying documentation, and negotiating care plans to meet both patient needs and payer requirements. Effective communication and teamwork are essential, as Utilization Review RNs frequently serve as liaisons between clinical staff and insurance representatives to facilitate timely authorizations and prevent unnecessary delays in patient care.

How do I become a utilization review RN?

To become a utilization review RN, you typically need to hold a valid registered nurse (RN) license and have experience in clinical nursing. Additional certifications such as the Certified Professional in Healthcare Quality (CPHQ) or Utilization Review Certification (URAC) can enhance job prospects, and strong knowledge of medical coding, insurance policies, and healthcare regulations is important.

What are the key skills and qualifications needed to thrive as a Utilization Review RN, and why are they important?

To thrive as a Utilization Review RN, you need a current RN license, strong clinical assessment skills, and knowledge of healthcare regulations and insurance guidelines. Familiarity with utilization management software, electronic health records (EHRs), and relevant certifications like CCM or ACM is often required. Excellent critical thinking, communication, and negotiation skills help you advocate for appropriate patient care while collaborating with providers and payers. These skills ensure cost-effective, quality care and compliance with regulatory standards in healthcare delivery.

What does an RN utilization review do?

An RN utilization review evaluates medical records and treatment plans to determine the appropriateness, necessity, and efficiency of healthcare services. They ensure compliance with insurance policies and clinical guidelines, often using electronic health records and requiring knowledge of coding and documentation standards. This role supports cost-effective patient care and involves collaboration with healthcare providers and insurance companies.

How to make $300,000 a year as a nurse?

To earn $300,000 annually as a Utilization Review RN, professionals typically need extensive experience, advanced certifications such as CCM or ANCC, and may work in high-paying settings like insurance companies or healthcare consulting firms. Increasing specialization, taking on leadership roles, or working overtime can also boost income, but reaching this level often requires a combination of skills, experience, and strategic career moves.

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

AspectUtilization Review RnCase Manager
CredentialsRN license, certifications in utilization reviewRN license, certifications in case management
Work EnvironmentHospitals, insurance companies, healthcare facilitiesHospitals, community agencies, insurance companies
Primary FocusReviewing medical necessity and appropriateness of careCoordinating patient care and discharge planning

Utilization Review Rns primarily focus on evaluating the necessity of medical treatments, while Case Managers coordinate patient care and discharge planning. Both roles require RN licensure and certifications, but their daily responsibilities and work environments differ slightly, with Utilization Review Rns concentrating on review processes and Case Managers on patient advocacy and care coordination.

How to make $150,000 as a nurse?

A Utilization Review RN can earn $150,000 by gaining extensive experience, obtaining certifications such as CCM or ANCC, and working in high-paying settings like insurance companies or managed care organizations. Advanced skills in case management, strong clinical knowledge, and sometimes working overtime or in leadership roles can also contribute to higher earnings.

What is a Utilization Review RN?

A Utilization Review RN is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services and treatments provided to patients. They review medical records, collaborate with healthcare teams, and ensure that patient care meets established guidelines and payer requirements. Their role helps control costs, optimize care, and support compliance with healthcare regulations. Utilization Review RNs often work in hospitals, insurance companies, or managed care organizations.
What are the most commonly searched types of Utilization Review Rn jobs in Iowa? The most popular types of Utilization Review Rn jobs in Iowa are:
What are popular job titles related to Utilization Review Rn jobs in Iowa? For Utilization Review Rn jobs in Iowa, the most frequently searched job titles are:
What job categories do people searching Utilization Review Rn jobs in Iowa look for? The top searched job categories for Utilization Review Rn jobs in Iowa are:
What are popular job titles related to Utilization Review Rn jobs in IA? For Utilization Review Rn jobs in IA, the most frequently searched job titles are:
Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Iowa as of June 2026, with employment types broken down into 88% Full Time, 10% Part Time, and 2% Contract. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution, with an average salary of $82,605 per year, or $39.7 per hour.
Case Management Director

Case Management Director

System Soft Technologies

Ottumwa, IA • On-site

$93K - $125K/yr

Full-time

Posted 16 days ago

Job description

Job Title: Case Management Director
Location: Ottumwa, IA
Employment Type: Full-Time
Salary Range: $93,272 - $125,900 per year, plus benefits and relocation assistance
Vendor fee-$3500
Position Summary
The Case Management Director is responsible for leading and overseeing the hospital's case management program, ensuring delivery of high-quality, efficient patient care. This role manages inpatient care facilitation, utilization management, case management, and discharge planning. The director supervises Case Managers and Social Workers, providing leadership, education, and support to maintain compliance, quality outcomes, and efficient resource utilization.
Supervises
  • Case Managers
  • Social Workers
Key Responsibilities
  • Lead, educate, and supervise the daily workflow of Case Managers and Social Workers.
  • Monitor departmental documentation to ensure compliance with regulatory and accreditation standards.
  • Collaborate with leadership and quality teams to develop and maintain quality improvement programs and track key metrics (e.g., avoidable days, readmissions).
  • Maintain case management and utilization review skills to provide coverage as needed.
  • Communicate with physicians regarding patient care plans, level of care, and bed assignments.
  • Oversee personnel actions including hiring, performance appraisals, employee schedules, and payroll records.
  • Facilitate multidisciplinary rounds to ensure collaborative, holistic patient care.
  • Participate in discharge planning, providing education and resources to patients and families.
  • Actively participate in Utilization Review and Revenue Cycle Committees.
  • Promote efficient use of clinical resources based on patient acuity.
  • Ensure departmental compliance with all applicable laws, regulations, accreditation standards, and internal policies.
  • Perform other duties as assigned.
Knowledge, Skills & Abilities
  • Understanding of payer requirements and discharge planning regulations to support policy development.
  • Knowledge of Medicare, managed care, and the full continuum of care, including inpatient, outpatient, and home health services.
  • Experience with utilization management, discharge planning, and case management.
  • Ability to work collaboratively with healthcare professionals at all levels.
  • Understanding of performance improvement concepts and quality initiatives.
  • Strong communication, leadership, and interpersonal skills; self-motivated and able to work independently or as part of a team.
  • Proven ability to build effective working relationships with physicians and other clinical staff.
Education
  • Graduate of an accredited Registered Nursing program required.
  • Bachelor of Science in Nursing (BSN) preferred.
Experience
  • Minimum of two years of experience in case management, utilization management, discharge planning, or related cost/quality management programs.
  • Two to three years of management experience preferred, with a minimum of two years in hospital-based nursing.
Certification / License
  • Current Registered Nurse (RN) license in Iowa, or multistate licensure eligible to practice in Iowa.

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