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Utilization Review Rn Jobs in Nebraska (NOW HIRING)

P3 Health Partners

RN Care Manager

Lincoln, NE

$85K - $105K/yr

We are looking for a RN Care Manager . If you are passionate about your work; eager to have fun ... The Care Manager may be responsible for activities overlapping with utilization review and quality ...

P3 Health Partners

RN Care Manager

Lincoln, NE · On-site

$85K - $105K/yr

We are looking for a RN Care Manager . If you are passionate about your work; eager to have fun ... The Care Manager may be responsible for activities overlapping with utilization review and quality ...

P3 Health Partners

RN Care Manager

Lincoln, NE · On-site

$85K - $105K/yr

We are looking for a RN Care Manager . If you are passionate about your work; eager to have fun ... The Care Manager may be responsible for activities overlapping with utilization review and quality ...

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All JobsUtilization Review Rn JobsUtilization Review Rn Jobs in Nebraska

Utilization Review Rn information

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How much do utilization review rn jobs pay per hour?

As of Aug 18, 2026, the average hourly pay for utilization review rn in Nebraska is $40.31, according to ZipRecruiter salary data. Most workers in this role earn between $31.88 and $46.30 per hour, depending on experience, location, and employer.

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.

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.

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 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 get into utilization review as a registered nurse?

To become a utilization review RN, you typically need a valid registered nurse license and experience in clinical settings. Additional certifications such as the Certified Professional in Healthcare Quality (CPHQ) or case management certification can enhance job prospects, and familiarity with electronic health records (EHR) systems is often required.

What are the most commonly searched types of Utilization Review Rn jobs in Nebraska?

The most popular types of Utilization Review Rn jobs in Nebraska are:

What are popular job titles related to Utilization Review Rn jobs in Nebraska?

For Utilization Review Rn jobs in Nebraska, the most frequently searched job titles are:

What job categories do people searching Utilization Review Rn jobs in Nebraska look for?

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Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Nebraska as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 15% Part Time, 3% Contract, and 1% Nights. Highlights an 87% Physical, 4% Hybrid, and 9% Remote job distribution, with an average salary of $83,852 per year, or $40.3 per hour.

RN Care Manager

P3 Health Partners

Lincoln, NE

$85K - $105K/yr

Full-time

Posted 23 days ago

P3 Health Partners rating

6.6

Company rating: 6.6 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

Job description

People. Passion. Purpose. 

At P3 Health Partners, our promise is to guide our communities to better health, unburden clinicians, align incentives and engage patients.

We are a physician-led organization relentless in our mission to overcome all obstacles by positively disrupting the business of health care, transforming it from sickness care into wellness guidance.  

We are looking for a RN Care Manager.  If you are passionate about your work; eager to have fun; and motivated to be part of a fast-growing organization in Las Vegas, Nevada, then you should consider joining our team.

Work Location & Schedule

This role offers a hybrid work arrangement. Candidates will follow our hybrid schedule, working in office three days per week. 

Overall Purpose:

This position is responsible for ensuring that assigned patient population(s) receive continuous, comprehensive and coordinated care throughout the continuum.  Through case finding, data and other tools, high risk patients will be identified and guided to enhance the achievement of the Quadruple Aim:  improved outcomes, improved experience of care for patients and providers and lower healthcare costs.  

The Care Manager will utilize the nursing process of assessment, planning, implementation and evaluation as well as clinical judgment.  Interventions with patients and / or stakeholders may be face to face or telephonic.  The Care Manager may be responsible for activities overlapping with utilization review and quality management programs.  

Essential Job Functions:

  • Promote the mission, vision and values of P3 Health Partners
  • Responsible for comprehensive patient assessments through medical records, clinician and patient interviews, telephonic and / or face to face
  • Develops, implements and evaluates patient care plans
  • Collaborates with Medical Management teams regarding care plans and patient’s progress
  • Identifies care needs and barriers to care. Develops plans to improve
  • Prepares documentation, as per timelines and policy
  • Coordinates care for assigned high risk patient population
  • Works with patients, families and care-givers to promote self- management and meet care plan goals
  • Builds relationships with PCPs, internal and external customers
  • Addresses gaps in care

Experience:

  • Strong clinical judgment and problem -solving skills required
  • Experience in Care Management preferred
  • Experience with Special Needs Programs [SNPs] preferred
  • Managed care experience preferred
  • Utilization review and discharge planning experience preferred
  • Excellent communication skills with patients, providers, internal and external customers required
  • Must have excellent computer skills
  • Must have excellent organizational skills and ability to work independently, with minimal supervision

Licensure / Certification:

  • Ability to obtain and maintain current registration to practice as a Registered Nurse in Nevada, Arizona, Oregon, and California
  • Certification in case management or ability to obtain within two years of employment
  • CPR certified or ability to obtain within 60 days of employment

Education:

Graduate from an Accredited School of Nursing or other applicable clinical role. Bachelor’s degree in Nursing preferred.

Pay range:  $85,000-105,000 depending on experience

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