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Utilization Review Rn Jobs in New Mexico (NOW HIRING)

MTK Healthcare

RN-Case Manager

Portales, NM · On-site

$59 - $62/hr

MTK Healthcare Inc. is Hiring RN Case Manager - Utilization Review & Swing Bed | Portales, NM | Monday-Friday (8:00 AM-4:30 PM), Day Shift Position Details * Position: RN Case Manager - Utilization ...

New

Presbyterian Healthcare Services

Current State of New Mexico Registered Nurse licensure required. * 2 years clinical nursing experience in relevant clinical practice area with utilization review or case management experience ...

Phsorg

Current State of New Mexico Registered Nurse licensure required. * 2 years clinical nursing experience in relevant clinical practice area with utilization review or case management experience ...

Phsorg

$34.68 - $52.95/hr

Current State of New Mexico Registered Nurse licensure required. * 2 years clinical nursing experience in relevant clinical practice area with utilization review or case management experience ...

Presbyterian Healthcare Services

$34.68 - $52.95/hr

Current State of New Mexico Registered Nurse licensure required. * 2 years clinical nursing experience in relevant clinical practice area with utilization review or case management experience ...

Cynet Health

RN - Case Manager

Portales, NM · On-site

Acute Care RN Case Manager - Utilization Review This position is responsible for routine case management and discharge planning. Conduct swing bed coordinator and utilization review duties. Evaluate ...

Cibola General Hospital

Case Manager

Grants, NM · On-site

$18.50 - $23.75/hr

The Case Manager / Utilization Review Nurse (RN) is responsible for coordinating patient care progression, discharge planning, and utilization review activities. This integrated role ensures ...

Cibola General Hospital

Case Manager

Grants, NM · On-site

$18.50 - $23.75/hr

Job Type Full-time Description The Case Manager / Utilization Review Nurse (RN) is responsible for coordinating patient care progression, discharge planning, and utilization review activities. This ...

CIBOLA GENERAL HOSPITAL CORPORATION

Case Manager

Grants, NM · On-site

$18.50 - $23.75/hr

Description The Case Manager / Utilization Review Nurse (RN) is responsible for coordinating patient care progression, discharge planning, and utilization review activities. This integrated role ...

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All JobsUtilization Review Rn JobsUtilization Review Rn Jobs in New Mexico

Utilization Review Rn information

See New Mexico salary details

$20

$40

$66

How much do utilization review rn jobs pay per hour?

As of Jul 11, 2026, the average hourly pay for utilization review rn in New Mexico is $40.97, according to ZipRecruiter salary data. Most workers in this role earn between $32.40 and $47.07 per hour, depending on experience, location, and employer.

How to get into utilization review as a nurse?

To become a utilization review RN, candidates typically need a valid nursing license and experience in clinical settings. Additional certifications such as Certified Professional in Healthcare Quality (CPHQ) or case management credentials can enhance prospects, and familiarity with electronic health records and insurance policies is beneficial.

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.

How to make $300,000 as a nurse?

A Utilization Review RN can earn $300,000 by gaining extensive experience, obtaining certifications such as Certified Review Officer (CRO), working in high-paying settings like insurance companies or managed care organizations, and taking on leadership or specialized roles that offer higher compensation. Advanced skills in clinical assessment, documentation, and understanding of healthcare policies can also contribute to higher earnings.

What does an RN utilization review do?

An RN utilization review evaluates medical records and treatment plans to determine the necessity, appropriateness, 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.

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 Certified Review Officer (CRO), working in high-demand settings, and possibly taking on leadership or specialized roles. Increasing your workload, working overtime, or pursuing advanced education can also contribute to higher earnings within this field.

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 New Mexico? The most popular types of Utilization Review Rn jobs in New Mexico are:
What are popular job titles related to Utilization Review Rn jobs in New Mexico? For Utilization Review Rn jobs in New Mexico, the most frequently searched job titles are:
What job categories do people searching Utilization Review Rn jobs in New Mexico look for? The top searched job categories for Utilization Review Rn jobs in New Mexico are:
What are popular job titles related to Utilization Review Rn jobs in NM? For Utilization Review Rn jobs in NM, the most frequently searched job titles are:
Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in New Mexico as of July 2026, with employment types broken down into 1% As Needed, 79% Full Time, 15% Part Time, 1% Temporary, and 4% Contract. Highlights an 91% Physical, 2% Hybrid, and 7% Remote job distribution, with an average salary of $85,227 per year, or $41 per hour.
Travel RN Utilization Management / Assistant Director of Nursing

Travel RN Utilization Management / Assistant Director of Nursing

Wellspring Nurse Source

Albuquerque, NM • On-site

$73K - $97K/yr

Contractor

Posted 4 days ago

Job description

Wellspring Nurse Source is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Albuquerque, New Mexico.

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

Wellspring Nurse Source Job ID #37449818. Pay package is based on 8 hour shifts and 40.0 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: RN Manager

About Wellspring Nurse Source

Wellspring One (formerly Wellspring Nurse Source) is a nurse-owned and operated healthcare staffing company built around one simple belief: clinicians deserve exceptional support. Our team is honored to represent what we believe is the greatest workforce on earth, and we work every day to support our clinicians with the same level of excellence they bring to their patients.


Wellspring One was named one of SIA’s Best Staffing Firms to Work For in 2026, a recognition that reflects our commitment to building a culture where clinicians feel supported, valued, and set up for success. From onboarding and compliance to payroll, career guidance, and on-assignment support, our dedicated Clinician Success Team is with you every step of your travel journey.


We’re not focused on becoming the biggest staffing company. Our goal is to be the best partner you’ll ever work with.

If you’re looking for a team that will advocate for you, support you, and help you find the right opportunities at the best rates, we’d love to be part of your journey.


Wellspring Nurse Source logo

About Wellspring Nurse Source

Sourced by ZipRecruiter

Wellspring Nurse Source, based in Shelton, CT, US, operates within the healthcare sector, specializing in the recruitment and placement of nursing professionals. Their official website, wellspringnursesource.com, can serve as a portal for nurses seeking opportunities and healthcare organizations looking for qualified healthcare staff. While specific details about the company's founding history and notable achievements are not expressly stated on the website, Wellspring Nurse Source central mission clearly revolves around connecting healthcare professionals and organizations, with a commitment to providing thorough, personalized matching to ensure both parties reach their professional and care goals.

Industry

Recruiting and staffing services

Company size

11 - 50 Employees

Headquarters location

Shelton, CT, US

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