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Utilization Review Rn Jobs in Oregon (NOW HIRING)

Asante

Case Management Specialist

Medford, OR · On-site

$23.28 - $32.02/hr

... RN Utilization Reviewer. They assume a pivotal role with the patient care team to achieve optimal clinical and resource outcomes. Position Qualifications Experience * 3 years of experience in ...

Personify Health

Perform Utilization Review for assigned members. * Serve as mentors to LVNs and provide guidance on ... Possession of a current California RN license; a multi-state license will also be required.

Personify Health

Perform Utilization Review for assigned members. * Serve as mentors to LVNs and provide guidance on ... Possession of a current California RN license; a multi-state license will also be required.

Personify Health

Perform Utilization Review for assigned members. * Serve as mentors to LVNs and provide guidance on ... Possession of a current California RN license; a multi-state license will also be required.

Personify Health

Perform Utilization Review for assigned members. * Serve as mentors to LVNs and provide guidance on ... Possession of a current California RN license; a multi-state license will also be required.

Personify Health

Perform Utilization Review for assigned members. * Serve as mentors to LVNs and provide guidance on ... Possession of a current California RN license; a multi-state license will also be required.

Personify Health

Perform Utilization Review for assigned members. * Serve as mentors to LVNs and provide guidance on ... Possession of a current California RN license; a multi-state license will also be required.

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All JobsUtilization Review Rn JobsUtilization Review Rn Jobs in Oregon

Utilization Review Rn information

See Oregon salary details

$22

$44

$72

How much do utilization review rn jobs pay per hour?

As of Jun 21, 2026, the average hourly pay for utilization review rn in Oregon is $44.70, according to ZipRecruiter salary data. Most workers in this role earn between $35.34 and $51.35 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 Oregon? The most popular types of Utilization Review Rn jobs in Oregon are:
What are popular job titles related to Utilization Review Rn jobs in Oregon? For Utilization Review Rn jobs in Oregon, the most frequently searched job titles are:
What job categories do people searching Utilization Review Rn jobs in Oregon look for? The top searched job categories for Utilization Review Rn jobs in Oregon are:
What cities in Oregon are hiring for Utilization Review Rn jobs? Cities in Oregon with the most Utilization Review Rn job openings:
What are popular job titles related to Utilization Review Rn jobs in OR? For Utilization Review Rn jobs in OR, the most frequently searched job titles are:
Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Oregon as of June 2026, with employment types broken down into 87% Full Time, 10% Part Time, and 3% Contract. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution, with an average salary of $92,985 per year, or $44.7 per hour.
Case Management Specialist

Case Management Specialist

Asante

Medford, OR • On-site

$23.28 - $32.02/hr

Full-time, Part-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 22 days ago

Job description

Additional Position Details: FTE: 0.000001 | On Call | Variable Schedule Days
Starting Wage: $23.28-$32.02 per hour, depending on experience
Position Summary
The Case Management Specialist functions as a member of the Case Management team. They utilize communication, organizational, and problem-solving skills to carry out the post-hospital care plans and interventions, utilization review, and denials management activities as defined by the RN Discharge Coordinator and RN Utilization Reviewer. They assume a pivotal role with the patient care team to achieve optimal clinical and resource outcomes.
Position Qualifications
Experience
  • 3 years of experience in administrative functions in care coordination and/or utilization management in healthcare settings is required.
  • Experience with Microsoft Word and Excel is required
  • Experience with EPIC is preferred
  • Current understanding of CMS regulations related to hospital discharge requirements is preferred.

Education
  • High School Diploma, GED, or equivalent experience demonstrating the ability to effectively communicate as required for the position is required
  • An Associate's degree in business, healthcare administration, or a related field is preferred
Total Rewards
We offer a comprehensive Total Rewards package designed to support your well-being and professional growth, including:
  • Competitive Pay: Hourly and salaried positions earn market-based compensation.
  • Health & Wellness: Medical, dental, and vision coverage for part-time and above employees and their eligible dependents beginning within 30 days of hire.
  • Retirement Savings: Employer-sponsored retirement plan with company contribution and match.
  • Paid Time Off: Generous ETO for part-time and above employees.
  • Professional Development: Continue to enhance your education through our tuition reimbursement and tuition repayment program
  • Additional Benefits: Life insurance, disability coverage, and employee assistance programs.

At Asante, we are guided by our values:
Excellence - Respect - Honesty - Service - Teamwork
Asante is proud to be an Equal Opportunity Employer. We are committed to creating a diverse and inclusive workplace and to employing and advancing qualified individuals of all backgrounds, including women, minorities, individuals with disabilities, and protected veterans.
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About Asante

Sourced by ZipRecruiter

As the largest healthcare provider in nine counties, Asante provides comprehensive medical care to more than 600,000 people throughout southern Oregon and northern California. At Asante, our top priority is you. We believe each person must be treated with compassion, dignity, honesty and skill. Our 6,347 employees work together to make this ideal a reality, supported by new technology, modern facilities, and a common purpose of healing and hope. Asante is based in Medford, Oregon, and governed by a board of directors composed of local volunteers and physicians. Board members give their time to ensure that the people of nine Southern Oregon and Northern California counties receive high-quality health care services provided with compassion. All decisions are made by people who live and work in our community.

Industry

Health care and social assistance

Company size

5,001 - 10,000 Employees

Headquarters location

Medford, OR, US

Year founded

1995

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