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Utilization Review Rn Jobs in Utah (NOW HIRING)

Imh

Manager Utilization and Care Management

Murray, UT · On-site +1

$44.99 - $69.44/hr

Lead, supervise, and mentor a team of RN or Behavioral Health Care Managers and RN or Behavioral Health Utilization Review clinicians, and related support positions ensuring clinical excellence and ...

HOME CAREGIVERS PARTNERSHIP LLC

RN

Springville, UT

Canyon Home Care is hiring for Registered Nurses (RN) and Licensed Practical Nurses (LPN) to work 1 ... Participates in utilization review of medical records as assigned. * Gives total patient care as ...

HOME CAREGIVERS PARTNERSHIP LLC

RN

Salt Lake City, UT

Canyon Home Care is hiring for Registered Nurses (RN) and Licensed Practical Nurses (LPN) to work 1 ... Participates in utilization review of medical records as assigned. * Gives total patient care as ...

HOME CAREGIVERS PARTNERSHIP LLC

RN

South Ogden, UT

Canyon Home Care is hiring for Registered Nurses (RN) and Licensed Practical Nurses (LPN) to work 1 ... Participates in utilization review of medical records as assigned. * Gives total patient care as ...

HOME CAREGIVERS PARTNERSHIP LLC

RN

South Ogden, UT

Canyon Home Care is hiring for Registered Nurses (RN) and Licensed Practical Nurses (LPN) to work 1 ... Participates in utilization review of medical records as assigned. * Gives total patient care as ...

HOME CAREGIVERS PARTNERSHIP LLC

RN

Springville, UT

Canyon Home Care is hiring for Registered Nurses (RN) and Licensed Practical Nurses (LPN) to work 1 ... Participates in utilization review of medical records as assigned. * Gives total patient care as ...

HOME CAREGIVERS PARTNERSHIP LLC

RN

Salt Lake City, UT

Canyon Home Care is hiring for Registered Nurses (RN) and Licensed Practical Nurses (LPN) to work 1 ... Participates in utilization review of medical records as assigned. * Gives total patient care as ...

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Utilization Review Rn information

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$38

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How much do utilization review rn jobs pay per hour?

As of Aug 29, 2026, the average hourly pay for utilization review rn in Utah is $38.49, according to ZipRecruiter salary data. Most workers in this role earn between $30.43 and $44.18 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 Utah?

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

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

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

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

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What cities in Utah are hiring for Utilization Review Rn jobs?

Cities in Utah with the most Utilization Review Rn job openings:

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Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Utah as of August 2026, with employment types broken down into 1% As Needed, 79% Full Time, 17% Part Time, 2% Contract, and 1% Nights. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution, with an average salary of $80,064 per year, or $38.5 per hour.

Utilization Review Nurse

University of Utah Health

Salt Lake City, UT • On-site

Full-time

This job post has expired today. Applications are no longer accepted.

University Of Utah rating

7.2

Company rating: 7.2 out of 10

Based on 159 frontline employees who took The Breakroom Quiz

386th of 627 rated colleges and universities

Job description

Overview
As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, integrity, quality and trust that are integral to our mission. EO/AA
This position is responsible for maintaining the financial integrity of both the patient and the organization through the provision of quality based patient care focusing on the medical necessity and efficiency of the delivery of such care; achieved via managing the cost of care while providing timely and accurate information to third party payers and medical care team. This position may be required to access and administer medications within their scope of practice and according to state law.
Corporate Overview: The University of Utah is a Level 1 Trauma Center and is nationally ranked and recognized for our academic research, quality standards and overall patient experience. Our five hospitals and eleven clinics provide excellence in our comprehensive services, medical advancement, and overall patient outcomes.
Responsibilities
Essential Functions
  • Applies approved utilization criteria to monitor appropriateness of admissions with associated levels of care and continued stay review.
  • Communication to third-party payers for initial and concurrent clinical review.
  • Reviews patient chart to ensure patient continues to meet medical necessity.
  • Documentation of all actions and information shared with care team members or third-party payer.
  • Alerts and discusses with physician/provider and case manager/discharge planner when patient no longer meets medical necessity criteria for the inpatient stay.
  • Discusses with physicians the appropriateness of resource utilization.
  • Tracks length of stay (LOS) and resource utilization to identify at risk patients.
  • Refers to UR committee any case that surpasses expected LOS, expected cost, or over/under-utilization of resources.
  • Performs verbal/fax clinical review with payer as determined by nursing judgment and/or collaboration with the payer per university contractual obligation.
  • Participant in UR Committee as needed.
  • Collects data on variances in LOS, avoidable days, costs/barriers to discharge/transition and denied days.
  • Prepares appeals on denied cases when appropriate.
  • At the discretion of department operational and patient care needs, this position is required to work rotating schedules, which may include variable hours, weekends, nights, and holidays to meet the staffing and patient care demands of a 24/7 complex health system. Regular, reliable, and punctual attendance during assigned shifts is considered an essential function of the role.
Knowledge / Skills / Abilities
  • Demonstrated availability to work variable and rotating shifts, including nights, weekends, and holidays, in a 24/7 patient care environment.
  • Ability to perform the essential functions of the job as outlined above.
  • Demonstrated team leadership, relationship building, critical analysis, and written and verbal communication skills.
  • Demonstrated knowledge of payers, payer systems, cost effective utilization management and InterQual criteria.
  • The ability to demonstrate knowledge of the principles of life span growth and development and the ability to assess data regarding the patient's status and provide care as described in the department's policies and procedures manual.
  • Ability to work autonomously and as a team member.

Qualifications
Required
  • One year Utilization Review or Case Management experience.
Licenses Required
  • Current license to practice as a Registered Nurse in the State of Utah, or obtain one within 90 days of hire under the interstate compact if switching residency to State of Utah. Must maintain current Interstate Compact (multi-state) license if residency is not being changed to Utah.
* Additional license requirements as determined by the hiring department.
Qualifications (Preferred)
Preferred
  • Basic Life Support Health Care Provider card.
  • Proficiency in application of InterQual Criteria, knowledge of ICD-9, DRG's and CPT Codes.
  • Utilization Review Certification designation.
  • Knowledge of CMS Regulations.
Working Conditions and Physical Demands
Employee must be able to meet the following requirements with or without an accommodation.
  • This is a sedentary position in an office setting that may exert up to 10 pounds and may lift, carry, push, pull or otherwise move objects. This position involves sitting most of the time and is not exposed to adverse environmental conditions. This position does not provide care to patients.

Physical Requirements
Color Determination, Listening, Manual Dexterity, Sitting, Speaking, Standing, Walking

What University Of Utah employees say

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About University of Utah

Sourced by ZipRecruiter

The University of Utah is the state’s flagship institution of higher education, with 18 schools and colleges, more than 100 undergraduate majors and graduate programs, and an enrollment of more than 38,000 students. It is a member of the Association of American Universities—an invitation-only, prestigious group of 71 leading research institutions. The U is advancing a new national model for higher education that delivers societal impact through education, research, health care, and community service, while making social, economic, and cultural contributions that improve lives across Utah and around the world.

Industry

Colleges, universities, and professional schools

Company size

10,000+ Employees

Headquarters location

Salt Lake City, UT, US

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