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Utilization Review Rn Jobs in Utah (NOW HIRING)

Giving Home Health Care

Registered Nurse (RN)

Syracuse, UT · On-site

$45 - $55/hr

Position: RN (contract) Location: Syracuse, UT Compensation: $45-55/hr Bonus: $1,500 bonus after 90 ... Giving Home is committed to maintaining transparent compensation practices and regularly reviews ...

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Utilization Review Rn information

See Utah salary details

$19

$38

$62

How much do utilization review rn jobs pay per hour?

As of Jun 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.

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 Utah? The most popular types of Utilization Review Rn jobs in Utah are:
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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 June 2026, with employment types broken down into 76% Full Time, 20% Part Time, and 4% Contract. Highlights an 85% In-person, 4% Hybrid, and 11% Remote job distribution, with an average salary of $80,064 per year, or $38.5 per hour.

RN Case Manager

HOME CAREGIVERS PARTNERSHIP LLC

Saint George, UT

Other

Posted 14 days ago

Job description

A Registered Nurse administers skilled nursing care to patients on an intermittent basis in their place of residence. This is performed in accordance with physician orders and plan of care under the direction and supervision of the Clinical Manager.


QUALIFICATIONS

  1. Graduate of an approved school of professional nursing and currently licensed in the state(s) in which practicing.
  2. One (1) year nursing experience, preferred.
  3. Acceptance of philosophy and goals of this Agency.
  4. Ability to exercise initiative and independent judgment.


RESPONSIBILITIES

  1. Provides services in accordance with the plan of care.
  2. Makes the initial evaluation visit, determines the immediate care and support needs of the patient, assesses
  3. eligibility and homebound status and develops the plan of care in coordination with other IDT members.
  4. Regularly reevaluates the patients nursing needs and revises the care plan to meet the patients needs.
  5. Initiates the plan of care and necessary revisions.
  6. Furnishes those services requiring substantial specialized nursing skill.
  7. Initiates appropriate preventive and rehabilitative nursing procedures.
  8. Prepares clinical and progress notes for each patient visit and summaries of care conferences on patients in a timely manner as per Agency policy.
  9. Coordinates services with other members of the IDT, all physicians involved in the patient care, other care providers, patient, representative and caregivers when appropriate.
  10. Informs physician and other personnel of changes in the patients condition and needs.
  11. Counsels the patient and family/significant others in meeting nursing related needs.
  12. Participates in in-service programs, supervising and teaching other nursing personnel.
  13. Understands and adheres to established Agency policies and procedures.
  14. Processes orders and notifies physician of patient needs and changes in condition. Completes certification/recertification orders and discharge summaries.
  15. Determines the amount and type of nursing needed by each individual patient.
  16. Refers to Physical Therapist, Speech Language Pathologist, Occupational Therapist and Medical Social Worker
  17. those patients requiring their specialized skills.
  18. Supervises the LPN/LVN every 30-days and supervises the HHA/CNA every 14-days (or per regulatory requirements) and teaches other nursing personnel.
  19. Assigns home health aides to specific patients with written patient care instructions.
  20. Conducts patient care conferences on patients assigned to his/her care.
  21. Participates in peer review and quality management as assigned.
  22. Participates in utilization review of medical records as assigned.
  23. Gives total patient care as needed.
  24. Takes on-call duty nights, weekends and holidays as assigned.
  25. Completes and submits OASIS assessments, reassessments, and transfers, resumptions of care, discharges and significant change in condition in accordance with Agency defined time frames.
  26. Appropriately utilizes ICD-10 diagnoses and codes.
  27. Observes confidentiality, safeguards all patient related information.
  28. Attends staff meetings and patient care conferences as scheduled.
  29. Completes documentation and paperwork in a timely manner per Agency policy.
  30. Immediately reports to Administrator/Clinical Manager any patient incidents/variances or complaints.
  31. Demonstrates competent performance of technical skills according to established procedures.
  32. Understands and adheres to established policies and procedures.
  33. Adheres to Agency standards and consistently interprets and accurately performs all assigned responsibilities.
  34. Maintains acceptable attendance status, per Agency policy.
  35. Reports all incomplete work assignments to Clinical Manager.
  36. Appearance is always within Agency standard; is clean and well-groomed.
  37. Demonstrates effective time management skills through daily documentation and infrequent overtime for routine assignments.
  38. Maintains clean and neat work environment.
  39. Demonstrates sound judgment, critical thinking and decision making.
  40. Maintains current CPR certification.
  41. Performs other duties as assigned.

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