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Utilization Review Rn Jobs in Birmingham, AL (NOW HIRING)

NHS Management, LLC

RN Unit Manager

Birmingham, AL

$37.25 - $49.25/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... utilization review activities. * Receives physicians' instructions regarding resident care and ... Current R.N. license by State required with experience in the long term care or working with the ...

Motion Recruitment

Care Coordinator/RN

Birmingham, AL · On-site

Experience in case management, utilization review, and care coordination. * Active License in good standing as a Registered Nurse (RN) * State of Alabama licensure as a Registered Nurse OR Multi ...

NHS Management Services

RN Unit Manager

Birmingham, AL · On-site

$37.25 - $49.25/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... utilization review activities. * Receives physicians' instructions regarding resident care and ... Current R.N. license by State required with experience in the long term care or working with the ...

NHS Management Services

RN Unit Manager

Columbiana, AL · On-site

$40.25 - $53.25/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... utilization review activities. * Receives physicians' instructions regarding resident care and ... Current R.N. license by State required with experience in the long term care or working with the ...

NHS Management, LLC

RN Unit Manager 8a-5p

Birmingham, AL

$37.25 - $49.25/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... utilization review activities. * Receives physicians' instructions regarding resident care and ... Current R.N. license by State required with experience in the long term care or working with the ...

Aveanna Healthcare

Hospice Registered Nurse RN PRN

Pell City, AL · On-site

$31 - $41/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Schedule: On Call RN - Friday to Sunday every other weekend for Talladega St Clair and Clay ... Participates in quality improvement, utilization review, and infection control activities as ...

NHS Management Services

RN Unit Manager 8a-5p

Birmingham, AL · On-site

$37.25 - $49.25/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... utilization review activities. * Receives physicians' instructions regarding resident care and ... Current R.N. license by State required with experience in the long term care or working with the ...

Aveanna Healthcare

Hospice Registered Nurse RN PRN

Pell City, AL · On-site

$31 - $41/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Schedule: On Call RN - Friday to Sunday every other weekend for Talladega St Clair and Clay ... Participates in quality improvement, utilization review, and infection control activities as ...

Birmingham

Quality Review Coordinator

Birmingham, AL · On-site

... private business and government utilization review, medical review, cost containment ... Registration (RN) from the state. The incumbent must know claims payment guidelines, billing ...

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All JobsUtilization Review Rn JobsUtilization Review Rn Jobs in Birmingham, AL

Utilization Review Rn information

See Birmingham, AL salary details

$20

$39

$64

How much do utilization review rn jobs pay per hour?

As of Aug 14, 2026, the average hourly pay for utilization review rn in Birmingham, AL is $39.63, according to ZipRecruiter salary data. Most workers in this role earn between $31.30 and $45.53 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.

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 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 knowledge of medical coding and insurance processes can enhance your qualifications. Gaining experience in case management or health insurance companies can also improve your chances of entering the field.

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.

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 Birmingham, AL?

The most popular types of Utilization Review Rn jobs in Birmingham, AL are:

What are popular job titles related to Utilization Review Rn jobs in Birmingham, AL?

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

What job categories do people searching Utilization Review Rn jobs in Birmingham, AL look for?

The top searched job categories for Utilization Review Rn jobs in Birmingham, AL are:

Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Birmingham, AL as of August 2026, with employment types broken down into 100% Full Time. Highlights an 83% In-person, and 17% Remote job distribution, with an average salary of $82,423 per year, or $39.6 per hour.

RN Unit Manager

NHS Management, LLC

Birmingham, AL

$37.25 - $49.25/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 9 days ago

Job description

Working with us means being part of something special: A team that is passionate about making an impact on our patients' lives each and every day. Unlike the typical hospital setting, our facility offers you the unique opportunity to walk alongside patients on their road to recovery from many different conditions. As you care for and help patients achieve goals and regain independence, you can form significant relationships with them and celebrate the successes they experience along the way.

- Competitive pay rates! Supportive Leadership!

- Exceptional LOW cost gold medical plan!

We are in search of a qualifiedRN Unit Manager:

  • Assists in maintaining resident care standards by supervising and directing activities of subordinate nurses engaged in quality assurance, infection control, and utilization review activities.
  • Receives physicians' instructions regarding resident care and ensures that orders are transmitted to other units as needed.
  • Oversees delegation of nursing and other therapeutic procedures to other level professionals and paraprofessional associates.
  • Makes regular patient rounds to observe and assess residents' physical conditions and behaviors, evaluates the quality of care provided, and ensures proper documentation of treatment and nursing observations.

Qualifications:

  • Current R.N. license by State required with experience in the long term care or working with the geriatric population preferred.
  • Must have at least two years nursing experience and one year supervisory experience.
  • Clerical ability is necessary to read reports and utilize data accurately for other purposes.
  • Skill in organizing and planning programs and managing personnel to provide nursing service for residents.
  • Ability to plan and direct the department, coordinating with other departments.

We offer the following benefits for you and your family:

  • Competitive Wages
  • Elite Low Cost Gold Plan Blue Cross Blue Shield Health Insurance
  • Dental Insurance, Life Insurance, Vision Insurance
  • 401K with company match
  • Paid Holidays and Paid Vacation

EOE

NHS Management logo

About NHS Management

Sourced by ZipRecruiter

NHS Management, LLC provides administrative and consulting services for individual health care facilities and companies across the southeast. Facilities served by NHS employ a comprehensive approach to care ensuring that their patients and residents receive the highest quality of care practical.

Industry

Business management consulting

Company size

1,001 - 5,000 Employees

Headquarters location

Tuscaloosa, AL, US

Year founded

1981

Social media

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