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

NHS Management, LLC

RN Unit Manager

Birmingham, AL · On-site

$37.25 - $49.25/hr

... 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

Columbiana, AL · On-site

$40.25 - $53.25/hr

... 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

... 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

Birmingham, AL · On-site

$37.25 - $49.25/hr

... 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 · On-site

$37.25 - $49.25/hr

... 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 · On-site

$37.25 - $49.25/hr

... 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 ...

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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 Sep 7, 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.

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 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 1% As Needed, 78% Full Time, 17% Part Time, 3% Contract, and 1% Nights. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution, with an average salary of $82,423 per year, or $39.6 per hour.

Unit Manager - RN

Athens Health and Rehabilitation LLC

Hoover, AL • On-site

$37.25 - $49.25/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 17 days ago

Job description

JOB DETAILS
We are in search of a qualified RN Unit Manager to be a leader in our facility -
Unit Managers are primarily responsible for overseeing day to day patient care, supervising, directing and developing nurse staff, and reporting to the Director of Nursing to ensure quality patient care within a long-term care center, skilled nursing facility or assisted living community. Our Unit Managers are required to be dependable and personable liaisons between residents and their families. Unit Managers are tasked with ensuring their unit complies with federal and state regulatory standards, and follows company policies and procedures.
  • 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 (low premiums and low deductibles!)
  • Dental Insurance, Life Insurance, Vision Insurance
  • 401K with company match
  • Paid Holidays and Paid Vacation

EOE

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