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Utilization Review Rn Jobs in Boston, MA (NOW HIRING)

US Tech Solutions

Utilization Review Nurse

Canton, MA · On-site

$55 - $60/hr

Active, unrestricted Registered Nurse (RN) license. * Associate Degree in Nursing (ADN) required ... Utilization Management (UM) * Medical Necessity Review * Prior Authorization * Precertification

GQR Global Markets

RN Case Manager

Everett, MA · On-site

$2.9K - $3.0K/wk

Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location: Everett, Massachusetts Start Date: January 27, 2026 Profession: Registered Nurse (RN) Facility: Estimated Pay ...

GQR Global Markets

RN - Case Manager

Everett, MA · On-site

$2.9K - $3.0K/wk

Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location: Everett, Massachusetts Start Date: January 27, 2026 Profession: Registered Nurse (RN) Facility: Estimated Pay ...

GQR

RN - Case Manager

Everett, MA · On-site

$2.9K - $3.0K/wk

Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location: Everett, Massachusetts Start Date: January 27, 2026 Profession: Registered Nurse (RN) Facility: Estimated Pay ...

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All JobsUtilization Review Rn JobsUtilization Review Rn Jobs in Boston, MA

Utilization Review Rn information

See Boston, MA salary details

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$74

How much do utilization review rn jobs pay per hour?

As of Aug 23, 2026, the average hourly pay for utilization review rn in Boston, MA is $45.93, according to ZipRecruiter salary data. Most workers in this role earn between $36.30 and $52.74 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 Boston, MA?

The most popular types of Utilization Review Rn jobs in Boston, MA are:

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

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Cities near Boston, MA with the most Utilization Review Rn job openings:

Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Boston, MA as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 13% Part Time, 4% Contract, and 1% Nights. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $95,540 per year, or $45.9 per hour.

Non-patient Care (utilization Review) Registered Nurse at Supplemental Health Care Boston, MA

Fairweather, LLC

Boston, MA • On-site

$79.17 - $86.72/hr

Other

Medical, Dental, Vision, Life, Retirement

Posted 5 days ago

Job description

Non-patient Care (utilization Review) Registered Nurse job at Supplemental Health Care. Boston, MA.

Non-patient Care (utilization Review) RN Opportunity

Take your career to the next level with an assignment at one of New England's top healthcare destinations. Supplemental Health Care is hiring experienced Non-patient Care (utilization Review) RNs for contract roles at a leading Level 1 trauma center in Boston, Massachusetts. This Magnet-recognized teaching hospital is known for innovation, advanced care, and nursing excellence - an ideal place to grow your skills in a dynamic, high-acuity environment.

With 40+ years of experience connecting healthcare professionals to career-advancing opportunities, SHC is here to support you every step of the way.

Qualifications:
  • Active Massachusetts Registered Nurse License
  • American Heart Association BLS
  • Minimum 1 year of recent Non-patient Care (utilization Review) experience
  • Strong clinical and critical thinking skills
  • Commitment to high-quality patient care
Non-patient Care (utilization Review) Registered Nurse Contract Details:
  • $1,740 - $1,906 per week*
  • 13-week full time contract with possibility to extend
  • Shift Type shifts available
  • 40 hours per week
  • RN will be working at a Teaching Hospital with a great reputation

*Estimated weekly payment may include both taxable wages and tax-free reimbursements for meals, housing, and incidentals. Please speak with a recruiter for details.

What We Offer:
  • Full medical, dental, vision, life, and even pet insurance!
  • Round the clock support. No matter where you are or what time it is, Supplemental Health Care is standing by.
  • SHC's Share the Care referral program is the most dynamic, profitable referral program in the industry.
  • 401(k) Retirement Savings Program with a wide range of investment options.
  • Discounted and free online access to CEU courses through Supplemental University.

Supplemental Health Care is an Equal Opportunity Employer. All candidates, including veterans and those with disabilities, are encouraged to apply. SHC will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable local, state, or federal law. To learn more, visit

Supplemental Health Care

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