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

American Traveler

Travel RN Case Manager

Boston, MA · On-site

Hospital-based Care Management/Utilization Review setting * Day shift, 8-hour shifts with a 9am start time * 40 hours per week with a weekend rotation * 13-week contract Requirements * Active MA RN ...

Lancesoft INC

Case Management (RN)

Milford, MA · On-site

$3.0K - $3.1K/wk

BSN required Active MA state RN license required 3+ yr of Hospital Case management & Utilization review required BLS (AHA) Covid Card Company Description LanceSoft is rated as one of the largest ...

Acadia Healthcare

Registered Nurse (RN) Part Time

Malden, MA · On-site

$42.95 - $51.28/hr

Our RNs are clinical professionals responsible for facilitating admissions, clinical intake assessments, and utilization review processes to assure continuity for the most appropriate level of care ...

New

Acadia Healthcare

Registered Nurse (RN)

Malden, MA · On-site

$42.95 - $51.28/hr

Our RNs are clinical professionals responsible for facilitating admissions, clinical intake assessments, and utilization review processes to assure continuity for the most appropriate level of care ...

Acadia Healthcare

Registered Nurse (RN)

Malden, MA · On-site

$42.95 - $51.28/hr

Our RNs are clinical professionals responsible for facilitating admissions, clinical intake assessments, and utilization review processes to assure continuity for the most appropriate level of care ...

Acadia Healthcare

Registered Nurse (RN)

Malden, MA

$42.95 - $51.28/hr

Our RNs are clinical professionals responsible for facilitating admissions, clinical intake assessments, and utilization review processes to assure continuity for the most appropriate level of care ...

STI

Case Manager - Registered Nurse

Cambridge, MA · On-site

Case Manager - Registered Nurse Cambridge, MA/Local candidates not accepted*** 3-6 Months ... Primary Responsibilities : 1. Performs utilization review and discharge planning to inpatient ...

STI

Case Manager - Registered Nurse

Cambridge, MA · On-site

Case Manager - Registered Nurse Cambridge, MA/Local candidates not accepted*** 3-6 Months ... Primary Responsibilities : 1. Performs utilization review and discharge planning to inpatient ...

Lancesoft INC

RN Case Manager

Milford, MA · On-site

$3.0K - $3.1K/wk

BSN required Active MA state RN license required 3+ yr of Hospital Case management & Utilization review required BLS (AHA) Company Description LanceSoft is rated as one of the largest staffing firms ...

UnitiMed

RN Case Manager

Everett, MA · On-site

Referral bonus up to $700 Registered Nurse (RN),Case Management/Utilization Review, About the Company: Uniti Med is an award-winning healthcare staffing company with a mission to provide staffing ...

UnitiMed

RN Case Manager

Beverly, MA · On-site

Referral bonus up to $700 Registered Nurse (RN),Case Management/Utilization Review, About the Company: Uniti Med is an award-winning healthcare staffing company with a mission to provide staffing ...

UnitiMed

RN Case Manager

Milford, MA · On-site

Referral bonus up to $700 Registered Nurse (RN),Case Management/Utilization Review, About the Company: Uniti Med is an award-winning healthcare staffing company with a mission to provide staffing ...

Colorwave Inc

Nurse Case Manager (RN)

Boston, MA · On-site

$75K - $161K/yr

Nurse Case Manager (RN) Hospitals on Incredible Health are actively hiring and accepting ... Clinical pathway, Navigator, or Utilization Review. Shifts available: day shift, night shift, and ...

Acadia Healthcare

Registered Nurse (RN) Part Time

Malden, MA · On-site

$42.95 - $51.28/hr

Our RNs are clinical professionals responsible for facilitating admissions, clinical intake assessments, and utilization review processes to assure continuity for the most appropriate level of care ...

New

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

Utilization Review Rn information

See Boston, MA salary details

$23

$45

$74

How much do utilization review rn jobs pay per hour?

As of Jul 11, 2026, the average hourly pay for utilization review rn in Boston, MA is $45.94, 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.

How to get into utilization review as a nurse?

To become a utilization review RN, candidates typically need a valid nursing license and experience in clinical settings. Additional certifications such as Certified Professional in Healthcare Quality (CPHQ) or case management credentials can enhance prospects, and familiarity with electronic health records and insurance policies is beneficial.

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 make $300,000 as a nurse?

A Utilization Review RN can earn $300,000 by gaining extensive experience, obtaining certifications such as Certified Review Officer (CRO), working in high-paying settings like insurance companies or managed care organizations, and taking on leadership or specialized roles that offer higher compensation. Advanced skills in clinical assessment, documentation, and understanding of healthcare policies can also contribute to higher earnings.

What does an RN utilization review do?

An RN utilization review evaluates medical records and treatment plans to determine the necessity, appropriateness, 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.

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 Certified Review Officer (CRO), working in high-demand settings, and possibly taking on leadership or specialized roles. Increasing your workload, working overtime, or pursuing advanced education can also contribute to higher earnings within this field.

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 Boston, MA? The most popular types of Utilization Review Rn jobs in Boston, MA are:
What are popular job titles related to Utilization Review Rn jobs in Boston, MA? For Utilization Review Rn jobs in Boston, MA, the most frequently searched job titles are:
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What cities near Boston, MA are hiring for Utilization Review Rn jobs? Cities near Boston, MA with the most Utilization Review Rn job openings:
Utilization Review Rn jobs near you
Travel RN Case Manager

Travel RN Case Manager

American Traveler

Boston, MA • On-site

Contractor

Medical, Dental, Vision, Life, Retirement

Posted 24 days ago

Job description

American Traveler is seeking a travel nurse RN Case Management for a travel nursing job in Boston, Massachusetts.

Job Description & Requirements
  • Specialty: Case Management
  • Discipline: RN
  • Start Date: ASAP
  • Duration: 13 weeks
  • 40 hours per week
  • Shift: 8 hours, days
  • Employment Type: Travel
Assignment Overview
  • Shift: Days, 5x8hrs
  • Hours: 40 hrs/wk
  • Start Date: Jun 29, 2026
  • Length: 13 weeks
  • Openings: 2
Description

American Traveler is hiring a travel RN for a Care Management position in a hospital setting in Boston, MA, requiring a minimum of 3 years of case management experience and an active MA RN license.

Details
  • Hospital-based Care Management/Utilization Review setting
  • Day shift, 8-hour shifts with a 9am start time
  • 40 hours per week with a weekend rotation
  • 13-week contract
Requirements
  • Active MA RN license required
  • BSN required
  • Minimum 3 years of experience in case management required
  • Extensive background and knowledge of current medical/surgical patterns of practice and acute inpatient care required
  • Knowledge of methods for assessing physical and mental impairment, characteristics of illness, and expected treatment approaches required
  • Knowledge of benefits, plan contracts, eligibility issues, and requirements required
  • 5+ years of experience in utilization management (UM) and case management (CM) preferred
  • Epic EMR experience preferred
  • CCM or related certification preferred
  • Must pass the Relias Advanced Dysrhythmia Test (A or B) prior to placement
  • Two professional references required: at least one must be at manager level or above, with a performance evaluation included; one reference must be within the last 12 months and the other within the last 3 years
Additional Information
  • Responsibilities include assessing, planning, implementing, monitoring, and evaluating options and services required to meet patient health needs using a collaborative process
  • Role involves managing length of stay (LOS) and promoting efficient utilization of resources
  • Determines medical necessity and appropriateness of admission using InterQual screening and inpatient lists from Medicare
  • Candidates residing within 50 miles of the facility will be placed at a local pay rate
  • Relias Advanced Dysrhythmia Test may only be taken twice; candidates should be prepared to complete this prior to starting

American Traveler Job ID #P-720912. Pay package is based on 8 hour shifts and 40 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: Travel RN - Case Management/Utilization Review - Case Management

About American Traveler

With over 25 years of experience, American Traveler has established a reputation for outstanding customer service. Our team ensures a smooth, worry-free experience for those starting on or expanding their travel nursing and allied careers.

With thousands of travel nursing and allied jobs nationwide, our attentive and approachable recruiters find positions that align perfectly with your career aspirations and personal requirements.

American Traveler offers exceptional benefits, including premium medical, dental, vision and life insurance beginning day one of your assignment, generous 401(k) match, substantial housing stipends, and more. Additionally, with 24/7 support and access to our in-house clinicians, you are assured confidence and comfort throughout your assignment.

With our team behind you, you can relax and enjoy a rewarding travel career.

Apply