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

Lancesoft INC

Case Management (RN)

Milford, MA · On-site

$3K - $3.10K/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 ...

STI

Case Manager - Registered Nurse

Cambridge, MA

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

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 ...

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

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

$3.01K - $3.11K/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

Everett, MA

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 ...

Verisk

MSA Nurse Reviewer

Woburn, MA · On-site

$80K - $85K/yr

Registered Nurse (RN) license in good standing with applicable Board of Nursing required * Experience in preparing medical review reports, medical bill reviews and utilization reviews in injury cases ...

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Utilization Review Rn information

See Boston, MA salary details

$23

$45

$74

How much do utilization review rn jobs pay per hour?

As of May 30, 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 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 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 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 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 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:
What job categories do people searching Utilization Review Rn jobs in Boston, MA look for? The top searched job categories for Utilization Review Rn jobs in Boston, MA are:
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
Infographic showing various Utilization Review Rn job openings in Boston, MA as of May 2026, with employment types broken down into 100% Full Time. Highlights an 66% In-person, and 34% Remote job distribution, with an average salary of $95,540 per year, or $45.9 per hour.

Case Management Registered Nurse - Travel - RNNM#01

NavitasPartners

Salem, MA

$65 - $70/hr

Other

Posted 14 hours ago

Job description

Case Management Registered Nurse (RN) - Travel
Location: Hyannis, MA 02601
Duration: 13 Weeks
Shift: Day | 58s
Type: Contract / Travel
Travel Pay Range: $65-$70/hour ($2,600-$2,800 weekly)

Overview:

"Navitas Healthcare, LLC" is seeking Case Management Registered Nurse for an exciting job in Hyannis, MA.

Responsibilities:

  • Assess new admissions and identify discharge planning needs.

  • Perform initial and ongoing clinical assessments using InterQual or similar criteria.

  • Conduct utilization reviews and collaborate with payers to ensure authorization and reimbursement.

  • Coordinate interdisciplinary care plans and complex discharge arrangements.

  • Educate patients/families on care options, coverage, and authorization status.

  • Arrange post-acute care with community or home health providers.

  • Support quality initiatives and ensure accurate, compliant documentation.

  • Adhere to hospital policies, safety, and infection control standards.

Qualifications:

  • Active Massachusetts RN license.

  • 3+ years recent acute care experience.

  • Strong background in discharge planning and/or utilization review.

  • Experience with InterQual or similar clinical review tools.

  • BSN and CCM/CPUM certification preferred.

  • Excellent communication, critical thinking, and EMR proficiency.

For more details contact at pmohanty@navitashealth.com or Call / Text at 516-806-4227.

About Navitas Healthcare, LLC certified WBENC and one of the fastest-growing healthcare staffing firms in the US providing Medical, Clinical and Non-Clinical services to numerous hospitals. We offer the most competitive pay for every position we cater. We understand this is a partnership. You will not be blindsided and your salary will be discussed upfront. 

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