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Utilization Review Rn Jobs in Bothell, WA (NOW HIRING)

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How much do utilization review rn jobs pay per hour?

As of Sep 2, 2026, the average hourly pay for utilization review rn in Bothell, WA is $47.27, according to ZipRecruiter salary data. Most workers in this role earn between $37.36 and $54.28 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 Bothell, WA?

The most popular types of Utilization Review Rn jobs in Bothell, WA are:

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For Utilization Review Rn jobs in Bothell, WA, the most frequently searched job titles are:

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The top searched job categories for Utilization Review Rn jobs in Bothell, WA are:

What cities near Bothell, WA are hiring for Utilization Review Rn jobs?

Cities near Bothell, WA with the most Utilization Review Rn job openings:

Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Bothell, WA as of August 2026, with employment types broken down into 1% As Needed, 85% Full Time, 11% Part Time, 2% Contract, and 1% Nights. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution, with an average salary of $98,314 per year, or $47.3 per hour.

RN Case Manager JD -Seattle, WA

Care Navigators On Demand

Seattle, WA • On-site

Full-time

Retirement

Re-posted 7 days ago

Job description

Job Opportunity

Job Information

Date Opened 03/01/2021

Job Type Full time

Industry Health Care

Work Experience 4-5 years

City Seattle

State/Province Washington

Country United States

Zip/Postal Code 98101

Job Description

Job Description Who are you? To succeed in our high-energy, high-reward environment, our clinicians provide compassionate critical care and deliver exceptional patient experiences, meaningful outcomes, and bonds for life. As our most acute level of care, our client's transitional care hospitals offer the same critical care patients receive in a traditional hospital or intensive care unit, but for an extended recovery period. Our clinicians play a vital role in the recovery process for chronic, critically ill and medically complex patients. As a Case Manager / CM you will:

  • Coordinate management of care for a specified patient population in a single hospital.
  • Follows patients throughout the continuum of care and ensures optimum utilization of resources, service delivery and compliance with external review agencies.
  • Provides ongoing support and expertise through comprehensive assessment, care planning, plan implementation and overall evaluation of individual patient needs.
  • Enhances the quality of patient management and satisfaction, to promote continuity of care and cost effectiveness through the integration of functions of case management, utilization review and management and discharge planning.

Requirements Appropriate minimum degree for preferred licensure or certification or commensurate experience in a related healthcare field. Healthcare professional licensure required as Registered Nurse, Licensed Clinical Social Worker (LCSW) or Licensed Social Worker (LSW). Appropriate certification in Case Management preferred; for example, Commission for Case Manager Certification (CCMC); Association of Rehabilitation Nurses (ARN) certification. Five years of experience in an acute care Medical/Surgical and/or ICU/CCU setting.

Benefits 401K

Care Navigators On Demand is an Equal Opportunity Employer and does not discriminate on the basis of race or ethnicity, religion, sex, national origin, age, veteran disability or genetic information or any other reason prohibited by law in employment.

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