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

Molina Healthcare

Care Review Clinician (RN)

Bothell, WA · On-site

$26.41 - $59.21/hr

Adheres to utilization management (UM) policies and procedures. Required Qualifications At least 2 ... Registered Nurse (RN). License must be active and unrestricted in state of practice. Ability to ...

Molina Healthcare

Care Review Clinician (RN)

Bothell, WA · On-site

$26.41 - $59.21/hr

... to utilization management (UM) policies and procedures. Required Qualifications • At least 2 ... • Registered Nurse (RN). License must be active and unrestricted in state of practice. • ...

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Showing results 21-40

All JobsUtilization Review Rn JobsUtilization Review Rn Jobs in Bothell, WA

Utilization Review Rn information

See Bothell, WA salary details

$23

$47

$77

How much do utilization review rn jobs pay per hour?

As of Aug 12, 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.

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 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 knowledge of medical coding and insurance processes can enhance your qualifications. Gaining experience in case management or health insurance companies can also improve your chances of entering the field.

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 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 Bothell, WA? The most popular types of Utilization Review Rn jobs in Bothell, WA are:
What are popular job titles related to Utilization Review Rn jobs in Bothell, WA? For Utilization Review Rn jobs in Bothell, WA, the most frequently searched job titles are:
What job categories do people searching Utilization Review Rn jobs in Bothell, WA look for? 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, 77% Full Time, 19% Part Time, and 3% Contract. Highlights an 89% Physical, 4% Hybrid, and 7% Remote job distribution, with an average salary of $98,314 per year, or $47.3 per hour.

Case Manager / Certified Wound Care Nurse (LPN or RN)

KU MedWest Ambulatory Surgery

Poulsbo, WA • On-site

$39.50 - $48.49/hr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 9 days ago

Job description

Case Manager / Certified Wound Care Nurse (RN or LPN)
Full-Time | Monday-Friday
Martha & Mary Health Services - Poulsbo, WA
Compensation
LPN: $36.50 - $44.76/hour
RN: $39.50 - $48.49/hour
Pay is determined by applicable years of experience
Make a Difference Every Day
Martha & Mary is seeking an experienced Registered Nurse (RN) or Licensed Practical Nurse (LPN) to join our clinical leadership team as a Case Manager / Certified Wound Care Nurse.
This is an excellent opportunity for a nurse who enjoys combining resident advocacy, clinical leadership, care coordination, and wound management into one rewarding role. Working Monday through Friday, you'll partner with physicians, therapy, social services, nursing leadership, and interdisciplinary team members to improve resident outcomes while leading our Skin Integrity and Wound Care Program.
If you enjoy building relationships, solving complex clinical challenges, mentoring staff, and seeing the direct impact of your work on residents' quality of life, we'd love to meet you.
What You'll Do
As our Case Manager / Certified Wound Care Nurse, you will:
  • Coordinate resident care from admission through discharge.
  • Lead interdisciplinary care planning and discharge coordination.
  • Serve as the clinical expert for wound prevention, assessment, treatment, and healing.
  • Conduct weekly wound rounds and comprehensive wound assessments.
  • Develop evidence-based treatment plans and monitor healing outcomes.
  • Collaborate with physicians, rehabilitation, pharmacy, dietary, infection prevention, and nursing teams.
  • Monitor quality indicators and implement interventions that improve resident outcomes.
  • Educate and mentor nursing staff on wound care best practices.
  • Participate in Quality Assurance and Performance Improvement (QAPI) initiatives.
  • Help reduce avoidable hospital readmissions while improving continuity of care.
  • Build meaningful relationships with residents and families while serving as a trusted clinical resource.
We're Looking For
Required Qualifications
  • Current Washington State RN or LPN license in good standing.
  • Associate Degree in Nursing (BSN preferred).
  • Current CPR certification.
  • Minimum two years of nursing experience in skilled nursing, rehabilitation, or long-term care preferred.
  • Previous experience in case management, admissions, care coordination, utilization review, or wound care strongly preferred.
  • Certified Wound Care Nurse (CWCN) certification preferred (or willingness to obtain within an approved timeframe).
Why Martha & Mary?
For more than 130 years, Martha & Mary has been a trusted, faith-based, not-for-profit organization dedicated to serving seniors and families throughout Kitsap County. We believe exceptional resident care starts with exceptional employees.
When you join our team, you'll become part of a collaborative culture where your clinical expertise is valued and your leadership makes a lasting difference.
Benefits Include
Martha & Mary offers fair wages, competitive benefits and supportive work environments, where we become friends and family. We invite you to apply and become a part of one of Kitsap County's largest not-for profit employers. The following benefits/compensation are offered at Martha & Mary.
  • Paid Time Off (PTO) is accrued at varying rates depending on length of employment. Accrual rates begin at 5.32 hours per month based on a 40-hour workweek. These accruals include the required sick leave per Washington State's Paid Sick Leave Law
  • 40% discount on child care services while working
  • Comprehensive benefit package after 60 days to include medical, dental, vision and life insurance options for full time employees.
  • Career advancement opportunities across multiple sites and departments
  • 403(b) Retirement Savings Plan is available immediately upon hire
  • 6 Paid Holidays
  • Employee Assistance and Counseling for life's challenges outside of the workplace
  • Cell phone, Health Club and Auto service discounts
  • And much more

Martha & Mary employee benefits and wages offered are reviewed annually and are intended to be fair, beneficial and competitive in today's market whether just entering our workforce or nearing retirement. Benefit offerings are based on employment status. Salary ranges, benefits and other compensation are subject to change.
Martha & Mary is an Equal Opportunity Employer.
We celebrate diversity and are committed to creating an inclusive environment for all employees.

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