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

Bethany of the Northwest

RN MDS Nurse

Everett, WA · On-site

$50 - $60/hr

Bethany is seeking a passionate and motivated RN MDS Nurse to join our team at Bethany in Everett. Come join our family and find out what the "Heart of Bethany" is. Bethany of the Northwest offers a ...

BETHANY OF THE NORTHWEST

RN MDS Nurse

Everett, WA

$50 - $60/hr

Bethany is seeking a passionate and motivated RN MDS Nurse to join our team at Bethany in Everett. Come join our family and find out what the "Heart of Bethany" is. Bethany of the Northwest offers a ...

UHS

UR COORDINATOR

Kirkland, WA · On-site

... reviews, quality documentation, appeals, and reporting. This role supports medical necessity ... Current Washington State Licensure (Associate or Full) LCSW/A, LMHC/A, LCPC, LPCC or RN Licensure.

New

FC Compassus LLC

Clinical Liaison RN

Snohomish, WA · On-site

$71K - $95K/yr

The Clinical Liaison RN (Exempt) - PAH is responsible for modeling the Compassus values of ... hospital service, utilization review/discharge planners/case managers, patients and patient ...

UHS

UR COORDINATOR

Kirkland, WA · On-site

$28.57 - $51.02/hr

... reviews, quality documentation, appeals, and reporting. This role supports medical necessity ... Current Washington State Licensure (Associate or Full) LCSW/A, LMHC/A, LCPC, LPCC or RN Licensure.

Virginia Mason Medical Center

Ambulatory RN

Seattle, WA · On-site

$45.49 - $74.35/hr

... service utilization, and maintain vital communication with patients, providers, and staff. To be ... Current Washington state licensure as an RN * CPR certification is required every two (2) years

CommonSpirit Health

Ambulatory RN

Seattle, WA · On-site

As our Ambulatory RN, you will thoughtfully coordinate and oversee the clinical team, ensuring ... service utilization, and maintain vital communication with patients, providers, and staff. To be ...

Avamere Living

MDS Coordinator - Avamere Burien

Burien, WA

$39.25 - $50/hr

MDS Coordinator (RN or LPN) Status : Full-Time (on-site 5 days per week) Wage: $82,000 - $130,000 ... Manage the Utilization Review (UR) process. * Oversee MAR's treatment, flow sheets and physician ...

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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 Jun 29, 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.

How do I become a utilization review RN?

To become a utilization review RN, you typically need to hold a valid registered nurse (RN) license and have experience in clinical nursing. Additional certifications such as the Certified Professional in Healthcare Quality (CPHQ) or Utilization Review Certification (URAC) can enhance job prospects, and strong knowledge of medical coding, insurance policies, and healthcare regulations is important.

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 does an RN utilization review do?

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

How to make $300,000 a year as a nurse?

To earn $300,000 annually as a Utilization Review RN, professionals typically need extensive experience, advanced certifications such as CCM or ANCC, and may work in high-paying settings like insurance companies or healthcare consulting firms. Increasing specialization, taking on leadership roles, or working overtime can also boost income, but reaching this level often requires a combination of skills, experience, and strategic career moves.

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 CCM or ANCC, and working in high-paying settings like insurance companies or managed care organizations. Advanced skills in case management, strong clinical knowledge, and sometimes working overtime or in leadership roles can also contribute to higher earnings.

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 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 June 2026, with employment types broken down into 1% As Needed, 59% Full Time, 8% Part Time, 1% Temporary, 30% Contract, and 1% Nights. Highlights an 88% Physical, 5% Hybrid, and 7% Remote job distribution, with an average salary of $98,314 per year, or $47.3 per hour.
RN MDS Nurse

RN MDS Nurse

Bethany of the Northwest

Everett, WA • On-site

$50 - $60/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 7 days ago

Job description

Bethany of the Northwest is a non-profit icon of the healthcare industry for nearly 100 years. Bethany is seeking a passionate and motivated RN MDS Nurse to join our team at Bethany in Everett. Come join our family and find out what the "Heart of Bethany" is. Bethany of the Northwest offers a generous benefit package, competitive salary and much more.
Pay Range: $50 to $60 per hour DOE
Benefits available:
  • Medical, Dental, Vision insurance
  • Life Insurance and short-term disability coverage
  • 403b and 403b matching.
  • EAP Employee assistance program
  • Employee discounts
  • Flexible spending account
  • Paid Sick leave
  • Paid time off
  • 7 Paid holidays plus one personal of your choice
  • Referral program

The RN MDS Nurse is responsible for ensuring the timely completion of accurate assessments and interdisciplinary care plans that meet Federal and State guidelines. The MDS RN identifies resident acuity, helping to determine specific care needs and communicating those needs to the care team as well as the residents' families and responsible parties. The MDS RN coordinates with other disciplines and trains staff on the RAI process as needed. Once completed and signed the RN will transmit the completed assessments. The RN will participate in the weekly Medicare meeting, daily clinical meeting and the monthly QAPI meeting.
As the Case Manager the RN will communicate with the insurance companies and provide requested information to obtain continued authorization for care.
  • Active RN in the state of Washington
  • Long term care/skilled nursing experience
  • Experience with MDS process and Case Mix Management
  • Knowledge of regulatory guidelines

Bethany of the Northwest is an equal opportunity employer and prohibits discrimination/harassment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

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