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Utilization Review Rn Jobs in Columbia, SC (NOW HIRING)

UHS

Utilization Review Coordinator

West Columbia, SC · On-site

Masters' degree in a recognized mental health field or Registered Nurse. * Experience: * Minimum of two years psychiatric experience in chart analysis and in the utilization review field. Excellent ...

UHS

Utilization Review Coordinator

West Columbia, SC

Masters' degree in a recognized mental health field or Registered Nurse. * Experience: * Minimum of two years psychiatric experience in chart analysis and in the utilization review field. Excellent ...

UHS

Utilization Review Coordinator

West Columbia, SC

Masters' degree in a recognized mental health field or Registered Nurse. * Experience: * Minimum of two years psychiatric experience in chart analysis and in the utilization review field. Excellent ...

UHS

Utilization Review Coordinator

West Columbia, SC

Masters' degree in a recognized mental health field or Registered Nurse. * Experience: * Minimum of two years psychiatric experience in chart analysis and in the utilization review field. Excellent ...

UHS

Utilization Review Coordinator

West Columbia, SC · On-site

Masters' degree in a recognized mental health field or Registered Nurse. * Experience: * Minimum of two years psychiatric experience in chart analysis and in the utilization review field. Excellent ...

genex

Telephonic Case Manager (RN)

Columbia, SC

Responsible for the performance of Utilization Review services, including pre-admission ... Uses clinical/nursing skills to determine whether all aspects of a patient's care, at every level ...

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All JobsUtilization Review Rn JobsUtilization Review Rn Jobs in Columbia, SC

Utilization Review Rn information

See Columbia, SC salary details

$19

$39

$63

How much do utilization review rn jobs pay per hour?

As of Jul 16, 2026, the average hourly pay for utilization review rn in Columbia, SC is $39.12, according to ZipRecruiter salary data. Most workers in this role earn between $30.91 and $44.90 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 Columbia, SC? The most popular types of Utilization Review Rn jobs in Columbia, SC are:
What are popular job titles related to Utilization Review Rn jobs in Columbia, SC? For Utilization Review Rn jobs in Columbia, SC, the most frequently searched job titles are:
What job categories do people searching Utilization Review Rn jobs in Columbia, SC look for? The top searched job categories for Utilization Review Rn jobs in Columbia, SC are:
What cities near Columbia, SC are hiring for Utilization Review Rn jobs? Cities near Columbia, SC with the most Utilization Review Rn job openings:
Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Columbia, SC as of July 2026, with employment types broken down into 1% As Needed, 77% Full Time, 18% Part Time, 1% Temporary, and 3% Contract. Highlights an 91% Physical, 2% Hybrid, and 7% Remote job distribution, with an average salary of $81,362 per year, or $39.1 per hour.
Registered Nurse Case Manager / Utilization Review

Registered Nurse Case Manager / Utilization Review

Healthcare Support Staffing

Columbia, SC

Full-time

Medical, Dental, Vision

Re-posted 15 days ago

Job description

Company Description

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!

Job Description

Location: Columbia, SC

Job Title: Registered Nurse Case Manager / Utilization Review Nurse


Calling all Registered Nurse Case Managers. Have immediate openings for Registered Nurse Case Managers and Utilization Review Nurses in Columbia, SC. Now is your time to apply and work for a Fortune 125  company.  Will take clinical nurses. 


Take advantage of flexible hours, a competitive salary, and be a RN Case Manager with one of the fastest-growing healthcare companies in the U.S. Get in NOW, while there is still huge room for growth and career development!


This exciting opportunity will require a RN Case Manager or Utilization Review Nurses who can provide a high level of service and attention to their patients. If you are a RN Case Manager and you meet the qualifications listed below, please click apply below for consideration!


Daily Responsibilities:

  • This RN Case Manager will be assisting members that have dual enrollment which means age 65 and over and have low income and resources
  • This RN Case Manager is a field case management position about 40% field the remainder of the time will be reporting to the North Charleston office if need be to perform assessments on members that have just signed up with the Medicare or Medicare plan
  • This RN Case Manager will also be responsible for assessing, planning and coordinating all medical services especially MMT (Medicare Medical Transportation services) and supporting services across the continuum of care for select members to promote quality, cost effective car
  • Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options
  • Utilize assessment skills and discretionary judgment to develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs and promote desired outcomes
  • Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socioeconomic needs of clients


Advantages of this Opportunity:

  • Competitive salary
  • Benefits offered, Medical, Dental, and Vision
  • Growth Opportunity
  • Fun and positive work environment
  • Interested in being considered?


If you are interested in being considered for the RN Case Manager position, please click the Apply button below! 

Qualifications

Requirements:

  • 1+ years of clinical nursing experience in an acute care setting
  • 1+ years of case management experience with the adult and geriatric population in a managed care, home health, Hospital, or Hospice setting
  • Knowledge of utilization management principles and healthcare managed care
  • Experience with medical decision support tools (i.e. Interqual, NCCN) and government sponsored managed care programs
Additional Information

Interested in being considered for this great Registered Nursing Opportunity?

If you are interested in being considered for the RN Case Manager position, please click the Apply button below! Seeking Multiple RN Case Managers and Utilization Review Nurses!

Healthcare Support logo

About Healthcare Support

Sourced by ZipRecruiter

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!Healthcare Support Staffing, Inc. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.

Industry

Recruiting and staffing services

Company size

201 - 500 Employees

Headquarters location

Maitland, FL, US

Year founded

2003

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