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How much do utilization review rn jobs pay per hour?

As of Aug 25, 2026, the average hourly pay for utilization review rn in Honolulu, HI is $41.82, according to ZipRecruiter salary data. Most workers in this role earn between $33.03 and $48.03 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 Honolulu, HI?

The most popular types of Utilization Review Rn jobs in Honolulu, HI are:

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For Utilization Review Rn jobs in Honolulu, HI, the most frequently searched job titles are:

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The top searched job categories for Utilization Review Rn jobs in Honolulu, HI are:

Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Honolulu, HI as of August 2026, with employment types broken down into 86% Full Time, 7% Part Time, and 7% Contract. Highlights an 93% In-person, and 7% Remote job distribution, with an average salary of $86,884 per year, or $41.8 per hour.

RN - Utilization Management

Spectrum Healthcare Resources

Honolulu, HI • Remote

Full-time

Posted 22 days ago

Job description

Job Description

Spectrum Healthcare Resources has a need for a Utilization Manager Registered Nurse (UMRN). These will be completely remote positions, working entirely from the Nurse's home. The Nurse will be reviewing cases, educating patients on appropriate care and managing health care costs for the dependents of our Nation's Active Duty and eligible retirees.

The Nurse will be working remotely Monday through Friday, 8 hours per day.

Requirements

  • Bachelors Nursing Degree
  • At least one active state nurse license, preferably compact state licensure
  • At least 2 years' experience working as a UMRN, preferably in a remote or hybrid environment.
  • Possess current certification in either
    • Completion of an accredited Certified Professional Utilization Review (CPUR) program
    • Certified Case Manager (CCM) issued by the Commission for Case Manager Certification.

--OR--

  • Possess two (2) years of full-time broad based registered nurse experience in a utilization management review or a case management setting within the preceding five (5) years. Notwithstanding the aforementioned experience requirements, the HCWs must have pertinent clinical experience within the past two (2) years sufficient to demonstrate current clinical competency for the setting and procedures required by this contract.
  • Highly organized, self-directed worker able to function in a high-volume environment without distractions.
  • Strong verbal and written communication skills.
  • Proficient level of experience with Microsoft Office applications and strong technical aptitude.
  • Must have access to secure, high speed internet.

Company Overview:

Spectrum Healthcare Resources (SHR) was established in 1988 to deliver systems and processes designed to meet the unique needs of Military and VA Health Systems.  SHR is a leading organization that provides physician and clinical staffing and management services to United States Military Treatment Facilities, VA clinics and other Federal Agencies through various contracting vehicles.  A Joint Commission Health Care Staffing Services firm, SHR is the military staffing division of TeamHealth, a Nationwide organization that serves 850 civilian and military hospitals with a team of 9,600 affiliated health care professionals. EOE/Disabled/Veterans

Location : LocationUS-HI-HonoluluRecruiter : Full Name: First LastJoseph DayDirect phone number314-744-4138Recruiter : Emailjoseph_day@spectrumhealth.comEmployment Type: OTHER
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About Spectrum Healthcare Resources

Sourced by ZipRecruiter

Spectrum is a leading organization that provides program management and physician and clinical staffing services to United States Military Treatment Facilities, VA Clinics and Federal Agencies. We are dedicated to the markets we serve, leading our organization’s experience for almost three decades.

Industry

Health care and social assistance

Company size

1,001 - 5,000 Employees

Headquarters location

Saint Louis, MO, US

Year founded

1988

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