The Case Manager is responsible for utilization reviews and resource management, discharge planning ... Previous RN/LPN/RT/SW/CM experience in an inpatient hospital setting dealing with critical care ...
The Case Manager is responsible for utilization reviews and resource management, discharge planning ... Previous RN/LPN/RT/SW/CM experience in an inpatient hospital setting dealing with critical care ...
RN Supervisor- FT Days
Ocala, FL · On-site
Familiarity with ICD-10 coding, utilization review, case management, and discharge planning ... Valid RN license in the state of Florida required; additional certifications such as Basic Life ...
RN Supervisor- FT Days
Ocala, FL · On-site
Familiarity with ICD-10 coding, utilization review, case management, and discharge planning ... Valid RN license in the state of Florida required; additional certifications such as Basic Life ...
RN Supervisor- FT Days
Ocala, FL · On-site
Sign-on Bonus: $$7,500.00 Overview of Position - Nurse Supervisor (RN) - Night Shift The Nursing ... Familiarity with ICD-10 coding, utilization review, case management, and discharge planning ...
RN Supervisor- FT Days
Ocala, FL · On-site
Sign-on Bonus: $$7,500.00 Overview of Position - Nurse Supervisor (RN) - Night Shift The Nursing ... Familiarity with ICD-10 coding, utilization review, case management, and discharge planning ...
Registered Nurse (RN)
Lecanto, FL · On-site
Registered Nurse, RN, develops and achieves professional growth goals and objectives personally and per Team Manager reviews b. Registered Nurse, RN, responsible for attending orientation and ...
Registered Nurse (RN)
Lecanto, FL · On-site
Registered Nurse, RN, develops and achieves professional growth goals and objectives personally and per Team Manager reviews b. Registered Nurse, RN, responsible for attending orientation and ...
Registered Nurse, RN, develops and achieves professional growth goals and objectives personally and per Team Manager reviews b. Registered Nurse, RN, responsible for attending orientation and ...
Registered Nurse, RN, develops and achieves professional growth goals and objectives personally and per Team Manager reviews b. Registered Nurse, RN, responsible for attending orientation and ...
Case Manager II
Ocala, FL · On-site
The CCM performs ongoing utilization review and acts as a liaison to the payor while assuring that ... RN, SW, OT, PT, ST, and Rehabilitation Counseling). - If licensure is required for his/her ...
Case Manager II
Ocala, FL · On-site
The CCM performs ongoing utilization review and acts as a liaison to the payor while assuring that ... RN, SW, OT, PT, ST, and Rehabilitation Counseling). - If licensure is required for his/her ...
... review current topics within the industry. Having the opportunity to grow, learn, and advance in ... Registered Nurse (RN) Licensure (Eligible to receive or renew) * New Grads welcome to apply!
... review current topics within the industry. Having the opportunity to grow, learn, and advance in ... Registered Nurse (RN) Licensure (Eligible to receive or renew) * New Grads welcome to apply!
Staff Registered Nurse (RN)
Brooksville, FL · On-site
$68K/yr
REGISTERED NURSE MANAGER PAY GRADE: 73N CREATED: FLSA STATUS: NON-EXEMPT REVISED: 7/3/2023 ... Check and review pharmacy shipment for accuracy and inform pharmacy of any discrepancies. B.
Staff Registered Nurse (RN)
Brooksville, FL · On-site
$68K/yr
REGISTERED NURSE MANAGER PAY GRADE: 73N CREATED: FLSA STATUS: NON-EXEMPT REVISED: 7/3/2023 ... Check and review pharmacy shipment for accuracy and inform pharmacy of any discrepancies. B.
Registered Nurse RN
Ocala, FL · On-site
... review current topics within the industry. Having the opportunity to grow, learn, and advance in ... Registered Nurse (RN) Licensure (Eligible to receive or renew) * New Grads welcome to apply!
Registered Nurse RN
Ocala, FL · On-site
... review current topics within the industry. Having the opportunity to grow, learn, and advance in ... Registered Nurse (RN) Licensure (Eligible to receive or renew) * New Grads welcome to apply!
Registered Nurse
Ocala, FL · On-site
... review current topics within the industry. Having the opportunity to grow, learn, and advance in ... Registered Nurse (RN) Licensure (Eligible to receive or renew) * New Grads welcome to apply!
Registered Nurse
Ocala, FL · On-site
... review current topics within the industry. Having the opportunity to grow, learn, and advance in ... Registered Nurse (RN) Licensure (Eligible to receive or renew) * New Grads welcome to apply!
Registered Nurse
Ocala, FL · On-site
... review current topics within the industry. Having the opportunity to grow, learn, and advance in ... Registered Nurse (RN) Licensure (Eligible to receive or renew) * New Grads welcome to apply!
Registered Nurse
Ocala, FL · On-site
... review current topics within the industry. Having the opportunity to grow, learn, and advance in ... Registered Nurse (RN) Licensure (Eligible to receive or renew) * New Grads welcome to apply!
Registered Nurse
Ocala, FL · On-site
... review current topics within the industry. Having the opportunity to grow, learn, and advance in ... Registered Nurse (RN) Licensure (Eligible to receive or renew) * New Grads welcome to apply!
Registered Nurse
Ocala, FL · On-site
... review current topics within the industry. Having the opportunity to grow, learn, and advance in ... Registered Nurse (RN) Licensure (Eligible to receive or renew) * New Grads welcome to apply!
Registered Nurse
Ocala, FL · On-site
... review current topics within the industry. Having the opportunity to grow, learn, and advance in ... Registered Nurse (RN) Licensure (Eligible to receive or renew) * New Grads welcome to apply!
Registered Nurse
Ocala, FL · On-site
... review current topics within the industry. Having the opportunity to grow, learn, and advance in ... Registered Nurse (RN) Licensure (Eligible to receive or renew) * New Grads welcome to apply!
Registered Nurse
Ocala, FL · On-site
... review current topics within the industry. Having the opportunity to grow, learn, and advance in ... Registered Nurse (RN) Licensure (Eligible to receive or renew) * New Grads welcome to apply!
Registered Nurse
Ocala, FL · On-site
... review current topics within the industry. Having the opportunity to grow, learn, and advance in ... Registered Nurse (RN) Licensure (Eligible to receive or renew) * New Grads welcome to apply!
... review current topics within the industry. Having the opportunity to grow, learn, and advance in ... Registered Nurse (RN) Licensure (Eligible to receive or renew) * New Grads welcome to apply!
... review current topics within the industry. Having the opportunity to grow, learn, and advance in ... Registered Nurse (RN) Licensure (Eligible to receive or renew) * New Grads welcome to apply!
Registered Nurse
Ocala, FL · On-site
... review current topics within the industry. Having the opportunity to grow, learn, and advance in ... Registered Nurse (RN) Licensure (Eligible to receive or renew) * New Grads welcome to apply!
Registered Nurse
Ocala, FL · On-site
... review current topics within the industry. Having the opportunity to grow, learn, and advance in ... Registered Nurse (RN) Licensure (Eligible to receive or renew) * New Grads welcome to apply!
Registered Nurse
Ocala, FL · On-site
... review current topics within the industry. Having the opportunity to grow, learn, and advance in ... Registered Nurse (RN) Licensure (Eligible to receive or renew) * New Grads welcome to apply!
Registered Nurse
Ocala, FL · On-site
... review current topics within the industry. Having the opportunity to grow, learn, and advance in ... Registered Nurse (RN) Licensure (Eligible to receive or renew) * New Grads welcome to apply!
Registered Nurse
Ocala, FL · On-site
... review current topics within the industry. Having the opportunity to grow, learn, and advance in ... Registered Nurse (RN) Licensure (Eligible to receive or renew) * New Grads welcome to apply!
Registered Nurse
Ocala, FL · On-site
... review current topics within the industry. Having the opportunity to grow, learn, and advance in ... Registered Nurse (RN) Licensure (Eligible to receive or renew) * New Grads welcome to apply!
Registered Nurse
Ocala, FL · On-site
... review current topics within the industry. Having the opportunity to grow, learn, and advance in ... Registered Nurse (RN) Licensure (Eligible to receive or renew) * New Grads welcome to apply!
Registered Nurse
Ocala, FL · On-site
... review current topics within the industry. Having the opportunity to grow, learn, and advance in ... Registered Nurse (RN) Licensure (Eligible to receive or renew) * New Grads welcome to apply!
Registered Nurse
Ocala, FL · On-site
... review current topics within the industry. Having the opportunity to grow, learn, and advance in ... Registered Nurse (RN) Licensure (Eligible to receive or renew) * New Grads welcome to apply!
Registered Nurse
Ocala, FL · On-site
... review current topics within the industry. Having the opportunity to grow, learn, and advance in ... Registered Nurse (RN) Licensure (Eligible to receive or renew) * New Grads welcome to apply!
Utilization Review Rn information
See Inverness, FL salary details
$16 - $19.24
2% of jobs
$19.24 - $22.47
9% of jobs
$24.69 is the 25th percentile. Wages below this are outliers.
$22.47 - $25.71
21% of jobs
The median wage is $28.33 / hr.
$25.71 - $28.95
23% of jobs
$28.95 - $32.18
13% of jobs
$34.70 is the 75th percentile. Wages above this are outliers.
$32.18 - $35.42
10% of jobs
$35.42 - $38.66
8% of jobs
$38.66 - $41.89
5% of jobs
$41.89 - $45.13
5% of jobs
$45.13 - $48.36
2% of jobs
$48.36 - $51.60
2% of jobs
$16
$31
$51
How much do utilization review rn jobs pay per hour?
As of Jul 6, 2026, the average hourly pay for utilization review rn in Inverness, FL is $31.62, according to ZipRecruiter salary data. Most workers in this role earn between $25.00 and $36.30 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?
| Aspect | Utilization Review Rn | Case Manager |
|---|---|---|
| Credentials | RN license, certifications in utilization review | RN license, certifications in case management |
| Work Environment | Hospitals, insurance companies, healthcare facilities | Hospitals, community agencies, insurance companies |
| Primary Focus | Reviewing medical necessity and appropriateness of care | Coordinating 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 cities near Inverness, FL are hiring for Utilization Review Rn jobs? Cities near Inverness, FL with the most Utilization Review Rn job openings:
Case Manager / PRN ( RN / RT / SW / LPN )
Oxford, FL • On-site
Per diem
Life, Retirement
Posted 17 days ago
Job description
Overview
Select Specialty Hospital
Critical Illness Recovery Hospital (LTACH)
Case Manager (PRN)
Requires a current licensure in a clinical discipline either as a Nurse or a Respiratory Therapist OR Social Work SW/MSW (potential license per state guidelines).
And
Previous discharge planning experience highly preferred.
SHIFT:
*Availability to work a minimum of 2 shifts per month on an "as needed" basis - shifts would be scheduled on weekdays, from appoximately 8a.m.-5p.m.*
Our hospital is a critical illness recovery hospital committed to providing world-class inpatient post-ICU services to chronic, critically ill patients who require extended healing and recovery. We help patients during some of the most vulnerable, painful moments of their lives - and our team plays a central role in providing compassionate, excellent care every step of the way.
Responsibilities
We are looking for valued employees who will be Champions of the Select Medical Way, which includes putting the patient first, helping to improve quality of life for the community in which you live and work, continuing to develop and explore new ideas, providing high-quality care and doing well by doing what is right.
The Case Manager is responsible for utilization reviews and resource management, discharge planning, treatment plan management and financial management, while also completing medical record documentation. You will report directly to the Director of Case Management and provide social work services, as necessary, per state guidelines.
Qualifications
How you will be successful in this environment:
We are seeking results-driven team players. Qualified candidates must be passionate about providing superior quality in all that they do.
Minimum requirements:
Preferred qualifications that will make you successful:
Additional Data
Why Join Us:
Equal opportunity employer, including disabled veterans
Select Specialty Hospital
Critical Illness Recovery Hospital (LTACH)
Case Manager (PRN)
Requires a current licensure in a clinical discipline either as a Nurse or a Respiratory Therapist OR Social Work SW/MSW (potential license per state guidelines).
And
Previous discharge planning experience highly preferred.
SHIFT:
*Availability to work a minimum of 2 shifts per month on an "as needed" basis - shifts would be scheduled on weekdays, from appoximately 8a.m.-5p.m.*
Our hospital is a critical illness recovery hospital committed to providing world-class inpatient post-ICU services to chronic, critically ill patients who require extended healing and recovery. We help patients during some of the most vulnerable, painful moments of their lives - and our team plays a central role in providing compassionate, excellent care every step of the way.
Responsibilities
We are looking for valued employees who will be Champions of the Select Medical Way, which includes putting the patient first, helping to improve quality of life for the community in which you live and work, continuing to develop and explore new ideas, providing high-quality care and doing well by doing what is right.
The Case Manager is responsible for utilization reviews and resource management, discharge planning, treatment plan management and financial management, while also completing medical record documentation. You will report directly to the Director of Case Management and provide social work services, as necessary, per state guidelines.
- Develops and implements a patient specific, safe and timely discharge plan.
- Performs verification of utilization criteria reviews.
- Builds relationships and coordinate with payor sources to assure proper reimbursement for hospital provided services, promote costs attentive care via focus on resource management within the plan of care.
- Demonstrates compliance with facility-wide Utilization Management policies and procedures.
- Coordinates UR compliance with Quality Management to assure all licensure and accrediting requirements are fulfilled.
- Maintains fiscal responsibilities. Assures the department is identifying and negotiating the fullest possible reimbursement to maximize insurance benefit coverage for the patient. Reviews insurance verification forms to minimize risk.
- Facilitates multi-disciplinary team meetings including physicians, nurses, respiratory therapists and rehabilitation therapists.
Qualifications
How you will be successful in this environment:
We are seeking results-driven team players. Qualified candidates must be passionate about providing superior quality in all that they do.
Minimum requirements:
- Current licensure in a clinical discipline either as a Nurse (RN /LPN/ LVN)or a Respiratory Therapist OR current license / certified Social Work license per state guidelines
- Previous RN/LPN/RT/SW/CM experience in an inpatient hospital setting dealing with critical care/acute care patients. (example: ICU, step-down, med surg, vents)
- Adequate experience in an acute medical case management setting and confidence to manage and direct a plan of care for chronically critically ill populations
Preferred qualifications that will make you successful:
- Specific experience in Care Management and Discharge Planning is preferred.
- Working knowledge of the insurance industry and government reimbursement.
- Availability to work a minimum of 2 shifts per month on an "as needed" basis - shifts would be scheduled on weekdays, from appoximately 8a.m.-5p.m.
Additional Data
Why Join Us:
- Start Strong: Extensive orientation program to ensure a smooth transition into our setting.
- Opportunity for Advancement: Demonstrate your skills and dedication which could lead to potential full-time opportunities
- Foster Well-being: We offer benefits which support the financial, work/life and emotional well-being of you and your family members. Part time/Per Diem positions are eligible for 401k based on reaching 1,000 hours within their first anniversary or subsequent calendar year. We also offer our employee assistance program to part time employees.
- Your Impact Matters: Join a team of over 44,000 committed to providing exceptional patient care
Equal opportunity employer, including disabled veterans