... a Registered Nurse, and/or have a Bachelor's Degree in Social Work or Psychology or equivalent education and experience in Utilization Review/ Management. Has knowledge of regulatory and ...
... a Registered Nurse, and/or have a Bachelor's Degree in Social Work or Psychology or equivalent education and experience in Utilization Review/ Management. Has knowledge of regulatory and ...
PRN Utilization Review Coordinator, including weekends $26-$37 This position is responsible for ... Qualifications Registered Nurse, LPN or Master's level Social Worker with experience in Utilization ...
PRN Utilization Review Coordinator, including weekends $26-$37 This position is responsible for ... Qualifications Registered Nurse, LPN or Master's level Social Worker with experience in Utilization ...
PT Utilization Review Coordinator, including weekends $26-$37 This position is responsible for ... Qualifications Registered Nurse, LPN or Master's level Social Worker with experience in Utilization ...
PT Utilization Review Coordinator, including weekends $26-$37 This position is responsible for ... Qualifications Registered Nurse, LPN or Master's level Social Worker with experience in Utilization ...
Part-Time Concurrent Review RN - Every Saturday and Sunday
Jacksonville, FL · Hybrid
$71K - $115K/yr
Unrestricted US Registered Nurse license * Florida State Licensure and/or Compact State Licensure ... Utilization Review/Management General Physical Demands * Exerting up to 10 pounds of force ...
Part-Time Concurrent Review RN - Every Saturday and Sunday
Jacksonville, FL · Hybrid
$71K - $115K/yr
Unrestricted US Registered Nurse license * Florida State Licensure and/or Compact State Licensure ... Utilization Review/Management General Physical Demands * Exerting up to 10 pounds of force ...
Part-Time Concurrent Review RN - Every Saturday and Sunday
Jacksonville, FL · On-site
$71K - $115K/yr
Unrestricted US Registered Nurse license * Florida State Licensure and/or Compact State Licensure ... Utilization Review/Management General Physical Demands * Exerting up to 10 pounds of force ...
Part-Time Concurrent Review RN - Every Saturday and Sunday
Jacksonville, FL · On-site
$71K - $115K/yr
Unrestricted US Registered Nurse license * Florida State Licensure and/or Compact State Licensure ... Utilization Review/Management General Physical Demands * Exerting up to 10 pounds of force ...
Coordinates on-site review of medical records with reviewers from third party payers. * Documents ... Registered Nurse: Associate Degree in Nursing required. * One year experience in psychiatric ...
Coordinates on-site review of medical records with reviewers from third party payers. * Documents ... Registered Nurse: Associate Degree in Nursing required. * One year experience in psychiatric ...
Part-Time Concurrent Review RN - Every Saturday and Sunday
Jacksonville, FL · Hybrid
$71K - $115K/yr
Unrestricted US Registered Nurse license * Florida State Licensure and/or Compact State Licensure ... Utilization Review/Management General Physical Demands * Exerting up to 10 pounds of force ...
Part-Time Concurrent Review RN - Every Saturday and Sunday
Jacksonville, FL · Hybrid
$71K - $115K/yr
Unrestricted US Registered Nurse license * Florida State Licensure and/or Compact State Licensure ... Utilization Review/Management General Physical Demands * Exerting up to 10 pounds of force ...
Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides ...
Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides ...
Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides ...
Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides ...
Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides ...
Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides ...
... Utilization Review Coordinator, and other members of the treatment team. Qualifications Required Education: Associate Degree in Nursing, -OR- Masters in Social Work or related field. New hire RNs, ...
... Utilization Review Coordinator, and other members of the treatment team. Qualifications Required Education: Associate Degree in Nursing, -OR- Masters in Social Work or related field. New hire RNs, ...
... Utilization Review Coordinator, and other members of the treatment team. Qualifications Required Education: Associate Degree in Nursing, -OR- Masters in Social Work or related field. New hire RNs, ...
... Utilization Review Coordinator, and other members of the treatment team. Qualifications Required Education: Associate Degree in Nursing, -OR- Masters in Social Work or related field. New hire RNs, ...
... utilization review, promoting appropriate utilization of resources, and identifying needs and ... New hire RNs, effective June 14, 2017, must have a BSN degree from an accredited school of nursing ...
... utilization review, promoting appropriate utilization of resources, and identifying needs and ... New hire RNs, effective June 14, 2017, must have a BSN degree from an accredited school of nursing ...
... utilization review, promoting appropriate utilization of resources, and identifying needs and ... New hire RNs, effective June 14, 2017, must have a BSN degree from an accredited school of nursing ...
... utilization review, promoting appropriate utilization of resources, and identifying needs and ... New hire RNs, effective June 14, 2017, must have a BSN degree from an accredited school of nursing ...
... Utilization Review Coordinator, and other members of the treatment team. Qualifications Required Education: Associate degree in Nursing, or Masters in Social Work or related field. New hire RNs, ...
... Utilization Review Coordinator, and other members of the treatment team. Qualifications Required Education: Associate degree in Nursing, or Masters in Social Work or related field. New hire RNs, ...
Graduate from an accredited school of nursing and has an active license as a Registered Nurse ... A minimum of 4 years of utilization/quality assurance review and ICD-9/10-CM/CPT-4 coding ...
Quick apply
Graduate from an accredited school of nursing and has an active license as a Registered Nurse ... A minimum of 4 years of utilization/quality assurance review and ICD-9/10-CM/CPT-4 coding ...
... Utilization Review Coordinator, and other members of the treatment team. Qualifications Required Education: Associate degree in Nursing, or Masters in Social Work or related field. New hire RNs, ...
... Utilization Review Coordinator, and other members of the treatment team. Qualifications Required Education: Associate degree in Nursing, or Masters in Social Work or related field. New hire RNs, ...
Registered Nurse (RN)
Palatka, FL · On-site
Registered Nurse, RN, develops and achieves professional growth goals and objectives personally and per Team Manager reviews * Registered Nurse, RN, responsible for attending orientation and ...
Registered Nurse (RN)
Palatka, FL · On-site
Registered Nurse, RN, develops and achieves professional growth goals and objectives personally and per Team Manager reviews * Registered Nurse, RN, responsible for attending orientation and ...
Appeals Registered Nurse
Jacksonville, FL · On-site
The Appeals RN works in collaboration with the Appeals Examiners/Reps to ensure redeterminations ... Basic knowledge and understanding of medical/clinical review processes (i.e., Appeals/Utilization ...
Appeals Registered Nurse
Jacksonville, FL · On-site
The Appeals RN works in collaboration with the Appeals Examiners/Reps to ensure redeterminations ... Basic knowledge and understanding of medical/clinical review processes (i.e., Appeals/Utilization ...
Licensure Required: RN, LPN Preferred: LVN Must haves: Medicare knowledge, InterQual or Milliman Experience, Clinical reviews for Utilization Management or Appeals Nice to haves: Medicare Appeals ...
Licensure Required: RN, LPN Preferred: LVN Must haves: Medicare knowledge, InterQual or Milliman Experience, Clinical reviews for Utilization Management or Appeals Nice to haves: Medicare Appeals ...
Utilization Review Rn information
See Jacksonville, FL salary details
$19.82 - $23.83
2% of jobs
$23.83 - $27.84
9% of jobs
$30.58 is the 25th percentile. Wages below this are outliers.
$27.84 - $31.85
21% of jobs
The median wage is $35.10 / hr.
$31.85 - $35.86
23% of jobs
$35.86 - $39.87
13% of jobs
$42.99 is the 75th percentile. Wages above this are outliers.
$39.87 - $43.88
10% of jobs
$43.88 - $47.89
8% of jobs
$47.89 - $51.90
5% of jobs
$51.90 - $55.91
5% of jobs
$55.91 - $59.91
2% of jobs
$59.91 - $63.92
2% of jobs
$19
$39
$63
How much do utilization review rn jobs pay per hour?
As of Sep 3, 2026, the average hourly pay for utilization review rn in Jacksonville, FL is $39.18, according to ZipRecruiter salary data. Most workers in this role earn between $30.96 and $45.00 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?
| 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 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 Jacksonville, FL?
The most popular types of Utilization Review Rn jobs in Jacksonville, FL are:
What are popular job titles related to Utilization Review Rn jobs in Jacksonville, FL?
For Utilization Review Rn jobs in Jacksonville, FL, the most frequently searched job titles are:
- Remote Utilization Review Nurse
- Remote Behavioral Health Utilization Review
- Remote Utilization Review Rn
- Remote Utilization Management Nurse
- Night Shift Remote Utilization Review Nurse
- Part Time Utilization Review Nurse
- Clinical Review Nurse Remote
- Utilization Review Nurse
- Temporary Utilization Review Nurse
- Remote Utilization Review Social Worker
What job categories do people searching Utilization Review Rn jobs in Jacksonville, FL look for?
The top searched job categories for Utilization Review Rn jobs in Jacksonville, FL are:
- Utilization Review
- Remote Utilization Review
- Remote Utilization Review Nurse Practitioner
- Remote Aetna Utilization Review Nurse
- Aetna Utilization Review Nurse
- Remote Lpn Utilization Review
- Remote Dental Utilization Review
- Utilization Review No Experience
- Remote Preservice Review Nurse
- Optum Utilization Review Nurse
What cities near Jacksonville, FL are hiring for Utilization Review Rn jobs?
Cities near Jacksonville, FL with the most Utilization Review Rn job openings:
Universal Health Services rating
6.9
Based on 254 frontline employees who took The Breakroom Quiz
454th of 898 rated healthcare providers
Job description
Responsibilities
The Utilization Review Director is responsible for directing and overseeing the Utilization Management Department. This includes the implementation of case management scenarios, consulting with all services to ensure the provision of an effective treatment plan for all patients, oversees the response to requests for services and interfaces with managed care organization, external reviewers, and other payers.
Directly supervises a minimum of 5 staff. Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws. Responsibilities include interviewing, hiring, and training employees; planning assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems
Must be a Registered Nurse, and/or have a Bachelor's Degree in Social Work or Psychology or equivalent education and experience in Utilization Review/ Management. Has knowledge of regulatory and reimbursement requirements. Able to monitor and evaluate records for quality and appropriateness of care. Able to work independently and collegially with all clinical disciplines and staff within the hospital. Demonstrates leadership ability, good communication skills, ability to delegate and supervise.
Ability to read, analyze, and interpret common scientific and technical journals, financial reports and legal documents. Ability to respond to common inquiries or complaints from customers, regulatory agencies or members of the business community. Ability to write speeches and articles for publication that conform to prescribed style and format. Ability to effectively present information to top management, public groups, and/or boards of directors.
Ability to work with mathematical concepts such as probability and statistical inference. Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations.
Ability to define problems, collect data, establish facts, and draw valid conclusions. Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables.
While performing the duties of this job, the employee is regularly required to stand, walk, and site; use hands to finger, handle, or feel, reach with hands and arms, stoop, kneel, crouch, or crawl.
The employee must regularly lift and/or move up to 25 pounds, and occasionally up to 75 pounds. Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception, and ability to adjust focus.
Qualifications
One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (NYSE: UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 300 corporation, annual revenues were $15.8 billion in 2024. During the year, UHS was again recognized as one of the World's Most Admired Companies by Fortune; and listed in Forbes ranking of America's Largest Public Companies.
Headquartered in King of Prussia, PA, UHS has approximately 99,000 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com
The Utilization Review Director is responsible for directing and overseeing the Utilization Management Department. This includes the implementation of case management scenarios, consulting with all services to ensure the provision of an effective treatment plan for all patients, oversees the response to requests for services and interfaces with managed care organization, external reviewers, and other payers.
Directly supervises a minimum of 5 staff. Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws. Responsibilities include interviewing, hiring, and training employees; planning assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems
Must be a Registered Nurse, and/or have a Bachelor's Degree in Social Work or Psychology or equivalent education and experience in Utilization Review/ Management. Has knowledge of regulatory and reimbursement requirements. Able to monitor and evaluate records for quality and appropriateness of care. Able to work independently and collegially with all clinical disciplines and staff within the hospital. Demonstrates leadership ability, good communication skills, ability to delegate and supervise.
Ability to read, analyze, and interpret common scientific and technical journals, financial reports and legal documents. Ability to respond to common inquiries or complaints from customers, regulatory agencies or members of the business community. Ability to write speeches and articles for publication that conform to prescribed style and format. Ability to effectively present information to top management, public groups, and/or boards of directors.
Ability to work with mathematical concepts such as probability and statistical inference. Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations.
Ability to define problems, collect data, establish facts, and draw valid conclusions. Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables.
While performing the duties of this job, the employee is regularly required to stand, walk, and site; use hands to finger, handle, or feel, reach with hands and arms, stoop, kneel, crouch, or crawl.
The employee must regularly lift and/or move up to 25 pounds, and occasionally up to 75 pounds. Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception, and ability to adjust focus.
Qualifications
One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (NYSE: UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 300 corporation, annual revenues were $15.8 billion in 2024. During the year, UHS was again recognized as one of the World's Most Admired Companies by Fortune; and listed in Forbes ranking of America's Largest Public Companies.
Headquartered in King of Prussia, PA, UHS has approximately 99,000 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com
What Universal Health Services employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom
About Universal Health Services
Sourced by ZipRecruiter
Universal Health Services (UHS) is a major player in the healthcare industry, based in King of Prussia, Pennsylvania, U.S. Founded in 1978, UHS offers hospital and healthcare services. Their diverse services range from acute care hospitals, behavioral health facilities and ambulatory centers nationwide. The company's mission of enhancing the health and well-being of their patients is reflected in their commitment to 'Helping Individuals Live Longer, Healthier and Happier Lives'. Universal Health Services' consistent growth and success in their industry have been recognized on numerous occasions, including being ranked amongst the Fortune 500 list of largest companies.
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
King of Prussia, PA, US