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Utilization Review Rn Jobs in Jacksonville, FL (NOW HIRING)

UF Health

Case Manager-PRN

Jacksonville, FL

... 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, ...

UF Health

Case Manager-PRN

Jacksonville, FL · On-site

... 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, ...

VITAS Healthcare

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 ...

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All JobsUtilization Review Rn JobsUtilization Review Rn Jobs in Jacksonville, FL

Utilization Review Rn information

See Jacksonville, FL salary details

$19

$38

$62

How much do utilization review rn jobs pay per hour?

As of Aug 12, 2026, the average hourly pay for utilization review rn in Jacksonville, FL is $38.38, according to ZipRecruiter salary data. Most workers in this role earn between $30.34 and $44.09 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.

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 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 knowledge of medical coding and insurance processes can enhance your qualifications. Gaining experience in case management or health insurance companies can also improve your chances of entering the field.

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.

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 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:
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:
What cities near Jacksonville, FL are hiring for Utilization Review Rn jobs? Cities near Jacksonville, FL with the most Utilization Review Rn job openings:
Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Jacksonville, FL as of August 2026, with employment types broken down into 1% As Needed, 83% Full Time, 13% Part Time, and 3% Contract. Highlights an 91% Physical, 3% Hybrid, and 6% Remote job distribution, with an average salary of $79,822 per year, or $38.4 per hour.

Case Manager-PRN

UF Health

Jacksonville, FL

Per diem

Re-posted 8 days ago

Job description

Overview

PRN Position

The Case Manager (CM) is an important member of the treatment team responsible for participating in the development of the patient's plan of care and facilitating efficient throughput, conducting utilization review, promoting appropriate utilization of resources, and identifying needs and establishing safe and appropriate discharge plans. The CM performs these functions throughout the care continuum by utilizing sound assessment skills and collaborating with the patient and their caregivers, Attending Physician, 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, effective June 14, 2017, must have a BSN degree from an accredited school of nursing within three (3) years of hire or transfer into the position. New hires or transfers into in the position between August 1, 2013 and June 13, 2017 must abide with the conditions in his or her offer letter and the verbiage in the job description signed upon hire or transfer into the position. Current employees who were hired or transferred into the position prior to August 1, 2013 will be grandfathered.
Preferred Education:
BSN, MSW
Required Licensure(s) /Certification(s):
Licensed to practice nursing in the state of Florida for those meeting ASN or BSN education requirement - Masters in Social work (or related field) accepted in lieu of RN licensure.
Required Experience:
1-2 years' experience discharge planning, case management, managed care, or Registered Nurse experience in a medical setting.
Preferred Experience:
Discharge planning and case management experience in a hospital setting; resource navigation, biopsychosocial assessment, community outreach
Necessary Skills:
1. Excellent verbal and written communication skills
2. Excellent organizational skills
3. Strong personal computer skills (i.e., Email, Word, Excel)
4. Good typing skills (20 wpm)
Age of Patients Served:
All Age Groups

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