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Utilization Review Rn Jobs in Lititz, PA (NOW HIRING)

Admissions RN - Days

Reading, PA ยท On-site

$41 - $50/hr

Registered Nurse (Rn) Tower Behavioral Health in Reading, PA is expanding! We are growing and want ... Demonstrate knowledge and utilization of universal precautions in providing direct patient care.

Performs initial reviews for medical necessity and appropriateness of setting for the assigned case ... Utilization management, care management, or clinical nursing specialty. Preferred * Previous ...

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Showing results 21-40

Utilization Review Rn information

See Lititz, PA salary details

$19

$39

$63

How much do utilization review rn jobs pay per hour?

As of Aug 11, 2026, the average hourly pay for utilization review rn in Lititz, PA is $39.17, 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.

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 job categories do people searching Utilization Review Rn jobs in Lititz, PA look for? The top searched job categories for Utilization Review Rn jobs in Lititz, PA are:
What cities near Lititz, PA are hiring for Utilization Review Rn jobs? Cities near Lititz, PA with the most Utilization Review Rn job openings:
Infographic showing various Utilization Review Rn job openings in Lititz, PA as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 16% Part Time, and 2% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $81,478 per year, or $39.2 per hour.

RN - Registered Nurse

Caron Treatment Center

Wernersville, PA โ€ข On-site

Other

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 16 days ago


Job description

Caron Treatment Center

Caron is one of the leading treatment centers in the US and is recognized for high-quality, evidence-based methods and thought leadership in addiction medicine. Mentored by respected experts in the field and ranked among Newsweek's Best Treatment Centers in PA five years in a row, Caron has built a culture that supports and sustains trauma-informed, resilient staff at all levels of the organization and values personal and professional growth. We invest in our employees, providing financial plans, generous Paid Time Off programs, paid holidays, 401K employer match, tuition reimbursement, employee assistance programs, and benchmarking to ensure ongoing competitive compensation. Full-Time employee benefits also include comprehensive medical, dental, and vision benefit packages with wellness plan reduced insurance premiums and company-paid life and disability insurance. Apply today to begin a rewarding career with us.

RN - Registered Nurse

Full Time, Day Shift

Have the opportunity to work either 5, 8-hour shifts (6am-2:30pm) or 4, 10-hour shifts (5:30am-4pm) - Your Choice!

Full Time, 2nd Shift

Have the opportunity to work either 5, 8-hour shifts (2:30pm-11pm) or 4, 10-hour shift (1pm-11pm) - Your Choice!

Schedule includes working every other weekend and holiday, with a repeating 2-week schedule

RN - Registered Nurse Duties and Responsibilities:

  • Assume the charge nurse role if applicable and/or unit nurse role by:
  • Receiving and giving accurate and thorough shift reports
  • Keeping the physicians informed of patient's conditions, change of conditions, LOC and triage information and needs
  • Correctly entering and taking off physician orders
  • Oversight of the care of patients by auxiliary personnel
  • Organizing and delegating patient care activities
  • Monitoring and/or performing diagnostic screening tests as ordered by physician
  • Providing thorough and accurate patient information during shift exchange for end of shift report
  • Assess individual patient care needs, initiate medical treatment plan and competently implement/instruct all care in the appropriate nursing practice to all staff.
  • Serve as a resource to treatment team members.
  • Perform nursing assessments, LOC, and review patient histories to document all necessary information in the Electronic Medical Record on all patients admitted to Caron.
  • Prepare patients for examinations: height/weight, vitals, collect and process lab specimens including UDS, UA, Chem Sticks, etc. following proper infection control procedures.
  • Utilize safe and effective practices of medication management as defined by policy including the oversight of self-administration observation of medication.
  • Administer and monitor the effects of medications, ensure accurate medication is ordered and administered for controlled substances and conduct accurate med counts.
  • Provide appropriate patient education as determined by patient assessments/needs and treatment plans.
  • Conduct 14-day, 25-day and PRN meetings with patients for assigned units when in unit nurse role.
  • Monitor and/or perform withdrawal assessments and appropriately implement/instruct the necessary nursing interventions.
  • Accurately and thoroughly document in the medical record utilizing approved medical record language and abbreviations adhering to the medical record policies and procedures.
  • Schedule all patient appointments related to their medical treatment.
  • Work a flexible schedule based upon service demands and work mandatory overtime as needed.
  • Attend all mandatory trainings as identified by Caron policies.
  • Attend multi-disciplinary treatment team meetings when in unit nurse role.
  • Maintain the quality control logs.
  • Provide support services for patient care issues to staff at other Caron facilities.
  • Maintain adequate staffing for each shift.
  • Ensure the highest level of professionalism for self and staff and maintain a clean and organized work environment.
  • Complete yearly training requirements and mentor new employees.
  • This job description reflects management's assignment of essential functions and does not prescribe or restrict the tasks that may be assigned.

Physical Requirements:

The physical and mental demands described here are representative of those that must be met to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • Lifting: up to 50 pounds on occasion.
  • Standing: up to several hours at a time, this may include walking, climbing steps, and descending steps.
  • Walking: must be able to ambulate throughout the assigned facilities on campus or Caron properties.
  • Sitting: up to several hours at a time for data entry into the computer or medical record documentation.

Education/Experience Qualifications:

  • Currently licensed as RN in Pennsylvania.
  • Current Certified Addiction Registered Nurse (CARN) certification preferred.
  • 1-3 years' experience working as an RN preferably in ER, acute care or mental health setting
  • Current CPR/First Aid training/certification.
  • 21 years of age or older is required
  • Requires a current, valid, unrestricted driver's license
  • Two years continuous sobriety preferred if in recovery.
  • Previous hospital/chemical dependency rehabilitation treatment program experience desired.
  • Possess a working knowledge of addictions with age specific patient populations preferred.
  • Working knowledge of electronic medical record and charting.
Qualifications Licenses & Certifications Required

Registered Nurse

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.