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Utilization Review Rn information

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$42

$68

How much do utilization review rn jobs pay per hour?

As of Jul 18, 2026, the average hourly pay for utilization review rn in Morris, CT is $42.20, according to ZipRecruiter salary data. Most workers in this role earn between $33.37 and $48.46 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?

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 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 Morris, CT are hiring for Utilization Review Rn jobs? Cities near Morris, CT with the most Utilization Review Rn job openings:
Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Morris, CT as of July 2026, with employment types broken down into 1% As Needed, 79% Full Time, 16% Part Time, 1% Temporary, and 3% Contract. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution, with an average salary of $87,773 per year, or $42.2 per hour.
RN; Registered Nurse - Oncology Ambulatory

RN; Registered Nurse - Oncology Ambulatory

Yale New Haven Health

New Haven, CT • On-site

Full-time

Re-posted 24 days ago

Yale New Haven Health rating

7.3

Company rating: 7.3 out of 10

Based on 228 frontline employees who took The Breakroom Quiz

263rd of 886 rated healthcare providers

Job description

Overview
To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.
Works Under The Supervision Of The Nurse Manager/Clinical Coordinator. The Registered Nurse (Rn) Assesses, Plans, Implements, Evaluates And Supervises Individual Patient Care On A Nursing Unit/Department According To Unit Policies And Procedures. Provides Supervision Of Non-Rn Personnel On The Assigned Unit. When Assuming The Charge Role, Delegates And Supervises Unit Activities. May Be Requires To Work On Other Nursing Units According To Distribution Of Staff And Patients. Performs Other Duties As Assigned Or Requested In Order To Maintain A High Level Of Service.
EEO/AA/Disability/Veteran
Responsibilities
  1. Assesses The Patient's Physical And Psychosocial Condition On An Ongoing Basis Throughout The Continuum Of Care.
  2. Develops, Communicates And Documents A Plan Of Care Reflecting Individualized Patient Problems And Interventions To Achieve Desired Outcomes, Involving The Patient, Family And Healthcare Team In This Process.
  3. Implements And Coordinates This Plan Of Care In Collaboration With The Healthcare Team.
  4. Evaluates The Effectiveness Of The Plan Of Care, Patient?S Response To Care, And Readiness For Discharge. Revises The Plan Of Care As Needed And Makes Referrals Where Indicated.
  5. Plans For Education After Assessing The Individual Learning Needs And Readiness Of The Patient And Family. Provides Educational Opportunities And Documents Outcomes.
  6. Functions As A Preceptor To New Staff.
  7. Functions As A Charge Nurse.
  8. Meets Performance Expectations For Customer Service, Teamwork, Resource Utilization, And Staff And Self Development As Outlined In Performance Review.
  9. Performs Other Duties As Assigned Or Directed To Ensure Smooth Operation Of The Department/Unit.
  10. Demonstrates Competency In The Care Of The Neuro Patient
  11. Demonstrates Skill And Knowledge In Neuro Assessment
  12. Demonstrates Skill And Knowledge In The Airway Management Of The Neuro Patient
  13. Demonstrates Skill And Understanding In Caring For A Trached Patient
  14. Demonstrates Skill And Understanding In Assisting The Physician And Caring For The Patient During Special Neuro Procedures
  15. Demonstrates Knowledge And Understanding Of Our 'Tia' Teaching Program
  16. Performs Pharynaeal, Endotracheal, Tracheostomy Suctioning According To Established Policy And Procedure: Pharynaeal, Endotracheal, Tracheastomy
  17. Demonstrates Skill And Understanding In The Use Of Equipment And Care Of Patient In A Halo Brace
  18. Demonstrates Skill And Understanding Of Nursing Responsibilities And Interventions For The Patient On A Ventilator

Qualifications
EDUCATION
Graduate Of An Accredited School Of Nursing; BSN Preferred. Proficient In Use Of Computer Software To Include Electronic Patient Records. Must Have Ability To Use Internet For Literature Searches Regarding Care For Patients.
EXPERIENCE
N/A
LICENSURE
Valid State Of Connecticut Registered Nurse License
SPECIAL SKILLS
BLS Required
Additional Information
  • Smilow Ambulatory Multispecialty Department YSC (NP 1, NP4, NP8) This department is rooted in oncology nursing excellence and serves as a hub for patients undergoing cancer treatment and management for solid tumor cancers. This specialized department caters to both medical oncology patients, who receive systemic therapies like chemotherapy, immunotherapy, and targeted therapies, and surgical oncology patients, who are in various stages of their surgical journey, including pre-operative evaluation, post-operative care, and follow-up.
  • The core philosophy of our department is to provide multidisciplinary and comprehensive cancer care to patients and their support system. We aim to provide a holistic approach to cancer care, ensuring that patients receive not only the most advanced medical and surgical treatments but also the crucial support services needed to navigate their cancer journey effectively.
  • RNs with Oncology experience required
  • Practice RN positions available:
  • Current Specialties
    • Breast Clinic Women's Services
    • Women's Services GYN
    • Neuro Surgery

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