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

RN Cancer Guides

Oncology Nurse Advocate

Inverness, FL · On-site

Current Florida RN or NP Preferred: BSN or MSN, Case Management Certification, utilization review experience Knowledge/Skills/Abilities * Strong computer skills, including Microsoft Office * Must be ...

Acadia Healthcare

Utilization Specialist

Ocklawaha, FL · On-site

$20 - $24/hr

We are looking to for a Full Time Utilization Review Specialist to join our team. The UR specialist ... Associate's, Bachelor's, or Master's degree in Social Work, Behavioral or Mental Health, Nursing ...

Acadia Healthcare

Utilization Specialist

Ocklawaha, FL · On-site

$20 - $24/hr

We are looking to for a Full Time Utilization Review Specialist to join our team. The UR specialist ... Associate's, Bachelor's, or Master's degree in Social Work, Behavioral or Mental Health, Nursing ...

UHS

Admissions RN - PRN

Ocala, FL · On-site

$63K - $86K/yr

... RN will review packets, accept and admit patients. This position requires a person to work with ... utilization review, marketing, and nursing. The Vines' Admissions department is an exciting ...

UHS

Admissions RN - PRN

Ocala, FL

$63K - $86K/yr

... RN will review packets, accept and admit patients. This position requires a person to work with ... utilization review, marketing, and nursing. The Vines' Admissions department is an exciting ...

UHS

ADMISSIONS RN - FT Nights

Ocala, FL · On-site

$63K - $86K/yr

... utilization review, marketing, and nursing. This position also qualifies for our $5,000.00 ... With 1 in 5 adults suffering from a mental illness, the Admissions RN must be able to adapt and ...

UHS

Admissions RN- FT (Day)

Ocala, FL · On-site

$63K - $86K/yr

... utilization review, marketing, and nursing. This position also qualifies for our $5,000.00 ... With 1 in 5 adults suffering from a mental illness, the Admissions RN must be able to adapt and ...

UHS

ADMISSIONS RN - FT Nights

Ocala, FL · On-site

$63K - $86K/yr

... utilization review, marketing, and nursing. This position also qualifies for our $5,000.00 ... With 1 in 5 adults suffering from a mental illness, the Admissions RN must be able to adapt and ...

UHS

ADMISSIONS RN - FT Nights

Ocala, FL

$63K - $86K/yr

... utilization review, marketing, and nursing. This position also qualifies for our $5,000.00 ... With 1 in 5 adults suffering from a mental illness, the Admissions RN must be able to adapt and ...

UHS

ADMISSIONS RN - FT Nights

Ocala, FL

$63K - $86K/yr

... utilization review, marketing, and nursing. This position also qualifies for our $5,000.00 ... With 1 in 5 adults suffering from a mental illness, the Admissions RN must be able to adapt and ...

UHS

Admissions RN- FT (Day)

Ocala, FL · On-site

$63K - $86K/yr

... utilization review, marketing, and nursing. This position also qualifies for our $5,000.00 ... With 1 in 5 adults suffering from a mental illness, the Admissions RN must be able to adapt and ...

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

Utilization Review Rn information

See Ocala, FL salary details

$19

$39

$64

How much do utilization review rn jobs pay per hour?

As of Jul 27, 2026, the average hourly pay for utilization review rn in Ocala, FL is $39.30, according to ZipRecruiter salary data. Most workers in this role earn between $31.06 and $45.14 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 are the most commonly searched types of Utilization Review Rn jobs in Ocala, FL? The most popular types of Utilization Review Rn jobs in Ocala, FL are:
What are popular job titles related to Utilization Review Rn jobs in Ocala, FL? For Utilization Review Rn jobs in Ocala, FL, the most frequently searched job titles are:
What job categories do people searching Utilization Review Rn jobs in Ocala, FL look for? The top searched job categories for Utilization Review Rn jobs in Ocala, FL are:
What cities near Ocala, FL are hiring for Utilization Review Rn jobs? Cities near Ocala, FL with the most Utilization Review Rn job openings:
Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Ocala, FL as of July 2026, with employment types broken down into 10% As Needed, 84% Full Time, and 6% Part Time. Highlights an 97% In-person, and 3% Remote job distribution, with an average salary of $81,736 per year, or $39.3 per hour.
Utilization Review Manager (On-site) (279)

Utilization Review Manager (On-site) (279)

LIFESTREAM BEHAVIORAL CENTER

Leesburg, FL

Other

Medical, Dental, Vision, Retirement, PTO

Posted 17 days ago

Job description

Job Purpose:
- The Utilization Review Manager - RN at LIFESTREAM BEHAVIORAL CENTER is responsible for overseeing the utilization review process to ensure that patient care services are delivered efficiently and effectively. This role involves collaborating with healthcare providers to optimize patient outcomes and resource utilization while ensuring compliance with regulatory and accreditation standards.
Key Responsibilities:
- Lead and manage the utilization review team to ensure timely and accurate assessments of patient care plans.
- Develop and implement utilization review policies and procedures in accordance with organizational and regulatory requirements.
- Collaborate with clinical staff to review patient cases and determine the appropriateness of care and services provided.
- Analyze data and prepare reports on utilization trends, recommending improvements to enhance patient care and resource management.
- Serve as a liaison between the healthcare team and insurance providers to facilitate authorizations and resolve any coverage issues.
- Provide education and training to staff on utilization review processes and best practices.
- Ensure compliance with all relevant regulations, standards, and guidelines related to utilization management.
- Participate in quality improvement initiatives to enhance the efficiency and effectiveness of patient care delivery.

Required Education:
- Current Registered Nurse (RN) license in the state of Florida or Florida Licensure as a clinical social worker, mental health counselor, or marriage and family therapist. Master's degree preferred.
Required Experience:
- Minimum of 3 years of clinical nursing experience, social work, or psychology preferably in a behavioral health or psychiatric setting.
- Minimum of 3 years of experience in utilization review or case management within a hospital and/or behavioral health.
- 3+ years of supervisory or management experience required.
Required Skills and Abilities:
- Strong understanding of utilization review processes and healthcare regulations.
- Excellent analytical skills to assess patient care needs and determine appropriate levels of service.
- Proficient in electronic medical records (EMR) systems and healthcare management software.
- Exceptional communication and interpersonal skills to collaborate with healthcare providers, patients, and insurance companies.
- Ability to lead and motivate a team, ensuring compliance with organizational policies and procedures.
- Detail-oriented with strong organizational skills to manage multiple cases simultaneously.
- Ability to handle sensitive information with confidentiality and professionalism.

LifeStream Benefits

  • Health/Dental/Vision Insurance
  • Short Term Disability
  • Pension Plan
  • 403(b)
  • PTO  (Over 4 weeks your 1st year!)
  • Flexible Work Schedules
  • Tuition Reimbursement Program
  • Free Telehealth Services
  • HRSA
  • And More!

Important Notice 
As part of our hiring process and in compliance with Section435.04, Florida Statutes, certain positions require a Level2 background screening. Employment offers are contingent upon meeting applicable requirements. For more details on Level 2 background screening requirements, please visit: Florida Care Provider Background Screening Clearinghouse  

LifeStream is an equal opportunity employer and does not discriminate against any applicant based on age, citizenship, color, covered veteran status, disability, gender identity, genetic information, marital status, race, religion, sex, sexual orientation, or other protected status in accordance with applicable federal, state, and local laws.  

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