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

Turning Point Plans

Clinical Review Nurse

Lake Mary, FL · On-site

As a Utilization Review Nurse, you will utilize your critical thinking skills, clinical expertise ... Licensed Nurse Practitioner (LPN) or Registered Nurse (RN) required * Comprehensive knowledge of ...

St. Francis Hospice

APRN

Titusville, FL · On-site

Responsibilities include participation in medical staff coverage rotation, clinical quality assurance, pharmacy and utilization review, and performance improvement activities. An APRN degree with an ...

Insight Global

RN Care Manager

Apopka, FL · On-site

$75K - $90K/yr

Insight Global is seeking a Care Manager (RN) for a top healthcare services client. This individual ... Experience in care management, utilization review, or discharge planning * Strong knowledge of ...

New

Solaris Healthcare College Park

RN Unit Manager

Orlando, FL · On-site

$37 - $49/hr

... and utilization review activities. * Participates in clinical risk identification, strategy ... Education Current R.N. license required with experience in the long term care or working with the ...

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

Utilization Review Rn information

See Orlando, FL salary details

$19

$39

$64

How much do utilization review rn jobs pay per hour?

As of Aug 16, 2026, the average hourly pay for utilization review rn in Orlando, FL is $39.47, according to ZipRecruiter salary data. Most workers in this role earn between $31.20 and $45.34 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 Orlando, FL?

The most popular types of Utilization Review Rn jobs in Orlando, FL are:

What are popular job titles related to Utilization Review Rn jobs in Orlando, FL?

For Utilization Review Rn jobs in Orlando, FL, the most frequently searched job titles are:

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The top searched job categories for Utilization Review Rn jobs in Orlando, FL are:

What cities near Orlando, FL are hiring for Utilization Review Rn jobs?

Cities near Orlando, FL with the most Utilization Review Rn job openings:

Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Orlando, FL as of August 2026, with employment types broken down into 75% Full Time, and 25% Contract. Highlights an 100% In-person job distribution, with an average salary of $82,100 per year, or $39.5 per hour.

Rheumatology - Utilization Review - Remote- 1099 (contract)

MRIoA

Orlando, FL • On-site, Remote

Contractor

Re-posted 7 days ago

Job description

Description
Flexible Independent Contractor (1099) Opportunity
Required State Medical License in Florida or Oregon
ABOUT MRIoA
Founded in 1983, Medical Review Institute of America (MRIoA) is a nationally recognized Independent Review Organization (IRO) specializing in technology-driven utilization management and clinical medical review solutions. We're a leader in Peer and Utilization Reviews, known for excellence and continuous improvement.
THE OPPORTUNITY:
We are currently seeking Board-Certified physicians in Rheumatology to conduct independent Utilization Reviews. This is a flexible, fully remote opportunity requiring just 1-2 hours per week-with no minimum commitment.
ADDITIONAL INFORMATION:
  • Work remotely from anywhere in the US (Per HIPAA Regulations, patient records cannot leave the US).
  • Covered under MRIoA's Errors and Omissions policy.
  • Independent Contractor (1099) opportunity.
  • Workers are required to adhere to all applicable HIPAA regulations and company policies and procedures regarding the confidentiality, privacy, and security of sensitive health information.

Requirements
  • Must have a Medical Degree MD or DO
  • Must have a current STATE medical license in Florida or Oregon
  • Current Board Certification in Rheumatology
  • Must have 5 years of clinical experience residency to be included
  • Daytime availability is required for peer-to-peer conversations

Apply