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Utilization Review Rn Jobs in Phoenix, AZ (NOW HIRING)

Utilization Review Nurse

Tempe, AZ · Remote

$35 - $45.94/hr

We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... Active, unrestricted RN licensure from the United States in [state], OR, active compact multistate ...

Case Manager/Utilization Review Nurse At The CORE Institute, we are dedicated to taking care of you ... A current and unrestricted Arizona Registered Nurse (RN) license. * Certification in Health Care ...

A Case Manager/Utilization Review Nurse, in collaboration with patients/families, physicians and ... A current and unrestricted Arizona Registered Nurse (RN) license. * Certification in Health Care ...

Responsibilities Utilization Review Manager (URM) Position: Full-Time Shift: Daytime This position ... Bachelor's degree from an accredited college/university in social work, mental health, or nursing ...

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Utilization Review Rn information

See Phoenix, AZ salary details

$21

$41

$68

How much do utilization review rn jobs pay per hour?

As of Aug 7, 2026, the average hourly pay for utilization review rn in Phoenix, AZ is $41.98, according to ZipRecruiter salary data. Most workers in this role earn between $33.17 and $48.22 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 cities near Phoenix, AZ are hiring for Utilization Review Rn jobs? Cities near Phoenix, AZ with the most Utilization Review Rn job openings:
Infographic showing various Utilization Review Rn job openings in Phoenix, AZ as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 14% Part Time, and 3% Contract. Highlights an 90% Physical, 3% Hybrid, and 7% Remote job distribution, with an average salary of $87,323 per year, or $42 per hour.

Utilization Review Registered Nurse, Care Coordinator

US Department of Veterans Affairs

Phoenix, AZ • On-site

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 4 days ago


U.S. Department Of Veterans Affairs rating

8.1

Company rating: 8.1 out of 10

Based on 670 frontline employees who took The Breakroom Quiz

46th of 289 rated public sector bodies


Job description

Utilization Review Registered Nurse

The Utilization Review (UR) Registered Nurse (RN) is responsible for providing competent, evidence-based care to assigned patients. Provides patient management, care coordination, and discharge/disposition planning for inpatient and outpatient settings. The UR RN assists Veterans, family members, and caregivers with receiving the most appropriate options and services to meet their complex health care needs. This includes, but is not limited to, acute, chronic, multiple, complex, catastrophic, or life-threatening illnesses; combat stress, residuals of traumatic brain injury; community adjustment; addictions and other health problems. Coordinates care with multiple providers across all levels and sites of care. The UR RN addresses psychosocial, as well as nursing and medical needs of patients and their families/caregivers, through participation in interdisciplinary patient care management practice. The UR RN also evaluates care and outcomes to ensure timely and appropriate provision of services. Demonstrates leadership in delivering and improving holistic care through collaborative strategies with others. Evaluates practice in an ongoing process, based on best evidence. Provides peers with informal constructive feedback for improvement. Fosters a safe and supportive environment conducive to the professional development of healthcare professionals. Contributes professional nursing perspective in discussions with the interdisciplinary team. Partners with others to effect change and produce optimal outcomes. Supports colleagues through UR knowledge sharing to provide safe, quality nursing care. Shares educational findings, experiences, and ideas with peers. Questions clinical practices for the purpose of providing evidence-based VA offers a comprehensive total rewards package: VA Nurse Total Rewards Pay Competitive salary, regular salary increases, potential for performance awards Paid Time Off 50 days of paid time off per year (26 days of annual leave, 13 days of sick leave, 11 paid Federal holidays per year) Retirement Traditional federal pension (5 years vesting) and federal 401K with up to 5% in contributions by VA Insurance Federal health/vision/dental/term life/long-term care (many federal insurance programs can be carried into retirement) Licensure 1 full and unrestricted license from any US State or territory Work Schedule 0700-1530 Telework Not available Virtual This is not a virtual position. Permanent Change of Station (PCS) Not authorized 30 Day Hiring Model The Department of Veterans Affairs is implementing a streamlined 30-Day Hiring Model designed to accelerate hiring while maintaining the highest standards of merit-based selection. This improved process reduces traditional hiring timelines by integrating early coordination, faster assessments, and efficient pre-employment actions. Applicants can expect a more transparent, predictable, and efficient hiring journey from announcement to entry on duty. What Applicants Can Expect Expedited Candidate Review Once the announcement closes, Human Resources will quickly review applications, issue certificates of eligible candidates the day after the announcement closes and refer applicants for hiring manager consideration. Quick Interviews & References HR may arrange interviews and will request references within 3-5 days after being referred to the hiring manager. Streamlined Pre-Employment Requirements: Following a tentative offer, applicants should be prepared to complete required steps, such as fingerprinting and background check, credentialing, and medical examination within 3 days of the offer. Clear and Timely Communication: Applicants will receive clear communication at key milestones, including referral, tentative offer, and onboarding instructions. After meeting pre-employment requirements, candidates will receive a final job offer and start date. Onboarding tasks may continue after starting, with HR ensuring timely completion for a smooth transition into VA service. If selected, applicants should be prepared to come onboard within 30 days of the announcement closing.


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