ZipRecruiter

Log In

1

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

previous pagenext page

Showing results 21-40

All JobsUtilization Review Rn JobsUtilization Review Rn Jobs in Pittsburgh, PA

Utilization Review Rn information

See Pittsburgh, PA salary details

$20

$41

$66

How much do utilization review rn jobs pay per hour?

As of Aug 17, 2026, the average hourly pay for utilization review rn in Pittsburgh, PA is $41.05, according to ZipRecruiter salary data. Most workers in this role earn between $32.45 and $47.16 per hour, depending on experience, location, and employer.

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.

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.

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 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 are the most commonly searched types of Utilization Review Rn jobs in Pittsburgh, PA?

The most popular types of Utilization Review Rn jobs in Pittsburgh, PA are:

What are popular job titles related to Utilization Review Rn jobs in Pittsburgh, PA?

For Utilization Review Rn jobs in Pittsburgh, PA, the most frequently searched job titles are:

What job categories do people searching Utilization Review Rn jobs in Pittsburgh, PA look for?

The top searched job categories for Utilization Review Rn jobs in Pittsburgh, PA are:

What cities near Pittsburgh, PA are hiring for Utilization Review Rn jobs?

Cities near Pittsburgh, PA with the most Utilization Review Rn job openings:

Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Pittsburgh, PA as of August 2026, with employment types broken down into 81% Full Time, and 19% Part Time. Highlights an 100% In-person job distribution, with an average salary of $85,380 per year, or $41 per hour.

RN Case Manager - Home Health

Interim HealthCare

Greensburg, PA • On-site

Full-time

Re-posted 20 days ago

Job description

Description

Status: Full-time

Salary: 80K - 95K

Territory: Westmoreland County and East end Pittsburgh

Our Registered Nurse Case Managers (RNCM) have been called to care when they're needed most. At Interim HealthCare, you'll support a full range of patient services to bring comfort and dignity to our clients.


What we offer our Registered Nurse Case Managers (RNCM):

  • Competitive pay, benefits, and incentives.
  • Truly flexible scheduling - a dedication to work/life balance - Full-time/ Part-time / PRN / Weekends
  • Daily Pay option available
  • No Overtime Required
  • 1:1 patient care

Working at Interim HealthCare means a career unlike any other. With integrity at the center of all we do, we know that when we support you and your community, you'll change lives every day.


As a Registered Nurse Case Manager (RNCM), you will:

  • Conduct In Person patient interviews and comprehensive physical assessments.
  • Oversee the implementation and ongoing assessment of the patient's plan of care through the management of home health aides, LPNs, RNs, and other caregivers.
  • Communicate patient conditions and collaborate with appropriate providers to deliver care when patient needs evolve.
  • Provide education to patients and families on proper home health care procedures. Ie. Wound care, IV administration, medication management.
  • Work to decrease readmissions by promoting preventative care and ensuring continuity of care.

To qualify as a Registered Nurse Case Manager (RNCM) position with us, you will need:

  • Licensure: Current unrestricted license to practice as a Registered Nurse (RN) in the state associated with this position
  • Current CPR/AED/BLS/First Aid certification
  • Reliable transportation to/from care sites and/or work locations.
  • One (1) year of professional experience practicing as a Registered Nurse (RN) in home health or similar setting; previous case management/utilization review experience preferred.
  • OASIS experience preferred.

At Interim HealthCare, we know that being our best is non-negotiable - that's why we treat your family like our own. We take a patient-centric approach to address each individual's mind, body, and spirit, our caregivers work tirelessly to help their patients and families find peace. From our unmatched referral response times to our focus on quality improvement, the most beautifully complicated time of your life is our life's work.


We're an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran, or disability status.

#PITT1

Apply