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Utilization Review Rn Jobs in Portland, OR (NOW HIRING)

Moda Health

RN Care Coordinator

Portland, OR · On-site

... and maintain RN audit scores at or above the 90% benchmark. * Applies clinical expertise and ... Utilization Review and Service Authorizations for members of assigned employer groups. * Consults ...

Adventist Health

Chart Auditor (Portland)

Portland, OR · On-site

$52.55 - $78.77/hr

Prior experience in utilization review, case management, coding, or clinical auditing: Preferred Licenses/Certifications: * Current licensed RN in the state of practice (RN), medical provider (MD ...

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All JobsUtilization Review Rn JobsUtilization Review Rn Jobs in Portland, OR

Utilization Review Rn information

See Portland, OR salary details

$22

$44

$73

How much do utilization review rn jobs pay per hour?

As of Jun 21, 2026, the average hourly pay for utilization review rn in Portland, OR is $44.84, according to ZipRecruiter salary data. Most workers in this role earn between $35.43 and $51.49 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.

How do I become a utilization review RN?

To become a utilization review RN, you typically need to hold a valid registered nurse (RN) license and have experience in clinical nursing. Additional certifications such as the Certified Professional in Healthcare Quality (CPHQ) or Utilization Review Certification (URAC) can enhance job prospects, and strong knowledge of medical coding, insurance policies, and healthcare regulations is important.

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 does an RN utilization review do?

An RN utilization review evaluates medical records and treatment plans to determine the appropriateness, necessity, 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.

How to make $300,000 a year as a nurse?

To earn $300,000 annually as a Utilization Review RN, professionals typically need extensive experience, advanced certifications such as CCM or ANCC, and may work in high-paying settings like insurance companies or healthcare consulting firms. Increasing specialization, taking on leadership roles, or working overtime can also boost income, but reaching this level often requires a combination of skills, experience, and strategic career moves.

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 CCM or ANCC, and working in high-paying settings like insurance companies or managed care organizations. Advanced skills in case management, strong clinical knowledge, and sometimes working overtime or in leadership roles can also contribute to higher earnings.

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 Portland, OR? The most popular types of Utilization Review Rn jobs in Portland, OR are:
What are popular job titles related to Utilization Review Rn jobs in Portland, OR? For Utilization Review Rn jobs in Portland, OR, the most frequently searched job titles are:
What job categories do people searching Utilization Review Rn jobs in Portland, OR look for? The top searched job categories for Utilization Review Rn jobs in Portland, OR are:
What cities near Portland, OR are hiring for Utilization Review Rn jobs? Cities near Portland, OR with the most Utilization Review Rn job openings:
Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Portland, OR as of June 2026, with employment types broken down into 88% Full Time, 10% Part Time, and 2% Contract. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution, with an average salary of $93,268 per year, or $44.8 per hour.
Travel RN Case Manager

Travel RN Case Manager

American Traveler

Portland, OR

Contractor

Medical, Dental, Vision, Life, Retirement

Posted 16 days ago

Job description

American Traveler is seeking a travel nurse RN Case Management for a travel nursing job in Portland, Oregon.

Job Description & Requirements
  • Specialty: Case Management
  • Discipline: RN
  • Start Date: 07/07/2026
  • Duration: 13 weeks
  • 40 hours per week
  • Shift: 8 hours, days
  • Employment Type: Travel
Assignment Overview
  • Shift: Days, 5x8hrs
  • Hours: 40 hrs/wk
  • Start Date: Jul 7, 2026
  • Length: 13 weeks
  • Openings: 1
Description

American Traveler is hiring an experienced RN Case Manager for an acute care hospital position in Oregon, requiring at least 2 years of inpatient case management experience and an active OR RN license.

Details
  • Short-term acute care hospital setting, Magnet-designated, teaching facility, and Level I Trauma Center
  • Case Management unit supporting adult inpatient and ED populations
  • Patient caseload ratio of approximately 1:20-25
  • Day shift, 5x8-hour shifts (7:00 AM – 3:30 PM), with variable weekend requirements
  • Start dates for this unit fall on Tuesdays
  • Floating required to adult inpatient, ED, and pediatrics within scope; refusal to float may result in contract cancellation, including to a nearby affiliate hospital
  • Block scheduling may be available upon request
  • No on-call requirements
  • Charting system: Epic (highly preferred but not required)
  • Local candidates are accepted
Requirements
  • Active Oregon (OR) RN license required; pending license accepted if application has been submitted and received by the licensing board to qualify for the 90-day license exemption
  • Current BLS and ACLS certifications required
  • Minimum 2 years of acute, inpatient, hospital case management experience within the last 5 years required
  • Experience in inpatient medical/surgical, ED, and pediatric settings required
  • Epic experience highly preferred
  • Travel nursing experience preferred
  • Two manager or supervisor references from within the last 24 months required for consideration; charge RN references are not acceptable
  • Proof of COVID vaccination required; no exemptions accepted
Additional Information
  • Provides RN case management services across adult inpatient and ED settings
  • First-time travelers are welcome to apply
  • Candidates who were previously employed at or on assignment with this health system must have been away for at least 6 months to be eligible to return as a traveler
  • Former employees or previous travelers at this facility must provide a reference from the OHSU manager who supervised them
  • RTO is limited to 7–10 days maximum and must be added to the end of the contract to make up for time off
  • Scrubs may be any solid color (no prints); scrubs are provided
  • Daily parking is available for $16 (required 8:00 AM–5:00 PM only); public transportation is highly encouraged
  • Contract length is 13 weeks minimum; interest in a longer assignment should be communicated

American Traveler Job ID #P-722282. Pay package is based on 8 hour shifts and 40 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: Travel RN - Case Management/Utilization Review - Case Management

About American Traveler

With over 25 years of experience, American Traveler has established a reputation for outstanding customer service. Our team ensures a smooth, worry-free experience for those starting on or expanding their travel nursing and allied careers.

With thousands of travel nursing and allied jobs nationwide, our attentive and approachable recruiters find positions that align perfectly with your career aspirations and personal requirements.

American Traveler offers exceptional benefits, including premium medical, dental, vision and life insurance beginning day one of your assignment, generous 401(k) match, substantial housing stipends, and more. Additionally, with 24/7 support and access to our in-house clinicians, you are assured confidence and comfort throughout your assignment.

With our team behind you, you can relax and enjoy a rewarding travel career.

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