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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

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 ...

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 ...

Adventist Health

Chart Auditor (Portland)

Portland, OR · On-site

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 Jul 14, 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 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 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 July 2026, with employment types broken down into 10% As Needed, 70% Full Time, 5% Part Time, 10% Contract, and 5% Nights. Highlights an 90% In-person, and 10% Remote job distribution, with an average salary of $93,268 per year, or $44.8 per hour.
RN, House Supervisor, Part Time, Night Shift

RN, House Supervisor, Part Time, Night Shift

Adventist Health

Portland, OR • On-site

$53.61 - $80.34/hr

Part-time, Other

Posted 28 days ago

Adventist Health rating

7.8

Company rating: 7.8 out of 10

Based on 241 frontline employees who took The Breakroom Quiz

131st of 884 rated healthcare providers

Job description


Adventist Health Portland has been caring for East Portland since 1893, growing alongside the community we serve. Today, more than 2,300 employees are dedicated to whole-person care, mind, body and spirit, across our 302-bed medical center, emergency department, and network of clinics, urgent care, home care and hospice services. The Adventist Health Northwest Heart Center, located on our medical center campus, provides advanced cardiovascular care, bringing together expert providers, innovative treatments and compassionate support for patients across the region.
Job Summary:
Provides overall supervision of the organization in collaboration with and in the absence of the administrative/executive team. Makes administrative decisions, collaborates with the Nursing Directors and other departments, ensures patient and staff safety, and oversees the functioning of the organization. Assists with/facilitates clinical functions. Supervises and directs the activities of various levels of assigned personnel using both professional and supervisory discretion and independent judgment.
Job Requirements:
Education and Work Experience:
  • Bachelor's Degree in nursing or equivalent combination of education/related experience: Required
  • Master's Degree: Preferred
  • Five years' technical experience: Preferred
  • One year's experience working in a critical care setting: Preferred

Licenses/Certifications:
  • Registered Nurse (RN) licensure in the state of practice: Required
  • Cardiopulmonary Resuscitation (CPR) certification or Basic Life Support (BLS) certification from approved vendor per AH policy: Required
  • Advanced Cardiovascular Life Support (ACLS) certification from approved vendor per AH policy: Required for all facilities, except Behavioral Health
  • Clinical specialty and/or nursing administration certification: Preferred

Facility Specific License/Certifications:
  • AHA-BLS or ARC-BLS or AHA-CPR or ARC-CPR: Required
  • AHA-ACLS or ARC-ALS: Required

Essential Functions:
  • Supervises nursing personnel and operations by making rounds on a regular basis. Assesses routine and non-routine conditions of patients through identification of symptoms and behavioral changes, reviewing histories of physiological/psychological, cultural and spiritual information, reviewing medical data such as medical history, physical exams, plan of care, etc. Works with staff in unusual cases to develop a prioritized interdisciplinary plan of care. May assist staff to revise the plan of care to meet changing needs of patients, making appropriate referrals, i.e. dietary, spiritual care, etc. Responds to all acute unit codes. Attends to medical emergencies for inpatients. Works with other area supervisors when needed to provide advice or assistance.
  • Facilitates hospital throughput including providing resources, managing bed placement, and patient transfers/discharges. Coordinates "bed huddles" as needed. Participates in discharge planning with patients, physicians, social workers, patient education, utilization review and other personnel as appropriate.
  • Supervises professional and ancillary personnel. Assists with orientation and training of registry/traveler staff, new and existing employees, assisting them in learning department routines, policies and procedures, etc. Supervises the quality and effectiveness of patient care delivered throughout the Hospital, using such methods as: direct observation, rounds, reviewing reports, checking documentation in the medical record, and exerting influence and giving direction to employees as needed. Ensures compliance of team with applicable laws, rules and regulations.
  • Maintains and adjusts unit-based staffing in order to meet patient needs, while observing regulatory mandates, budget guidelines and needs throughout the hospital.
  • Evaluates employee, patient, family, and physician complaints. Responds courteously and promptly and resolves problems within the scope of delegated authority, consulting with administration as required. In the review of patient conditions, works with patients, family, physician, and healthcare team members in order to maintain standards of acceptable quality care.
  • Performs other job-related duties as assigned.

Organizational Requirements:
Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply.
Adventist Health participates in E-Verify. Visit https://adventisthealth.org/careers/everify/ for more information about E-Verify. By choosing to apply, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand the contents therein.
About Us
Adventist Health is a faith-based, nonprofit, integrated health system serving more than 100 communities on the West Coast and Hawaii with over 440 sites of care, including 27 acute care facilities. Founded on Adventist heritage and values, Adventist Health provides care in hospitals, clinics, home care, and hospice agencies in both rural and urban communities. Our compassionate and talented team of more than 38,000 includes employees, physicians, Medical Staff, and volunteers driven in pursuit of one mission: living God's love by inspiring health, wholeness and hope.

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