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

Amedisys, Inc.

RN Clinical Manager

Roseburg, OR

$90K - $120K/yr

Reviews requests for services and determines patient eligibility/suitability for home care services ... One year of clinical RN experience in home health or hospice. * One year of RN management ...

Amedisys, Inc.

RN Clinical Manager

Roseburg, OR · On-site

$90K - $120K/yr

Reviews requests for services and determines patient eligibility/suitability for home care services ... Current RN license, specific to the state(s) you are assigned to work. * One year of clinical RN ...

Host Healthcare

RN - Labor and Delivery

Roseburg, OR · On-site

S. with an immediate option for this RN position in Roseburg, OR. Sign-up here to submit your ... Reviews FROM REAL HOST HEALTHCARE TRAVELERS: "Host is the best travel agency. We have been using ...

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

Utilization Review Rn information

See Remote, OR salary details

$21

$42

$68

How much do utilization review rn jobs pay per hour?

As of Jun 21, 2026, the average hourly pay for utilization review rn in Remote, OR is $42.24, according to ZipRecruiter salary data. Most workers in this role earn between $33.37 and $48.51 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 Remote, OR? The most popular types of Utilization Review Rn jobs in Remote, OR are:
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What job categories do people searching Utilization Review Rn jobs in Remote, OR look for? The top searched job categories for Utilization Review Rn jobs in Remote, OR are:
What cities near Remote, OR are hiring for Utilization Review Rn jobs? Cities near Remote, OR with the most Utilization Review Rn job openings:
Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Remote, OR as of June 2026, with employment types broken down into 88% Full Time, 9% Part Time, and 3% Contract. Highlights an 86% Physical, 2% Hybrid, and 12% Remote job distribution, with an average salary of $87,860 per year, or $42.2 per hour.
Registered Nurse RN - Avamere Rehab of Coos Bay

Registered Nurse RN - Avamere Rehab of Coos Bay

Avamere Living

Coos Bay, OR

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 24 days ago

Avamere rating

6.0

Company rating: 6.0 out of 10

Based on 53 frontline employees who took The Breakroom Quiz

110th of 228 rated social care providers

Job description

Registered Nurse - RN 

Setting: Skilled Nursing

Status: Full-Time, Part-Time or PRN 

Schedules Needed:

Day Shift -LPN or RN

Friday – Sunday

NOC Shift- LPN or RN either

PRN

Full-Time Sunday – Wednesday

Location:  Avamere Rehab of Coos Bay - 2625 Koos Bay Blvd. Coos Bay, OR 97420

Apply now at TeamAvamere.com

    At Avamere, we believe in taking care of our employees. We offer a comprehensive benefits package that includes:

    •  Health Insurance: Comprehensive medical, dental, and vision plans. Low individual and family deductible. 
    • 401 (k) Plan: After 90 days of employment, with matching program.
    • Paid Time Off (PTO): Accrue up to 4 weeks PTO per year, 6 holidays and accrued sick leave.
    • EAP Canopy with unlimited telehealth mental health visits.
    • Continuing Education and Higher Education Reimbursement.
    • Generous employee referral bonus program.
    • Flexible Spending Accounts & CERA: Medical FSA, Dependent Care FSA and CERA (Commuter Expense Reimbursement Account).
    • Professional Development: Opportunities for growth and development within the company.
    • Voluntary Benefits: Life insurance, disability coverage, supplemental hospital, accident and critical illness coverage, Legal Services, Pet Insurance, discount programs and more.

    Responsibilities:

    • Implement and maintain established nursing practice objectives and standards; Provide direct patient care to residents.
    • Complete required recordkeeping while admitting, transferring, and discharging residents.
    • Coordinate with nursing staff and support personnel daily to plan shift services, programs, and activities to ensure the resident’s total regimen of patient care is maintained.
    • Prepare and administer medications and review medication cards for completeness and accuracy.
    • Review patient care plans for appropriate resident goals, problems, approaches, and revisions based on nursing needs.
    • Supervise the day-to-day nursing and caregiving activities performed by CNAs.
    • Chart nurses’ notes in an informative and descriptive manner that reflects the care provided to the resident and resident’s response to care.
    • Participate in facility surveys by authorized government agencies.
    • Maintain confidentiality of all resident care information in accordance with HIPAA guidelines.

    Qualifications:

    • Must possess a nursing degree from an accredited college or university.
    • Must possess a current, unencumbered, active license to practice as a RN in this state.
    • Knowledgeable of nursing and medical practices and procedures, as well as laws, regulations and guidelines that pertain to nursing care facilities.
    • Must chart nurses’ notes in an informative and descriptive manner that reflects the care provided to the resident and resident’s response to care.
    • Experience with Electronic Medical Records and computer documentation systems.
    • Effective communication, organization and prioritization skills.
    • Customer service skills/experience required.
    • Knowledge of reimbursement programs, Medicare and Medicaid preferred.
    • Maintain confidentiality of all resident care information in accordance with HIPAA guidelines.
    • Must be able to read, write and speak English fluently.
    • Must have an active CPR/BLS certification

    Avamere is an Equal Opportunity Employer and participates in E-Verify

    #clinical95

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