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Utilization Review Rn Jobs in Richmond, VA (NOW HIRING)

Syra Health

ACT Registered Nurse

Petersburg, VA · On-site

Audit physician orders for medication changes, lab work, informed consents, and AIMS utilization ... Participate in daily staff organizational meetings, treatment planning reviews, and shift ...

Eutis Staffing

Registered Nurse (RN)

Richmond, VA · On-site

Note: Please review the remarks section. Registered Nurses (RNs) are responsible for providing comprehensive nursing care within adult institutions, utilizing the nursing process of assessment ...

Brookside Rehab and Nursing

Registered Nurse

Richmond, VA · On-site

$38 - $43.45/hr

) Registered Nurses (RNs) - Be the Heart of Skilled Care! Forest Hill Health and Rehabilitation ... pay reviews • Support for personal well-being (EAP programs, mental health resources) • ...

Brookside Rehab and Nursing

Registered Nurse

Richmond, VA · On-site

$38 - $43.45/hr

) Registered Nurses (RNs) - Be the Heart of Skilled Care! Rosedale Health and Rehabilitation ... Annual performance reviews and competitive bi-annual pay reviews * Support for personal well-being ...

Brookside Rehab and Nursing

Registered Nurse

Richmond, VA · On-site

$38 - $43.45/hr

) Registered Nurses (RNs) - Be the Heart of Skilled Care! Shalom Gardens Health and Rehab | Richmond ... Annual performance reviews and competitive bi-annual pay reviews * Support for personal well-being ...

Brookside Rehab and Nursing

Registered Nurse

Henrico, VA · On-site

$38 - $43.45/hr

Registered Nurses (RNs) - Be the Heart of Skilled Care! Shalom Gardens Health and Rehab | Richmond ... Annual performance reviews and competitive bi-annual pay reviews * Support for personal well-being ...

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Showing results 21-40

All JobsUtilization Review Rn JobsUtilization Review Rn Jobs in Richmond, VA

Utilization Review Rn information

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$41

$68

How much do utilization review rn jobs pay per hour?

As of Aug 9, 2026, the average hourly pay for utilization review rn in Richmond, VA is $41.94, according to ZipRecruiter salary data. Most workers in this role earn between $33.12 and $48.17 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 are the most commonly searched types of Utilization Review Rn jobs in Richmond, VA? The most popular types of Utilization Review Rn jobs in Richmond, VA are:
What are popular job titles related to Utilization Review Rn jobs in Richmond, VA? For Utilization Review Rn jobs in Richmond, VA, the most frequently searched job titles are:
What job categories do people searching Utilization Review Rn jobs in Richmond, VA look for? The top searched job categories for Utilization Review Rn jobs in Richmond, VA are:
What cities near Richmond, VA are hiring for Utilization Review Rn jobs? Cities near Richmond, VA with the most Utilization Review Rn job openings:
Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Richmond, VA as of August 2026, with employment types broken down into 4% As Needed, 72% Full Time, 20% Part Time, and 4% Contract. Highlights an 94% In-person, 2% Hybrid, and 4% Remote job distribution, with an average salary of $87,231 per year, or $41.9 per hour.

Registered Nurse Navigator (RN), Structural Heart - Cardiac Surgery at St. Mary's & Memorial Regiona

Bon Secours

Mechanicsville, VA • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 12 days ago

Job description

Thank you for considering a career at Bon Secours!
Scheduled Weekly Hours:
40
Work Shift:
Days (United States of America)
As a faith-based and patient-focused organization, Bon Secours exists to enhance the health and well-being of all people in mind, body and spirit through exceptional patient care. Success in this goal requires a culture of compassion, collaboration, excellence and respect. Bon Secours seeks people that are committed to our values of compassion, human dignity, integrity, service and stewardship to create an environment where associates want to work and help communities thrive.
Registered Nurse (RN) Navigator, Structural Heart - St. Mary's and Memorial Regional
Job Summary:
The RN Navigator provides essential support to patients by guiding them through the healthcare system, ensuring they have access to necessary resources, and helping them manage all aspects of their care journey. This role involves assisting patients in understanding their medical condition(s) and treatment plans, including assisting patients with scheduling, overcoming logistical barriers, and connecting them with community resources to ensure a smooth and supportive healthcare experience. Navigators may work in a specific specialty area (ex: oncology, women's/breast health, cardiology, neuro, etc.) based on organizational/patient needs and clinical background, to provide focused patient navigation support.
Essential Functions:
  • Guides patients in understanding their diagnoses, treatment options, and the healthcare process, including developing patient education programs and tools.
  • Serves as the essential link for communication and assessment between patients and all care providers.
  • Coordinates and advocates for care across multidisciplinary teams, ensuring that all medical, social, and psychological needs are addressed. This may involve scheduling multidisciplinary planning conferences, developing concise patient summaries for use by the care team, and documenting recommendations using standardized protocols in accordance with nationally recognized care guidelines.
  • Monitors patient progress and communicates with the care team to adjust treatment plans as necessary.
  • Facilitates appointments for consultations and support services within established service standards, including social workers, dietitians, physicians, etc.
  • Participates in patient education programs, community outreach, and quality improvement initiatives.
  • Tracks patient outcomes, ensuring findings are communicated to patient/providers. May also prepare reports to support quality initiatives and programs.

This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Employees may be required to perform other job-related duties as required by their supervisor, subject to reasonable accommodation.
Education:
Bachelor's degree in nursing (preferred)
Licensure/Certification:
  • Licensed Registered Nurse in state of practice (required)
  • BLS Basic Life Support - American Heart Association (preferred upon hire, must obtain from approved source prior to direct patient care at BSMH; required at hire for RSFH)
  • Oncology Nurse Navigator - Certified Generalist (ONN-CG) - Academy of Oncology Nurse & Patient Navigators (preferred, if placed in Oncology department)
  • Breast Health Clinical Navigator (BHCN) - National Consortium of Breast Centers (NCBC) (preferred, if placed in Mammography department)

Experience:
3 years of direct patient care experience as an RN (required)
Experience with discharge planning or utilization review (preferred)
Range:
Minimum: $38.63
Maximum: $61.82
Bon Secours is an equal opportunity employer.
As a Bon Secours associate, you're part of a Mission that matters. We support your well-being - personally and professionally. Our benefits are built to grow with you and meet your unique needs, every step of the way.
What we offer
  • Competitive pay, incentives, referral bonuses and 403(b) with employer contributions (when eligible)
  • Medical, dental, vision, prescription coverage, HSA/FSA options, life insurances, mental health resources and discounts
  • Paid time off, parental and FMLA leave, short- and long-term disability, backup care for children and elders
  • Tuition assistance, professional development and continuing education support

Benefits may vary based on the market and employment status.
Department:
Bon Secours Cardiac Surgery - St. Mary's
It is our policy to abide by all Federal and State laws, as well as, the requirements of 41 CFR 60-1.4(a), 60-300.5(a) and 60-741.5(a). Accordingly, all applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you'd like to view a copy of the affirmative action plan or policy statement for Mercy Health- Youngstown, Ohio or Bon Secours - Franklin, Virginia; Petersburg, Virginia; and Emporia, Virginia, which are Affirmative Action and Equal Opportunity Employer, please email recruitment@mercy.com. If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at recruitment@mercy.com.
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About Bon Secours

Sourced by ZipRecruiter

As a faith-based and patient-focused organization, Bon Secours exists to enhance the health and well-being of all people in mind, body and spirit through exceptional patient care. Success in this goal requires a culture of compassion, collaboration, excellence and respect. Bon Secours seeks people that are committed to our values of compassion, human dignity, integrity, service and stewardship to create an environment where associates want to work and help communities thrive.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Marriottsville, MD, US

Year founded

1983

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