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Utilization Review Rn Jobs in Sarasota, FL (NOW HIRING)

RN Cancer Guides

Oncology Nurse Advocate

Bradenton, FL · On-site

Current Florida RN or NP Preferred: BSN or MSN, Case Management Certification, utilization review experience Knowledge/Skills/Abilities * Strong computer skills, including Microsoft Office * Must be ...

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Utilization Review Rn information

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How much do utilization review rn jobs pay per hour?

As of Aug 11, 2026, the average hourly pay for utilization review rn in Sarasota, FL is $40.75, according to ZipRecruiter salary data. Most workers in this role earn between $32.21 and $46.78 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 Sarasota, FL? The most popular types of Utilization Review Rn jobs in Sarasota, FL are:
What are popular job titles related to Utilization Review Rn jobs in Sarasota, FL? For Utilization Review Rn jobs in Sarasota, FL, the most frequently searched job titles are:
What job categories do people searching Utilization Review Rn jobs in Sarasota, FL look for? The top searched job categories for Utilization Review Rn jobs in Sarasota, FL are:
What cities near Sarasota, FL are hiring for Utilization Review Rn jobs? Cities near Sarasota, FL with the most Utilization Review Rn job openings:
Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Sarasota, FL as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 16% Part Time, and 2% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $84,756 per year, or $40.7 per hour.

Oncology Nurse Advocate

RN Cancer Guides

Bradenton, FL • On-site

Contractor

Re-posted yesterday

Job description

Company Description
RN Cancer Guides' mission is to provide compassionate professional oncology nursing guidance to patients and their families through their cancer journey. Based out of Tampa, FL, we are a small, fast-growing team of Oncology Nurses who assist cancer patients and their caregivers while they attempt to navigate the complex healthcare system.
Job Description
Work directly with Bradenton/Sarasota clients to help them coordinate their cancer care and navigate the healthcare system. Committed and passionate about changing the way cancer patients and their caregivers experience cancer care by empowering them to make informed decisions and give them peace of mind knowing that a qualified oncology nurse is on their side helping to guide them through their journey with cancer.
Essential Responsibilities
  • Interview patients and their loved ones to identify issues relating to their medical care
  • Assist clients or their caregivers with developing scope of services with clearly stated goals and objectives
  • Assist clients with general healthcare coordination across multiple providers and facilities
  • Act as a liaison between clients and their healthcare team, and serve as their advocate to ensure clients are well-informed and active participants in their own healthcare
  • Help clients understand their medical conditions and treatment options
  • Develop and implement action plans to help clients reach their goals
  • Provide clients with well-researched healthcare options (doctors, facilities, treatment, clinical trials, and other community services and resources available)
  • Coordinate appointments, care, including compiling medical records for upcoming medical appointments
  • Maintain HIPAA standards regarding confidentiality of highly sensitive patient information and perform all activities with discretion

Qualifications
Education: Graduate from accredited nursing school
Experience: At least 5 years of clinical experience as a Registered Nurse in Oncology. Experience in case management, discharge planning, eligibility or membership, utilization management.
Certifications: Oncology Certified Nurse (OCN)
Licensure: Current Florida RN or NP
Preferred: BSN or MSN, Case Management Certification, utilization review experience
Knowledge/Skills/Abilities
  • Strong computer skills, including Microsoft Office
  • Must be possess strong customer service skills
  • Must have excellent interpersonal, verbal and written communication skills, and compassion
  • Familiarity with online research tools

Additional Information
All your information will be kept confidential according to EEO guidelines.

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