Managers are looking for candidates with clinical experience from a hospital (Preferred) Min. 2- 3 years clinical nursing experience 1 year of utilization review or medical claim review RN License ...
Managers are looking for candidates with clinical experience from a hospital (Preferred) Min. 2- 3 years clinical nursing experience 1 year of utilization review or medical claim review RN License ...
Min. 2- 3 years clinical nursing experience . * 1 year of utilization review or medical claim review . * RN License Required . * Preferred Experience in one of more of the following areas critical ...
Min. 2- 3 years clinical nursing experience . * 1 year of utilization review or medical claim review . * RN License Required . * Preferred Experience in one of more of the following areas critical ...
Care Review Clinician
Spokane, WA · On-site
Min. 2- 3 years clinical nursing experience. 1 year of utilization review or medical claim review. RN License Required. Preferred experience in one of more of the following areas critical care ...
Care Review Clinician
Spokane, WA · On-site
Min. 2- 3 years clinical nursing experience. 1 year of utilization review or medical claim review. RN License Required. Preferred experience in one of more of the following areas critical care ...
Registered Nurse - Rehab Case Manager
Spokane, WA · On-site
$66K - $128K/yr
Registered Nurse - Rehab Case Manager. Nurses with experience in any of the following areas are ... Utilization Review, or VAD patients. * Shift(s) available: day shift * Job types available ...
Registered Nurse - Rehab Case Manager
Spokane, WA · On-site
$66K - $128K/yr
Registered Nurse - Rehab Case Manager. Nurses with experience in any of the following areas are ... Utilization Review, or VAD patients. * Shift(s) available: day shift * Job types available ...
RNs are supported by a robust, collaborative interdisciplinary team, including Physical Therapy ... Case Management & Utilization Review Nurse * Full-Time Physical Therapy support on day shift
New
RNs are supported by a robust, collaborative interdisciplinary team, including Physical Therapy ... Case Management & Utilization Review Nurse * Full-Time Physical Therapy support on day shift
New
RNs are supported by a robust, collaborative interdisciplinary team, including Physical Therapy ... Case Management & Utilization Review Nurse * Full-Time Physical Therapy support on day shift
New
RNs are supported by a robust, collaborative interdisciplinary team, including Physical Therapy ... Case Management & Utilization Review Nurse * Full-Time Physical Therapy support on day shift
New
RNs are supported by a robust, collaborative interdisciplinary team, including Physical Therapy ... Case Management & Utilization Review Nurse * Full-Time Physical Therapy support on day shift
New
RNs are supported by a robust, collaborative interdisciplinary team, including Physical Therapy ... Case Management & Utilization Review Nurse * Full-Time Physical Therapy support on day shift
New
RNs are supported by a robust, collaborative interdisciplinary team, including Physical Therapy ... Case Management & Utilization Review Nurse * Full-Time Physical Therapy support on day shift
New
RNs are supported by a robust, collaborative interdisciplinary team, including Physical Therapy ... Case Management & Utilization Review Nurse * Full-Time Physical Therapy support on day shift
New
RNs are supported by a robust, collaborative interdisciplinary team, including Physical Therapy ... Case Management & Utilization Review Nurse * Full-Time Physical Therapy support on day shift
New
RNs are supported by a robust, collaborative interdisciplinary team, including Physical Therapy ... Case Management & Utilization Review Nurse * Full-Time Physical Therapy support on day shift
New
RNs are supported by a robust, collaborative interdisciplinary team, including Physical Therapy ... Case Management & Utilization Review Nurse * Full-Time Physical Therapy support on day shift
New
RNs are supported by a robust, collaborative interdisciplinary team, including Physical Therapy ... Case Management & Utilization Review Nurse * Full-Time Physical Therapy support on day shift
New
RNs are supported by a robust, collaborative interdisciplinary team, including Physical Therapy ... Case Management & Utilization Review Nurse * Full-Time Physical Therapy support on day shift
New
RNs are supported by a robust, collaborative interdisciplinary team, including Physical Therapy ... Case Management & Utilization Review Nurse * Full-Time Physical Therapy support on day shift
New
RNs are supported by a robust, collaborative interdisciplinary team, including Physical Therapy ... Case Management & Utilization Review Nurse * Full-Time Physical Therapy support on day shift
New
RNs are supported by a robust, collaborative interdisciplinary team, including Physical Therapy ... Case Management & Utilization Review Nurse * Full-Time Physical Therapy support on day shift
New
RNs are supported by a robust, collaborative interdisciplinary team, including Physical Therapy ... Case Management & Utilization Review Nurse * Full-Time Physical Therapy support on day shift
New
RNs are supported by a robust, collaborative interdisciplinary team, including Physical Therapy ... Case Management & Utilization Review Nurse * Full-Time Physical Therapy support on day shift
New
RNs are supported by a robust, collaborative interdisciplinary team, including Physical Therapy ... Case Management & Utilization Review Nurse * Full-Time Physical Therapy support on day shift
New
RNs are supported by a robust, collaborative interdisciplinary team, including Physical Therapy ... Case Management & Utilization Review Nurse * Full-Time Physical Therapy support on day shift
New
RNs are supported by a robust, collaborative interdisciplinary team, including Physical Therapy ... Case Management & Utilization Review Nurse * Full-Time Physical Therapy support on day shift
New
RNs are supported by a robust, collaborative interdisciplinary team, including Physical Therapy ... Case Management & Utilization Review Nurse * Full-Time Physical Therapy support on day shift
New
RNs are supported by a robust, collaborative interdisciplinary team, including Physical Therapy ... Case Management & Utilization Review Nurse * Full-Time Physical Therapy support on day shift
RNs are supported by a robust, collaborative interdisciplinary team, including Physical Therapy ... Case Management & Utilization Review Nurse * Full-Time Physical Therapy support on day shift
RNs are supported by a robust, collaborative interdisciplinary team, including Physical Therapy ... Case Management & Utilization Review Nurse * Full-Time Physical Therapy support on day shift
New
RNs are supported by a robust, collaborative interdisciplinary team, including Physical Therapy ... Case Management & Utilization Review Nurse * Full-Time Physical Therapy support on day shift
New
RNs are supported by a robust, collaborative interdisciplinary team, including Physical Therapy ... Case Management & Utilization Review Nurse * Full-Time Physical Therapy support on day shift
New
RNs are supported by a robust, collaborative interdisciplinary team, including Physical Therapy ... Case Management & Utilization Review Nurse * Full-Time Physical Therapy support on day shift
New
Prior case management, utilization review, and discharge planning experience preferred * Certified Case Manager (CCM) or Board Certification in Nursing Case Management (RN BC) preferred Specific Job ...
Prior case management, utilization review, and discharge planning experience preferred * Certified Case Manager (CCM) or Board Certification in Nursing Case Management (RN BC) preferred Specific Job ...
Prior case management, utilization review, and discharge planning experience preferred * Certified Case Manager (CCM) or Board Certification in Nursing Case Management (RN BC) preferred Specific Job ...
Prior case management, utilization review, and discharge planning experience preferred * Certified Case Manager (CCM) or Board Certification in Nursing Case Management (RN BC) preferred Specific Job ...
Utilization Review Rn information
See Spokane Valley, WA salary details
$21.42 - $25.75
2% of jobs
$25.75 - $30.08
9% of jobs
$33.04 is the 25th percentile. Wages below this are outliers.
$30.08 - $34.41
21% of jobs
The median wage is $37.92 / hr.
$34.41 - $38.74
23% of jobs
$38.74 - $43.07
13% of jobs
$46.44 is the 75th percentile. Wages above this are outliers.
$43.07 - $47.40
10% of jobs
$47.40 - $51.74
8% of jobs
$51.74 - $56.07
5% of jobs
$56.07 - $60.40
5% of jobs
$60.40 - $64.73
2% of jobs
$64.73 - $69.06
2% of jobs
$21
$42
$69
How much do utilization review rn jobs pay per hour?
As of Aug 22, 2026, the average hourly pay for utilization review rn in Spokane Valley, WA is $42.33, according to ZipRecruiter salary data. Most workers in this role earn between $33.46 and $48.61 per hour, depending on experience, location, and employer.
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.
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.
What is the difference between Utilization Review Rn vs Case Manager?
| Aspect | Utilization Review Rn | Case Manager |
|---|---|---|
| Credentials | RN license, certifications in utilization review | RN license, certifications in case management |
| Work Environment | Hospitals, insurance companies, healthcare facilities | Hospitals, community agencies, insurance companies |
| Primary Focus | Reviewing medical necessity and appropriateness of care | Coordinating 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 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 case management certification can enhance job prospects, and familiarity with electronic health records (EHR) systems is often required.
What are popular job titles related to Utilization Review Rn jobs in Spokane Valley, WA?
For Utilization Review Rn jobs in Spokane Valley, WA, the most frequently searched job titles are:
What job categories do people searching Utilization Review Rn jobs in Spokane Valley, WA look for?
The top searched job categories for Utilization Review Rn jobs in Spokane Valley, WA are:
What cities near Spokane Valley, WA are hiring for Utilization Review Rn jobs?
Cities near Spokane Valley, WA with the most Utilization Review Rn job openings:
Job description
Company Description
Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing.
Job Description
Title: Medical Claims Review Nurse
Duration: 3 months (Temp to Hire)
Location: Spokane, WA
Responsibilities:
Non-exempt employee, 40 hours per week. Hours of operation 6 am - 5 pm. The manager is open for the employee to pick their start time as long as they know they must complete and 8 hour shift. They can choose.
This not remote, in office.
Production Guidelines after training- manager does 100% review of case on the first 2 months, so they receive feedback and then after that, they are audited monthly on a percentage of their caseloads and given feedback on the audited cases.
Managers are looking for candidates with clinical experience from a hospital (Preferred)
Min. 2- 3 years clinical nursing experience
1 year of utilization review or medical claim review
RN License Required
Preferred Experience in one of more of the following areas critical care, emergency medicine, surgical, paediatrics, advanced practice nursing, and billing and coding experience
Great organizational skills
Critical thinkers and the ability to make decisions using clinical background/knowledge
Able to work independently
Able to collaborate and work with peers to make decisions
Knowledge of state and federal regulations
In-depth Knowledge of ICD-9, CPT, and HCPTS
Great Verbal and Written Communication Skills because they will be interacting with Medical Directors.
Interviews: Phone screen and if it goes well then an in person interview
Knowledge/Skills/Abilities:
Demonstrated ability to communicate, problem solve, and work effectively with people.
Excellent organizational skill with the ability to manage multiple priorities.
Work independently and handle multiple projects simultaneously.
Knowledge of applicable state, and federal regulations.
In depth knowledge of Interqual and other references for length of stay and medical necessity determinations.
Experience with NCQA.
Ability to take initiative and see tasks to completion.
Computer Literate (Microsoft Office Products).
Excellent verbal and written communication skills.
Ability to abide by policies.
Ability to maintain attendance to support required quality and quantity of work.
Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).
Skilled at establishing and maintaining positive and effective work relationships with co-workers, clients, members, providers and customers.
Required Experience:
Minimum 2-4 years of clinical practice. Preferably hospital nursing, utilization management, and/or case management.
Required Licensure/Certification: Active, unrestricted State.
Additional Information
Kind Regards
Sumit Agarwal
732-902-2125
About Integrated Resources
Sourced by ZipRecruiter
Integrated Resources Inc (IRI), based in Edison, NJ, US, is an esteemed player in the staffing solutions industry with a credible presence on their official website irionline.com. Notably, IRI provides a range of professional staffing services including contract, contract-to-hire, and direct hire solutions to a wide spectrum of industries such as healthcare, life sciences, manufacturing, financial, insurance, and others. Since its inception, IRI has been committed to delivering top-talent and optimum solutions to meet its clients' diverse needs.
Industry
Recruiting and staffing services
Company size
51 - 200 Employees
Headquarters location
Edison, NJ, US
Year founded
1996