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Utilization Review Rn Jobs in Springfield, MA (NOW HIRING)

Trinityhealth

Registered Nurse - RN - MSICU

Hartford, CT · On-site

$36.15 - $59.95/hr

Attend to patients requiring advanced monitoring, heightened observation, utilization of invasive ... Valid RN license in Connecticut * Candidates with a minimum of one year of acute inpatient nursing ...

Trinity Health

Registered Nurse - RN - MSICU

Hartford, CT · On-site

$36.15 - $59.95/hr

Attend to patients requiring advanced monitoring, heightened observation, utilization of invasive ... Valid RN license in Connecticut * Candidates with a minimum of one year of acute inpatient nursing ...

Trinityhealth

Registered Nurse - RN - MSICU

Hartford, CT

$36.15 - $59.95/hr

Attend to patients requiring advanced monitoring, heightened observation, utilization of invasive ... Valid RN license in Connecticut * Candidates with a minimum of one year of acute inpatient nursing ...

Trinity Health

Registered Nurse - RN - MSICU

Hartford, CT · On-site

$36.15 - $59.95/hr

Attend to patients requiring advanced monitoring, heightened observation, utilization of invasive ... Valid RN license in Connecticut * Candidates with a minimum of one year of acute inpatient nursing ...

Trinityhealth

Registered Nurse - RN - MSICU

Hartford, CT

$36.15 - $59.95/hr

Attend to patients requiring advanced monitoring, heightened observation, utilization of invasive ... Valid RN license in Connecticut * Candidates with a minimum of one year of acute inpatient nursing ...

Trinityhealth

Registered Nurse - RN - MSICU

Hartford, CT

$36.15 - $59.95/hr

Attend to patients requiring advanced monitoring, heightened observation, utilization of invasive ... Valid RN license in Connecticut * Candidates with a minimum of one year of acute inpatient nursing ...

Trinity Health

Registered Nurse - RN - MSICU

Hartford, CT

$36.15 - $59.95/hr

Attend to patients requiring advanced monitoring, heightened observation, utilization of invasive ... Valid RN license in Connecticut * Candidates with a minimum of one year of acute inpatient nursing ...

Trinity Health

Registered Nurse - RN - MSICU

Hartford, CT · On-site

$36.15 - $59.95/hr

Attend to patients requiring advanced monitoring, heightened observation, utilization of invasive ... Valid RN license in Connecticut * Candidates with a minimum of one year of acute inpatient nursing ...

Yale New Haven Hospital

RN - MICU

Hartford, CT

The Registered Nurse (Rn) Assesses, Plans, Implements, Evaluates And Supervises Individual Patient ... Utilization, And Staff And Self Development As Outlined In Performance Review. * Performs Other ...

Yale New Haven Health

RN - MICU

Hartford, CT

The Registered Nurse (Rn) Assesses, Plans, Implements, Evaluates And Supervises Individual Patient ... Utilization, And Staff And Self Development As Outlined In Performance Review. * Performs Other ...

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All JobsUtilization Review Rn JobsUtilization Review Rn Jobs in Springfield, MA

Utilization Review Rn information

See Springfield, MA salary details

$21

$42

$68

How much do utilization review rn jobs pay per hour?

As of Jul 11, 2026, the average hourly pay for utilization review rn in Springfield, MA is $42.13, according to ZipRecruiter salary data. Most workers in this role earn between $33.32 and $48.37 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 Springfield, MA? The most popular types of Utilization Review Rn jobs in Springfield, MA are:
What are popular job titles related to Utilization Review Rn jobs in Springfield, MA? For Utilization Review Rn jobs in Springfield, MA, the most frequently searched job titles are:
What job categories do people searching Utilization Review Rn jobs in Springfield, MA look for? The top searched job categories for Utilization Review Rn jobs in Springfield, MA are:
What cities near Springfield, MA are hiring for Utilization Review Rn jobs? Cities near Springfield, MA with the most Utilization Review Rn job openings:
Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Springfield, MA as of July 2026, with employment types broken down into 1% As Needed, 80% Full Time, 15% Part Time, 1% Temporary, and 3% Contract. Highlights an 91% Physical, 2% Hybrid, and 7% Remote job distribution, with an average salary of $87,639 per year, or $42.1 per hour.
Registered Nurse (RN) - Critical Care Float Pool

Registered Nurse (RN) - Critical Care Float Pool

Yale New Haven Hospital

Hartford, CT

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 7 days ago

Yale New Haven Hospital rating

7.3

Company rating: 7.3 out of 10

Based on 29 frontline employees who took The Breakroom Quiz

367th of 1,018 rated hospitals

Job description

Overview
To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.
Works Under The Supervision Of The Nurse Manager/Clinical Coordinator. The Registered Nurse (Rn) Assesses, Plans, Implements, Evaluates And Supervises Individual Patient Care On A Nursing Unit/Department According To Unit Policies And Procedures. Provides Supervision Of Non-Rn Personnel On The Assigned Unit. When Assuming The Charge Role, Delegates And Supervises Unit Activities. May Be Requires To Work On Other Nursing Units According To Distribution Of Staff And Patients. Performs Other Duties As Assigned Or Requested In Order To Maintain A High Level Of Service.
EEO/AA/Disability/Veteran
Responsibilities
  1. Assesses The Patient's Physical And Psychosocial Condition On An Ongoing Basis Throughout The Continuum Of Care.
  2. Develops, Communicates And Documents A Plan Of Care Reflecting Individualized Patient Problems And Interventions To Achieve Desired Outcomes, Involving The Patient, Family And Healthcare Team In This Process.
  3. Implements And Coordinates This Plan Of Care In Collaboration With The Healthcare Team.
  4. Evaluates The Effectiveness Of The Plan Of Care, Patient?S Response To Care, And Readiness For Discharge. Revises The Plan Of Care As Needed And Makes Referrals Where Indicated.
  5. Plans For Education After Assessing The Individual Learning Needs And Readiness Of The Patient And Family. Provides Educational Opportunities And Documents Outcomes.
  6. Functions As A Preceptor To New Staff.
  7. Functions As A Charge Nurse.
  8. Meets Performance Expectations For Customer Service, Teamwork, Resource Utilization, And Staff And Self Development As Outlined In Performance Review.
  9. Performs Other Duties As Assigned Or Directed To Ensure Smooth Operation Of The Department/Unit.
  10. Demonstrates Competency In The Care Of The Neuro Patient
  11. Demonstrates Skill And Knowledge In Neuro Assessment
  12. Demonstrates Skill And Knowledge In The Airway Management Of The Neuro Patient
  13. Demonstrates Skill And Understanding In Caring For A Trached Patient
  14. Demonstrates Skill And Understanding In Assisting The Physician And Caring For The Patient During Special Neuro Procedures
  15. Demonstrates Knowledge And Understanding Of Our 'Tia' Teaching Program
  16. Performs Pharynaeal, Endotracheal, Tracheostomy Suctioning According To Established Policy And Procedure: Pharynaeal, Endotracheal, Tracheastomy
  17. Demonstrates Skill And Understanding In The Use Of Equipment And Care Of Patient In A Halo Brace
  18. Demonstrates Skill And Understanding Of Nursing Responsibilities And Interventions For The Patient On A Ventilator

Qualifications
EDUCATION:
Graduation from an accredited school of nursing. BSN preferred. All newly hired registered nurses must have current
BCLS certification or must obtain within one month of hire.
EXPERIENCE:
Registered Nurse is the foundational job description for all RNs. All RNs are encouraged to advance through the SPIRE clinical advancement program.
ACCOUNTABILITY:
Accountable to practice within the Scope and Standards of Practice within the Nurse Practice Act of their state of
practice. RNs at YNHH are accountable to YNHHS standards of professional behavior. Nursing practice is overseen
by the Chief Nursing Officer (CNO) in each delivery network, and RNs are accountable to their chain of command . RNs are accountable to team members and upholding standards of professional behavior.
COMPLEXITY):
In personal and job-related decisions and actions, consistently demonstrates the values of integrity (doing the right
thing), patient-centered (putting patients and families first), respect (valuing all people and embracing all differences),
accountability (being responsible and taking action), and compassion (being empathetic).
Accountable to the Scope and Standards of practice noted in this job description.
LICENSURE/CERTIFICATION:
Licensed and a currently registered nurse in the State of Connecticut. Clinical specialty certification highly
encouraged.
Benefits:
  • Competitive salary based on experience and qualifications.
  • Comprehensive health, dental, and vision insurance.
  • Retirement savings plan with employer contributions.
  • Paid time off and flexible scheduling options.
  • Professional development and continuing education opportunities.
  • Employee wellness initiatives and support programs.
Additional Information
Heart and Vascular Cardiac ICU (5-1 SP)
The Cardiac ICU is a fast paced, high acuity, 14-bed, critical care unit that cares for adult patients with complex cardiac, medical diagnoses such as myocardial infarction, cardiogenic shock, unstable arrhythmias, and heart failure. Our patients are treated with medical and interventional management. Nursing staff are trained in advanced heart failure management, including short- and long-term mechanical circulatory support (with devices such as intra-aortic balloon pumps, Impella catheters, and LVADs) and evaluation for advanced therapies and transplantation.
RN-HVC Cardiothoracic ICU (CTICU/WP3)
Cardiothoracic ICU is an 18-bed cardiac surgery unit, specializing in care for complex post-operative CABG, valve replacements, aortic dissection repairs, heart transplants and LVAD implantation. This is also the only unit in YNHH health system that cares for patients requiring ECMO, whether it is VV (lung bypass) or VA (heart and lung bypass). In addition, patients may require additional devices including IABP, Impella/VADs, and/or CRRT. Nurses will be trained to devices based on previous experience and progression of skills, expectations and critical thinking.
HVC Cardiovascular ICU and Stepdown (5-4 SP)
The Cardiovascular ICU and Stepdown is a 14-bed hybrid unit consisting of 8 ICU and 6 stepdown beds. We specialize in caring for patients post complex vascular surgery, such as aortic repairs, and post cardiac surgery patients such as CABG and valve replacements in our ICU beds. In the stepdown beds we care for patients with a variety of complex heart and vascular diagnoses.

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