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

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 · 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

$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 ...

Vivian Health

Dermatology RN in Windsor, CT

Windsor, CT · On-site

Registered Nurse (RN) - Dermatology Location Detail: 399 Farmington Ave Farmington (10083) Shift ... utilization through inquiring into evidence-based practices. * Evaluates and reviews the plan of ...

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 ...

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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 Aug 21, 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.

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?

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 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 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 August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 14% Part Time, 4% Contract, and 1% Nights. Highlights an 90% Physical, 3% Hybrid, and 7% Remote job distribution, with an average salary of $87,639 per year, or $42.1 per hour.

Registered Nurse Case Manager RN

Trinity Health

Hartford, CT • On-site

Full-time

Re-posted 27 days ago

Trinity Health rating

6.6

Company rating: 6.6 out of 10

Based on 354 frontline employees who took The Breakroom Quiz

569th of 891 rated healthcare providers

Job description

Employment Type:Full timeShift:Day ShiftDescription:

Position Purpose

At Saint Francis Hospital, the Registered Nurse Case Manager coordinates patient care across the continuum, ensuring safe, highquality, and costeffective outcomes. This role partners with physicians, interdisciplinary teams, patients, and families to assess needs, develop and implement care plans, monitor progress, and facilitate timely transitions of care while advocating for the patient's overall wellbeing.

What You Will Do

As a Registered Nurse (RN) Case Manager, you will serve as a key driver of a collaborative care management process that coordinates, monitors, and plans healthcare services throughout the patient's illness and recovery. Responsibilities include:

  • Coordinating care across the interdisciplinary team

  • Assessing clinical, psychosocial, and discharge needs

  • Monitoring patient progress and outcomes

  • Supporting safe, timely transitions of care

  • Ensuring compliance with regulatory, accreditation, and utilization standards

Minimum Qualifications

Required:

  • Graduation from an accredited nursing school

  • Valid RN License in Connecticut

Preferred:

  • Bachelor's degree in Nursing

  • 3 years of acute care RN experience required of diversified, progressive nursing experience in acute care and/or other settings across the continuum of care.

  • Demonstrated understanding of nationally recognized medical utilization criteria

  • Knowledge of HCFA/OBRA, State of Connecticut regulatory requirements, and Joint Commission (JCAHO) accreditation standards

Certification: BLS certification required

Position Highlights & Benefits

  • Schedule: Full Time 40 hours/Day Shift

Ministry / Facility Information

Saint Francis Hospital has been an anchor institution in Connecticut since 1897. A member of Trinity Health Of New England and Trinity Health, one of the nation's largest multiinstitutional Catholic healthcare delivery systems, Saint Francis Hospital is a 617bed Level I Trauma Center and major teaching hospital. Additional Saint Francis entities include the Comprehensive Women's Health Center, the Connecticut Joint Replacement Institute, and the Smilow Cancer Hospital.

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.

What Trinity Health employees say

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About Trinity Health

Sourced by ZipRecruiter

Trinity Health Ann Arbor is a 537 -bed teaching hospital located on 340 acre campus. Recognized by IBM Watson as a Top 100 Hospital and #1 Teaching Hospital, Trinity Health Ann Arbor has been a leading health care provider for more than 100 years. Trinity Health has received numerous local and national awards in recognition of our leadership, quality outcomes, and clinical excellence.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Livonia, MI, US

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