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Utilization Review Rn Jobs in Vernon, CT (NOW HIRING)

Vivian Health

RN Case Manager in Avon, CT

Avon, CT · On-site

Registered Nurse (RN) Case Manager Location Detail: 71 Haynes Street (10627) Shift Detail: Day ... utilization review/management is preferred. COMPETENCIES · Requires good analytical ...

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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 7, 2026, the average hourly pay for utilization review rn in Vernon, CT is $42.26, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.51 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 popular job titles related to Utilization Review Rn jobs in Vernon, CT? For Utilization Review Rn jobs in Vernon, CT, the most frequently searched job titles are:
What cities near Vernon, CT are hiring for Utilization Review Rn jobs? Cities near Vernon, CT with the most Utilization Review Rn job openings:
Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Vernon, CT as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 14% Part Time, and 4% Contract. Highlights an 90% Physical, 3% Hybrid, and 7% Remote job distribution, with an average salary of $87,902 per year, or $42.3 per hour.

RN Case Manager in Avon, CT

Vivian Health

Avon, CT • On-site

Other

Posted 3 days ago

New

Job description

Registered Nurse (RN) Case Manager

Location Detail: 71 Haynes Street (10627)

Shift Detail: Day shift and weekends.

Work where every moment matters. 
Every day, over 40,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing every moment matters here.  We invite you to become part of Connecticut’s most comprehensive healthcare network as a Clinical Nurse Educator.

The Greater Manchester Region has approximately 2,500 employees. It includes Manchester Memorial Hospital, a 249-bed community hospital, Rockville General, a campus of Manchester Memorial Hospital, a 102-bed facility, a large multispecialty provider group and visiting nurse services. The Greater Manchester Region serves a region of 300,000 people in 19 towns.

POSITION SUMMARY:

The Care Manager provides a link between provider and payer organizations, physicians and the community in the transition of patient care through the health care system. Monitors all admissions for the appropriateness of observation services or inpatient hospitalization, according to InterQual criteria. Utilizing the nursing process, identifies patients with discharge planning needs and coordinates necessary services in the home or nursing facility setting. Coordinates patient care by using independent nursing judgment and working collaboratively with the interdisciplinary team. Communicates, as appropriate, the patient’s clinical condition and care needs. Demonstrates knowledge of the principles of growth and development over the life span and the skills necessary to provide age appropriate care to the patient population served. Professional knowledge and judgment will be utilized when guidelines are unavailable or inappropriate for a given situation. Promotes the profession of nursing and professional practice through collegial support and interactions. Is primarily assigned to one hospital, but will be required to provide coverage at the other hospital as needed. Reports to the Manager of Care Management.

Qualifications

EDUCATION/CERTIFICATION

· Graduate of an accredited school of Nursing

· Baccalaureate degree in an applicable field required.

· Must have a current license as a Registered Nurse in the State of Connecticut.

· Professional certification in case management or clinical specialty is preferred.

EXPERIENCE

· Must have at least five (5) years of nursing experience in a medical surgical acute care setting

· Additional experience in case management, home care, and utilization review/management is preferred.

COMPETENCIES

· Requires good analytical, organizational and interpersonal skills as well as the ability to communicate effectively in English, both verbally and in writing.

· A basic proficiency in personal computers is required.

We take great care of careers.

With locations around the state, Hartford HealthCare offers exciting opportunities for career development and growth. Here, you are part of an organization on the cutting edge – helping to bring new technologies, breakthrough treatments and community education to countless men, women and children. We know that a thriving organization starts with thriving colleagues-- we provide a competitive benefits program designed to ensure work/life balance. Every moment matters. And this isyour moment.

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