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

Yale New Haven Health

RN; Registered Nurse

Madison, CT · On-site

Resource Utilization: The RN utilizes appropriate resources to plan provide and sustain evidence-based nursing services that are safe, effective and fiscally responsible Environmental Health: The RN ...

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Utilization Review Rn information

See Wolcott, CT salary details

$21

$43

$70

How much do utilization review rn jobs pay per hour?

As of Aug 7, 2026, the average hourly pay for utilization review rn in Wolcott, CT is $43.10, according to ZipRecruiter salary data. Most workers in this role earn between $34.04 and $49.47 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 cities near Wolcott, CT are hiring for Utilization Review Rn jobs? Cities near Wolcott, CT with the most Utilization Review Rn job openings:
Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Wolcott, CT as of July 2026, with employment types broken down into 1% As Needed, 82% Full Time, 14% Part Time, 1% Temporary, and 2% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $89,638 per year, or $43.1 per hour.

RN; Registered Nurse

Yale New Haven Health

Madison, CT • On-site

Full-time

Re-posted 24 days ago

Yale New Haven Health rating

7.3

Company rating: 7.3 out of 10

Based on 232 frontline employees who took The Breakroom Quiz

305th of 887 rated healthcare providers

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.
As an integral member of the Yale New Haven Health System (YNHHS) healthcare team, the Registered Professional Nurse (RN) upholds the YNHHS mission, vision, values and strategic initiatives to provide the highest level of patient centered care. The RN practices professional nursing as a registered nurse within the legal and ethical framework established by the Connecticut Nurse Practice Act, American Nurses Association Scope and Standards for Nursing Practice, ANA Code of Ethics for Nurses and the YNHHS Professional Practice Model. The professional role of the RN is exemplified by the qualities of leadership, delegation, collaboration, effective communication, ensuring quality outcomes. YNHHS nurses practice in a framework outlined in our professional practice model, which states, "Achieving outcomes through Autonomy and Accountability". We value Nursing Professional Governance, and use evidence and data to support our practice with the patient and family at the center, always. The RN provides care that: * Establishes and maintains a therapeutic relationship with the patient and family encompasses an understanding and integration of cultural and diversity into practice * Includes communicating and working collaboratively with the patient, family and health care team members * Includes respecting the patient's values, preferences, expressed needs and knowledge of the healthcare situation in holistic data collection, in formulating health care outcomes and in the evaluation process.
EEO/AA/Disability/Veteran
Responsibilities
  • 1. STANDARDS OF PRACTICE RN practice is guided by the ANA Scope and Standards of Practice (2015). The Standards of Practice describe a competent level of nursing care as demonstrated by utilizing the nursing process components of assessment, diagnosis, outcomes identification, planning, implementation and evaluation. Assessment: The registered nurse collects pertinent data and information relative to the healthcare consumer's health or situation Diagnosis: The RN analyzes the assessment data to determine the actual and potential diagnoses or the issues. Outcomes Identification: The RN identifies expected outcomes for a plan individualized to the healthcare consumer or the situation. Planning: The RN develops and modifies a plan of care that prescribes strategies and alternatives to attain expected outcomes. Implementation: The RN implements the identified plan. Coordination of Care: The RN coordinates care delivery and transitions in care. Health Teaching and Health Promotion: The RN employs strategies to promote health and a safe environment. Evaluation: The RN evaluates progress toward attainment of outcomes.
  • 2. STANDARDS OF PROFESSIONAL PERFORMANCE The ANA Standards of Professional Performance (2015) describe a competent level of behavior in the professional role, including activities related to: ethics, culturally congruent practice, communication, collaboration, leadership, education, evidence-based practice and research, quality of practice professional practice evaluation, resource utilization and environmental health. The RN is expected to engage in professional role activities, including leadership, appropriate to their education and position. The RN is accountable to for their professional actions to themselves, their healthcare consumers, their peers and ultimately to society. Ethics: The RN practices ethically. Culturally congruent practice: The RN practices in a manner that is congruent with cultural diversity and inclusion principles. Communication: The RN communicates effectively in all areas of practice Collaboration: The RN collaborates with healthcare consumer and other key stakeholders in the conduct of nursing practice. Leadership: The RN leads within the professional practice setting and the profession. Education: the RN seeks knowledge and competence that reflects current nursing practice and promotes futuristic thinking. Evidence-Based Practice and Research: The RN integrates evidence and research findings into practice Quality of Practice: The RN contributes to quality nursing practice. Professional Practice Evaluation: The RN evaluates owns' and others' nursing practice. Resource Utilization: The RN utilizes appropriate resources to plan provide and sustain evidence-based nursing services that are safe, effective and fiscally responsible Environmental Health: The RN practices in an environmentally safe and healthy manner.

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.
LICENSURE
Licensed and a currently registered nurse in the State of Connecticut. Clinical specialty certification highly encouraged.
SPECIAL SKILLS
Registered Nurse is the foundational job description for all RNs. All RNs are encouraged to advance through the SPIRE clinical advancement program.
PHYSICAL DEMAND
Requires prolonged standing; walking; use of sight, hearing, and touch. May be exposed to infectious diseases. Will be exposed to physical, mental and emotional illness as well as end of life conditions and death. Moderate stress and risk of injury from patient care. Standing/walking for more than half of the day. Frequently bending, reaching, pushing, pulling, twisting and lifting. Must be able to assist pushing/pulling/lifting patients ranging from five (5) to three hundred (300) pounds.
Additional Information
Previous Urology experience preferred.
Previous ambulatory experience strongly preferred.
YNHHS Requisition ID
184385

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