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Utilization Review Rn Jobs (NOW HIRING)

York Hospital

RN - Utilization Review

York, ME · On-site

Utilization Review Rn Travel profession RN utilization review job. Start date 08/24/2026, end date 11/23/2026, duration 13 weeks. City: York, State: ME. Equal opportunity employer. MedSource LLC does ...

Zack Group

Travel Utilization Review RN

Tuba City, AZ · On-site

Utilization Review * Discipline: RN * Start Date: 09/07/2026 * Duration: 13 weeks * 40 hours per week * Shift: 8 hours, days * Employment Type: Travel Zack Group is currently seeking Utilization ...

Olaro

Travel Utilization Review RN

Tuba City, AZ · On-site

Olaro is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Tuba City, Arizona. & Requirements * Specialty: Utilization Review * Discipline: RN * Start Date: 09/07 ...

GLC On-The-Go

Travel Utilization Review RN

Tuba City, AZ · On-site

$2.2K - $2.3K/wk

Utilization Review * Discipline: RN * Start Date: 09/07/2026 * Duration: 13 weeks * 36 hours per week * Shift: 12 hours * Employment Type: Travel Utilization Review RN - Case Management | Tuba City ...

CommonSpirit Health

Utilization Review RN

Houston, TX · On-site

$41.14 - $61.20/hr

Utilization Review RN Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of ...

GQR Healthcare

Travel Utilization Review RN

Tuba City, AZ · On-site

$2.2K - $2.3K/wk

Utilization Review * Discipline: RN * Start Date: 09/07/2026 * Duration: 13 weeks * 36 hours per week * Shift: 12 hours, days * Employment Type: Travel Contract - W2 Case Management/Utilization ...

Next Move Healthcare

RN, Utilization Review

Tuba City, AZ · On-site

$2.7K/wk

RN, Utilization Review Care Career is looking for Utilization Review RN's to fulfill an assignment in Tuba City, Arizona. Gross Pay: $2,772 Hourly Rate: $32 Weekly Stipend: $1,472 Shift: 5x8 Hour Day ...

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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 6, 2026, the average hourly pay for utilization review rn in the United States is $42.28, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 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.
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Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 83% Full Time, 13% Part Time, and 3% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

RN - Utilization Review

Tuba City Regional - Tuba City, AZ - Medefis

Tuba City, AZ • On-site

Other

Medical, Dental, Vision, Retirement

Posted 3 days ago

New

Job description

RN - Utilization Review

Prime HealthCare Staffing, a national health care staffing company with over 20 years in the business, is looking for an experienced RN - Utilization Review for our customer in Tuba City, Arizona. The ideal candidate will possess a current Arizona license. This is a RN position in the Utilization Review RN Unit. You must have a Nursing License and at least 2 years of recent Utilization Review US nursing experience as a RN - Utilization Review. Prime`s team of experienced health care professionals are here to guide you through the process 24/7.

Prime Benefits

  • First Day Medical, Dental, Vision and Rx benefits
  • Housing and Meal stipends
  • 401(k) Savings plan after 90 days
  • Travel/Licensure Reimbursement
  • Competitive pay rates
  • Referral Bonus Plan
  • Assignment Bonus on select assignments (ask your recruiter for details)
  • Weekly Direct Deposit

Qualifications

  • At least 2-years total experience in your specialty
  • Current BLS and/or ACLS (AHA Preferred) and/or Specialty Certifications
  • Active Nursing License per state
  • Current Updated Resume
  • Supervisory Professional References
  • Must complete Drug Screen and Background Screen

Prime HealthCare Staffing has day and night shifts available. Submit your resume and experience the Prime difference.

Client Details Setting Hospital City Tuba City State AZ

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