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Utilization Review Jobs in Oregon (NOW HIRING)

P3 Health Partners

RN Care Manager

Medford, OR · On-site

$85K - $95K/yr

The Care Manager may be responsible for activities overlapping with utilization review and quality management programs. Essential Job Functions: * Promote the mission, vision and values of P3 Health ...

P3 Health Partners

RN Care Manager

Roseburg, OR

$85K - $95K/yr

The Care Manager may be responsible for activities overlapping with utilization review and quality management programs. Essential Job Functions: * Promote the mission, vision and values of P3 Health ...

P3 Health Partners

RN Care Manager

Salem, OR

$85K - $95K/yr

The Care Manager may be responsible for activities overlapping with utilization review and quality management programs. Essential Job Functions: * Promote the mission, vision and values of P3 Health ...

P3 Health Partners

RN Care Manager

Roseburg, OR · On-site

$85K - $95K/yr

The Care Manager may be responsible for activities overlapping with utilization review and quality management programs. Essential Job Functions: * Promote the mission, vision and values of P3 Health ...

P3 Health Partners

RN Care Manager

Salem, OR · On-site

$85K - $95K/yr

The Care Manager may be responsible for activities overlapping with utilization review and quality management programs. Essential Job Functions: * Promote the mission, vision and values of P3 Health ...

Dane Street

Orthopedics Physician

Union, OR · On-site

Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management expertise Expanded credentials as an expert in Independent Medical Exams ...

Dane Street

Board-Certified Orthopedist

Union, OR

These are advisory-only opinions. ● Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management expertise ● Expanded credentials as ...

Dane Street, LLC

Board-Certified Neurologist

Eugene, OR · On-site

$321K - $401K/yr

Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management expertise * Expanded credentials as an expert in Independent Medical Exams

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All JobsUtilization Review JobsUtilization Review Jobs in Oregon

Utilization Review information

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$22

$44

$72

How much do utilization review jobs pay per hour?

As of Sep 6, 2026, the average hourly pay for utilization review in Oregon is $44.70, according to ZipRecruiter salary data. Most workers in this role earn between $35.34 and $51.35 per hour, depending on experience, location, and employer.

What is a utilization review?

A Utilization Review (UR) job involves assessing the medical necessity, efficiency, and appropriateness of healthcare services. UR professionals, often nurses or healthcare specialists, review patient records, insurance claims, and treatment plans to ensure they meet industry standards and payer requirements. They work with healthcare providers, insurance companies, and regulatory agencies to optimize care while controlling costs. Their goal is to balance quality patient care with cost-effective resource utilization.

What does a utilization review do?

A typical day in Utilization Review involves reviewing patient medical records, evaluating the necessity and appropriateness of proposed treatments or services, and documenting recommendations based on clinical criteria and insurance policies. Utilization Review specialists often collaborate closely with physicians, nurses, and insurance representatives to gather additional information and clarify cases. While much of the role is desk-based and may include remote work options, it requires regular communication with both clinical and administrative teams. This position offers variety and challenge, as no two cases are exactly alike, and there are often opportunities to advance into supervisory or quality improvement roles within the department.

What are the key skills and qualifications needed to thrive in utilization review?

To thrive in Utilization Review, professionals typically need a background in nursing or healthcare, strong clinical assessment capabilities, and a thorough understanding of medical guidelines and insurance regulations. Familiarity with electronic medical records (EMR) systems and utilization management software, and often certification such as Certified Utilization Review Specialist (CURN), are important. Excellent critical thinking, attention to detail, and strong communication skills enable effective case evaluation and collaboration with healthcare teams. These skills and qualifications ensure objective, accurate decisions that support cost-effective, quality patient care within compliance standards.

How do I get into a utilization review?

To become a utilization review specialist, typically a healthcare or related degree such as nursing, health administration, or social work is required. Certification in case management or utilization review, like the Certified Professional in Healthcare Quality (CPHQ), can enhance job prospects, and strong analytical and communication skills are essential for success in the role.

Is utilization review a stressful job?

Utilization review is a healthcare role that involves evaluating medical necessity and appropriateness of services, often under strict deadlines and documentation requirements. The job can be stressful due to high workload, the need for accuracy, and managing complex cases, but stress levels vary based on work environment and individual coping skills.

What are the most commonly searched types of Utilization Review jobs in Oregon?

The most popular types of Utilization Review jobs in Oregon are:

What are popular job titles related to Utilization Review jobs in Oregon?

For Utilization Review jobs in Oregon, the most frequently searched job titles are:

What job categories do people searching Utilization Review jobs in Oregon look for?

The top searched job categories for Utilization Review jobs in Oregon are:

What cities in Oregon are hiring for Utilization Review jobs?

Cities in Oregon with the most Utilization Review job openings:

Utilization Review jobs near you
Infographic showing various Utilization Review job openings in Oregon as of August 2026, with employment types broken down into 70% Full Time, 24% Part Time, and 6% Contract. Highlights an 59% In-person, and 41% Remote job distribution, with an average salary of $92,985 per year, or $44.7 per hour.

RN Care Manager

P3 Health Partners

Medford, OR • On-site

$85K - $95K/yr

Full-time

Posted 5 days ago

P3 Health Partners rating

6.6

Company rating: 6.6 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

Job description

People. Passion. Purpose.
At P3 Health Partners, our promise is to guide our communities to better health, unburden clinicians, align incentives and engage patients.
We are a physician-led organization relentless in our mission to overcome all obstacles by positively disrupting the business of health care, transforming it from sickness care into wellness guidance.
We are looking for a RN Care Manager. If you are passionate about your work; eager to have fun; and motivated to be part of a fast-growing organization, then you should consider joining our team.
Work Location & Schedule
This role offers a hybrid work arrangement. Candidates will follow our hybrid schedule, working in office three days per week.
Overall Purpose:
This position is responsible for ensuring that assigned patient population(s) receive continuous, comprehensive and coordinated care throughout the continuum. Through case finding, data and other tools, high risk patients will be identified and guided to enhance the achievement of the Quadruple Aim: improved outcomes, improved experience of care for patients and providers and lower healthcare costs.
The Care Manager will utilize the nursing process of assessment, planning, implementation and evaluation as well as clinical judgment. Interventions with patients and / or stakeholders may be face to face or telephonic. The Care Manager may be responsible for activities overlapping with utilization review and quality management programs.
Essential Job Functions:
  • Promote the mission, vision and values of P3 Health Partners
  • Responsible for comprehensive patient assessments through medical records, clinician and patient interviews, telephonic and / or face to face
  • Develops, implements and evaluates patient care plans
  • Collaborates with Medical Management teams regarding care plans and patient's progress
  • Identifies care needs and barriers to care. Develops plans to improve
  • Prepares documentation, as per timelines and policy
  • Coordinates care for assigned high risk patient population
  • Works with patients, families and care-givers to promote self- management and meet care plan goals
  • Builds relationships with PCPs, internal and external customers
  • Addresses gaps in care

Experience:
  • Strong clinical judgment and problem -solving skills required
  • Experience in Care Management preferred
  • Experience with Special Needs Programs [SNPs] preferred
  • Managed care experience preferred
  • Utilization review and discharge planning experience preferred
  • Excellent communication skills with patients, providers, internal and external customers required
  • Must have excellent computer skills
  • Must have excellent organizational skills and ability to work independently, with minimal supervision

Licensure / Certification:
  • Ability to obtain and maintain current registration to practice as a Registered Nurse in Nevada, Arizona, Oregon, and California
  • Certification in case management or ability to obtain within two years of employment
  • CPR certified or ability to obtain within 60 days of employment

Education:
Graduate from an Accredited School of Nursing or other applicable clinical role. Bachelor's degree in Nursing preferred.
Pay range: $85,000-95,000 depending on experience
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights notice from the Department of Labor.

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