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Utilization Review Jobs in Portland, OR (NOW HIRING)

Description Utilization Review RN at Providence Health Plaza. Utilization Management covers 7 days/week, including holidays. This posting is not for a specific job vacancy. It serves to establish a ...

RN Case Manager

Portland, OR ยท On-site

$1.9K - $2.0K/wk

Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location: Portland, Oregon Start Date: July 28, 2026 Profession: Registered Nurse (RN) Facility: Short Term Acute Care ...

RN - Case Manager

Portland, OR ยท On-site

$1.9K - $2.0K/wk

Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location: Portland, Oregon Start Date: July 28, 2026 Profession: Registered Nurse (RN) Facility: Short Term Acute Care ...

Pharmacist in Beaverton, OR

Beaverton, OR ยท On-site

$61.50 - $74/hr

Review pharmacy and medical claims; conduct drug utilization reviews and develop clinical policies * Participate in Pharmacy and Therapeutics (P&T) Committee activities * Communicate therapeutic ...

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Utilization Review information

See Portland, OR salary details

$22

$44

$73

How much do utilization review jobs pay per hour?

As of Aug 21, 2026, the average hourly pay for utilization review in Portland, OR is $44.84, according to ZipRecruiter salary data. Most workers in this role earn between $35.43 and $51.49 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 Portland, OR?

The most popular types of Utilization Review jobs in Portland, OR are:

What cities near Portland, OR are hiring for Utilization Review jobs?

Cities near Portland, OR with the most Utilization Review job openings:

Infographic showing various Utilization Review job openings in Portland, OR 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 $93,268 per year, or $44.8 per hour.

Utilization Review RN

Providence Health & Service

Portland, OR โ€ข On-site

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 10 days ago


Job description

Description

Utilization Review RN at Providence Health Plaza. Utilization Management covers 7 days/week, including holidays.

This posting is not for a specific job vacancy. It serves to establish a place for current or future interested applicants to apply for Utilization Review RN at Providence Oregon Regional Shared Services (Providence Health Plaza) in Portland, OR. We may not have openings for each of these categories today, but the organization offers on-call, part time and full-time opportunities for day shift.

The RN Coordinator-Utilization Review supports the care of the patient through assessment, planning, implementation and evaluation of appropriate services and resources to maximize optimum outcomes. This position works collaboratively with the multiple disciplines, both internal and external to the organization, in effecting quality and cost-effective management of the patient care along the continuum.

Providence caregivers are not simply valued - they're invaluable. Join our team at Providence Oregon Regional Shared Services and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.

Required Qualifications:

  • Bachelor's Degree Nursing, OR Associates Degree and 2 or more years of related experience in lieu of a Bachelor's Degree
  • Upon hire: Oregon Registered Nurse License
  • Five (5) years Clinical experience in an acute adult medical/surgical care setting, OR Five (5) years Current Utilization Review or Case Management experience.
  • Demonstrated clinical expertise and experience related to a wide variety of patient populations and care delivery models.

Why Join Providence?

Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.

About Providence

At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.

Posted are the minimum and the maximum wage rates on the wage range for this position. The successful candidate's placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits.

Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.

About the Team

Providence has been serving the Pacific Northwest since 1856 when Mother Joseph of the Sacred Heart and four other Sisters of Providence arrived in Vancouver, Washington Territory. As the largest healthcare system and largest private employer in Oregon, Providence is located in areas ranging from the Columbia Gorge to the wine country to sunny southern Oregon to charming coastal communities to the urban setting of Portland.

Our award-winning and comprehensive medical centers are known for outstanding programs in cancer, cardiology, neurosciences, orthopedics, women's services, emergency and trauma care, pediatrics and neonatal intensive care. Our not-for-profit network also provides a full spectrum of care with leading-edge diagnostics and treatment, outpatient health centers, physician groups and clinics, numerous outreach programs, and hospice and home care.

Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.

Requsition ID: 439934

Company: Providence Jobs

Job Category: Health Information Management

Job Function: Revenue Cycle

Job Schedule: Part time

Job Shift: Multiple shifts available

Career Track: Nursing

Department: 5016 RS UTILIZATION MGMT

Address: OR Portland 4400 NE Halsey St

Work Location: Providence Health Plaza (HR) Bldg 1-Portland

Workplace Type: Hybrid

Pay Range: $50.14 - $77.83

The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.