Join a dynamic healthcare team in the Pacific Northwest as a Registered Nurse Care Manager specializing in Utilization Review. This role involves coordinating care and managing the utilization of ...
Join a dynamic healthcare team in the Pacific Northwest as a Registered Nurse Care Manager specializing in Utilization Review. This role involves coordinating care and managing the utilization of ...
Utilization Management Clinician I
Seattle, WA · On-site
$74K - $115K/yr
About the Role The Level I Utilization Management Clinician performs utilization review for medical ... Conduct review of hospital notification or prior authorization care requests against established ...
Utilization Management Clinician I
Seattle, WA · On-site
$74K - $115K/yr
About the Role The Level I Utilization Management Clinician performs utilization review for medical ... Conduct review of hospital notification or prior authorization care requests against established ...
About the Role The Level I Utilization Management Clinician performs utilization review for medical ... Conduct review of hospital notification or prior authorization care requests against established ...
Quick apply
About the Role The Level I Utilization Management Clinician performs utilization review for medical ... Conduct review of hospital notification or prior authorization care requests against established ...
Utilization Management Coordinator I
$43K - $60K/yr
The level I UM Coordinator is responsible for administrative functions in processing Utilization ... Reviews, corrects, and approves authorization requests via the web portal; determines appropriate ...
Utilization Management Coordinator I
$43K - $60K/yr
The level I UM Coordinator is responsible for administrative functions in processing Utilization ... Reviews, corrects, and approves authorization requests via the web portal; determines appropriate ...
The level I UM Coordinator is responsible for administrative functions in processing Utilization ... Reviews, corrects, and approves authorization requests via the web portal; determines appropriate ...
Quick apply
The level I UM Coordinator is responsible for administrative functions in processing Utilization ... Reviews, corrects, and approves authorization requests via the web portal; determines appropriate ...
Utilization Management Coordinator I
Seattle, WA · On-site +1
$21 - $28.98/hr
The level I UM Coordinator is responsible for administrative functions in processing Utilization ... Reviews completed denial letters for accuracy and adherence to compliance deadlines. Edits and ...
Utilization Management Coordinator I
Seattle, WA · On-site +1
$21 - $28.98/hr
The level I UM Coordinator is responsible for administrative functions in processing Utilization ... Reviews completed denial letters for accuracy and adherence to compliance deadlines. Edits and ...
Interqual or Milliman experience Utilization review experience Case Management experience Hours for this Position: Flexible - roughly 8:00-5:00 or 8:30 to 5:00 Advantages of this Opportunity:
Interqual or Milliman experience Utilization review experience Case Management experience Hours for this Position: Flexible - roughly 8:00-5:00 or 8:30 to 5:00 Advantages of this Opportunity:
Organ Utilization Coordinator
Bellevue, WA · On-site
$36.50 - $52.94/hr
Participate in case reviews and continuous process improvement initiatives to increase utilization rates. Collaborative Responsibilities * Collaborate with transplant programs, ODS, and recovery ...
Organ Utilization Coordinator
Bellevue, WA · On-site
$36.50 - $52.94/hr
Participate in case reviews and continuous process improvement initiatives to increase utilization rates. Collaborative Responsibilities * Collaborate with transplant programs, ODS, and recovery ...
Organ Utilization Coordinator
$36.50 - $52.94/hr
Participate in case reviews and continuous process improvement initiatives to increase utilization rates. Collaborative Responsibilities * Collaborate with transplant programs, ODS, and recovery ...
Organ Utilization Coordinator
$36.50 - $52.94/hr
Participate in case reviews and continuous process improvement initiatives to increase utilization rates. Collaborative Responsibilities * Collaborate with transplant programs, ODS, and recovery ...
Supervisor Utilization Management Hybridrole(3days/weekin office)atourBurlington, Renton, Spokane ... Knowledge of payment coding guidelines, as applicable (Payment Review only). * Experience with AI ...
Supervisor Utilization Management Hybridrole(3days/weekin office)atourBurlington, Renton, Spokane ... Knowledge of payment coding guidelines, as applicable (Payment Review only). * Experience with AI ...
Review analyses of activities, costs, operations and forecast data to determine progress toward ... Develop, implement, and maintain utilization management programs to facilitate the use of ...
Review analyses of activities, costs, operations and forecast data to determine progress toward ... Develop, implement, and maintain utilization management programs to facilitate the use of ...
RN MDS Nurse
Everett, WA · On-site
$50 - $60/hr
Bethany of the Northwest is a non-profit icon of the healthcare industry for nearly 100 years. Bethany is seeking a passionate and motivated RN MDS Nurse to join our team at Bethany in Everett. Come ...
RN MDS Nurse
Everett, WA · On-site
$50 - $60/hr
Bethany of the Northwest is a non-profit icon of the healthcare industry for nearly 100 years. Bethany is seeking a passionate and motivated RN MDS Nurse to join our team at Bethany in Everett. Come ...
Manager, Case Management - RN or MSW
$129K - $194K/yr
Current or previous case management or utilization review leadership experience. For MSW Manager: Required Education and Experience Masters in Social work from an accredited school. Minimum of two ...
Manager, Case Management - RN or MSW
$129K - $194K/yr
Current or previous case management or utilization review leadership experience. For MSW Manager: Required Education and Experience Masters in Social work from an accredited school. Minimum of two ...
Manager, Case Management - RN or MSW
Seattle, WA · On-site
$129K - $194K/yr
Current or previous case management or utilization review leadership experience. For MSW Manager: Required Education and Experience Masters in Social work from an accredited school. Minimum of two ...
Manager, Case Management - RN or MSW
Seattle, WA · On-site
$129K - $194K/yr
Current or previous case management or utilization review leadership experience. For MSW Manager: Required Education and Experience Masters in Social work from an accredited school. Minimum of two ...
Follows patients throughout the continuum of care and ensures optimum utilization of resources, service delivery and compliance with external review agencies. * Provides ongoing support and expertise ...
Follows patients throughout the continuum of care and ensures optimum utilization of resources, service delivery and compliance with external review agencies. * Provides ongoing support and expertise ...
... utilization of resources, service delivery and compliance with external review agencies. • Provides ongoing support and expertise through comprehensive assessment, care planning, plan ...
... utilization of resources, service delivery and compliance with external review agencies. • Provides ongoing support and expertise through comprehensive assessment, care planning, plan ...
Denial Management Specialist
Kirkland, WA · Remote
$28.83 - $46.14/hr
Wage Range: $28.83 - $46.14 per hour 5 years of experience in denial management, utilization review or prior authorization in a hospital, provider, or healthcare system. Healthcare medical billing ...
Denial Management Specialist
Kirkland, WA · Remote
$28.83 - $46.14/hr
Wage Range: $28.83 - $46.14 per hour 5 years of experience in denial management, utilization review or prior authorization in a hospital, provider, or healthcare system. Healthcare medical billing ...
As aNetwork Performance/Utilization Manager, your primary responsibilitiesmay include: * Advise clients on network strategy, provider capacity,utilizationtrends, access challenges, and market ...
As aNetwork Performance/Utilization Manager, your primary responsibilitiesmay include: * Advise clients on network strategy, provider capacity,utilizationtrends, access challenges, and market ...
As aNetwork Performance/Utilization Manager, your primary responsibilitiesmay include: * Advise clients on network strategy, provider capacity,utilizationtrends, access challenges, and market ...
As aNetwork Performance/Utilization Manager, your primary responsibilitiesmay include: * Advise clients on network strategy, provider capacity,utilizationtrends, access challenges, and market ...
As aNetwork Performance/Utilization Manager, your primary responsibilitiesmay include: * Advise clients on network strategy, provider capacity,utilizationtrends, access challenges, and market ...
As aNetwork Performance/Utilization Manager, your primary responsibilitiesmay include: * Advise clients on network strategy, provider capacity,utilizationtrends, access challenges, and market ...
Utilization Review information
See Seattle, WA salary details
$24.35 - $29.27
2% of jobs
$29.27 - $34.20
9% of jobs
$37.56 is the 25th percentile. Wages below this are outliers.
$34.20 - $39.12
21% of jobs
The median wage is $43.11 / hr.
$39.12 - $44.04
23% of jobs
$44.04 - $48.97
13% of jobs
$52.80 is the 75th percentile. Wages above this are outliers.
$48.97 - $53.89
10% of jobs
$53.89 - $58.82
8% of jobs
$58.82 - $63.74
5% of jobs
$63.74 - $68.67
5% of jobs
$68.67 - $73.59
2% of jobs
$73.59 - $78.51
2% of jobs
$24
$48
$78
How much do utilization review jobs pay per hour?
What jobs make $3,000 a day?
What jobs pay 4000 a week without a degree?
What does a typical day look like for someone working in Utilization Review?
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 skills do you need for utilization review?
What is a Utilization Review job?
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 are the key skills and qualifications needed to thrive in the Utilization Review position, and why are they important?
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?
- Remote Utilization Review Rn
- Remote Utilization Management Nurse
- Remote Utilization Management
- Remote Utilization Review Nurse
- Per Diem Utilization Review Nurse
- No Experience Utilization Review Nurse
- Remote Prior Authorization Nurse
- Utilization Review Physician
- Utilization Management
- Part Time Utilization Review Nurse
- Remote Utilization Review
- Remote Occupational Therapy Utilization Review
- Remote Physical Therapy Utilization Review
- Remote Aetna Utilization Review Nurse
- Remote Lpn Utilization Review
- Insurance Utilization Review
- Utilization Review Manager
- Discharge Planner Utilization Review
- Utilization Review Nurse Compact License
- Chart Utilization Review

Other
Medical, Dental, Vision, Retirement
Posted 25 days ago
Job description
Join a dynamic healthcare team in the Pacific Northwest as a Registered Nurse Care Manager specializing in Utilization Review. This role involves coordinating care and managing the utilization of services for patients in acute and post-acute skilled care settings. You will collaborate closely with interdisciplinary teams both inside and outside the organization to enhance patient outcomes and ensure cost-effective care.
Job Summary
As a vital member of the care team, you will continuously assess the appropriateness and timeliness of care levels, ensuring resources are used efficiently. Your daily activities include rounding with patients, conducting assessments, and facilitating smooth transitions from hospital to home or other care facilities. You will also identify and resolve discharge barriers, provide clear documentation, and support peer-to-peer reviews for concurrent denials.
Education and Experience
- Minimum of 2 years of Registered Nursing experience in acute care or care management/utilization review.
- Current RN license valid in the region or multistate license.
- BLS certification is required.
- Bachelor's degree in Nursing and Care Manager Certification are preferred.
- Strong organizational and prioritization skills.
- Excellent written and verbal communication tailored to diverse audiences.
- Proficiency with technology and software, including intermediate to advanced Microsoft Office skills.
- Ability to maintain confidentiality and accurate documentation.
- Demonstrated teamwork, collaboration, and customer service skills in fast-paced environments.
- Independent problem-solving and sound judgment to complete tasks effectively.
Work Environment and Benefits
This full-time exempt position offers a supportive work environment with opportunities for professional growth. Benefits include competitive compensation, comprehensive medical, dental, and vision coverage, retirement plans with employer contributions, tuition reimbursement, employee wellness programs, and more. The location provides access to numerous outdoor recreational activities such as hiking, kayaking, fishing, and cultural experiences in the Pacific Northwest region.