ZipRecruiter

Log In

2

Remote Rn Utilization Review Nurse Jobs in Arizona

Molina Healthcare

Care Review Clinician (RN)

Mesa, AZ · Remote

$26.41 - $51.49/hr

Remote position, must reside in Arizona. Work hours: Monday - Friday 8:30am- 5:00pm Mountain Time ... • Registered Nurse (RN). License must be active and unrestricted in state of practice. • ...

Molina Healthcare

Care Review Clinician (RN)

Mesa, AZ · Remote

$26.41 - $51.49/hr

Remote position, must reside in Arizona. Work hours: Monday - Friday 8:30am- 5:00pm Mountain Time ... Registered Nurse (RN). License must be active and unrestricted in state of practice. Ability to ...

Molina Healthcare

Care Review Clinician (RN)

Gilbert, AZ · Remote

$26.41 - $51.49/hr

Remote position, must reside in Arizona. Work hours: Monday - Friday 8:30am- 5:00pm Mountain Time ... • Registered Nurse (RN). License must be active and unrestricted in state of practice. • ...

Molina Healthcare

Care Review Clinician (RN)

Chandler, AZ · Remote

$26.41 - $51.49/hr

Remote position, must reside in Arizona. Work hours: Monday - Friday 8:30am- 5:00pm Mountain Time ... • Registered Nurse (RN). License must be active and unrestricted in state of practice. • ...

Molina Healthcare

Care Review Clinician (RN)

Chandler, AZ · Remote

$26.41 - $51.49/hr

Remote position, must reside in Arizona. Work hours: Monday - Friday 8:30am- 5:00pm Mountain Time ... Registered Nurse (RN). License must be active and unrestricted in state of practice. Ability to ...

Molina Healthcare

Care Review Clinician (RN)

Tucson, AZ · Remote

$26.41 - $51.49/hr

Remote position, must reside in Arizona. Work hours: Monday - Friday 8:30am- 5:00pm Mountain Time ... Registered Nurse (RN). License must be active and unrestricted in state of practice. Ability to ...

Molina Healthcare

Care Review Clinician (RN)

Scottsdale, AZ · Remote

$26.41 - $51.49/hr

Remote position, must reside in Arizona. Work hours: Monday - Friday 8:30am- 5:00pm Mountain Time ... Registered Nurse (RN). License must be active and unrestricted in state of practice. Ability to ...

next page

Showing results 1-20

People also search for

All JobsRemote Rn Utilization Review Nurse JobsRemote Rn Utilization Review Nurse Jobs in Arizona

Remote Rn Utilization Review Nurse information

See Arizona salary details

$19

$39

$64

How much do remote rn utilization review nurse jobs pay per hour?

As of May 28, 2026, the average hourly pay for remote rn utilization review nurse in Arizona is $39.40, according to ZipRecruiter salary data. Most workers in this role earn between $31.15 and $45.24 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Remote RN Utilization Review Nurse, and why are they important?

To thrive as a Remote RN Utilization Review Nurse, you need an active RN license, strong clinical knowledge, and experience in case management or utilization review. Proficiency with healthcare review software, electronic health records (EHRs), and familiarity with insurance guidelines or regulatory requirements is vital. Excellent communication, critical thinking, and time management skills distinguish top performers in remote settings. These skills enable nurses to make accurate, timely decisions about patient care while ensuring compliance and efficient resource utilization.

What are some common challenges faced by Remote RN Utilization Review Nurses, and how can they be addressed?

Remote RN Utilization Review Nurses often encounter challenges such as managing large caseloads, maintaining effective communication with interdisciplinary teams, and staying updated with ever-changing insurance guidelines. Balancing productivity expectations while ensuring thorough case reviews can be demanding. To address these challenges, nurses can utilize robust organizational tools, participate in ongoing training sessions, and leverage regular virtual meetings to stay connected with colleagues and supervisors, ensuring both efficiency and high-quality patient care.

What is a Remote RN Utilization Review Nurse?

A Remote RN Utilization Review Nurse is a registered nurse who evaluates medical records and healthcare services from a remote location to ensure that patients receive appropriate, necessary, and cost-effective care. They review treatment plans, check for compliance with insurance and healthcare guidelines, and often work with healthcare providers, insurance companies, and patients to coordinate care. This role typically involves assessing the medical necessity of procedures, authorizing services, and helping prevent unnecessary treatments or hospitalizations.

What is the difference between Remote Rn Utilization Review Nurse vs Remote Rn Case Manager?

AspectRemote Rn Utilization Review NurseRemote Rn Case Manager
CertificationsRN license, possibly UR or CCM certificationRN license, CCM or other case management certification
Work EnvironmentReviewing medical records, insurance guidelines, and authorizationsCoordinating patient care, discharge planning, and resource management
Employer & Industry UsageHealth insurance companies, third-party administratorsHospitals, health plans, healthcare providers

Remote Rn Utilization Review Nurses primarily evaluate medical necessity for insurance approvals, focusing on documentation and guidelines. In contrast, Remote Rn Case Managers coordinate patient care, discharge planning, and resource allocation. Both roles require RN licensure and related certifications but differ in daily tasks and work focus.

What are the most commonly searched types of Rn Utilization Review Nurse jobs in Arizona? The most popular types of Rn Utilization Review Nurse jobs in Arizona are:
What are popular job titles related to Remote Rn Utilization Review Nurse jobs in Arizona? For Remote Rn Utilization Review Nurse jobs in Arizona, the most frequently searched job titles are:
What job categories do people searching Remote Rn Utilization Review Nurse jobs in Arizona look for? The top searched job categories for Remote Rn Utilization Review Nurse jobs in Arizona are:
Remote Rn Utilization Review Nurse jobs near you
Care Review Clinician (RN)

Care Review Clinician (RN)

Molina Healthcare

Mesa, AZ • Remote

$26.41 - $51.49/hr

Full-time

Posted 3 days ago

Molina Healthcare rating

8.0

Company rating: 8.0 out of 10

Based on 191 frontline employees who took The Breakroom Quiz

147th of 258 rated insurance

Job description

Job Summary
Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.

This position will support the Arizona state Plan. We are seeking a candidate with an Arizona RN licensure.  The ideal candidate will have experience with UM and prior authorization with both inpatient and outpatient.  Candidates with a Behavioral Health background are highly preferred. Further details to be discussed during our interview process.

 

Remote position, must reside in Arizona.

Work hours: Monday - Friday 8:30am- 5:00pm Mountain Time with some weekends and holidays. 

 

KNOWLEDGE/SKILLS/ABILITIES

  • Assesses inpatient services for members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines.
  • Analyzes clinical service requests from members or providers against evidence based clinical guidelines.
  • Identifies appropriate benefits, eligibility and expected length of stay for requested treatments and/or procedures.
  • Conducts inpatient reviews to determine financial responsibility for Molina Healthcare and its members. May also perform prior authorization reviews and/or related duties as needed.
  • Processes requests within required timelines.
  • Refers appropriate cases to Medical Directors and presents them in a consistent and efficient manner.
  • Requests additional information from members or providers in consistent and efficient manner.
  • Makes appropriate referrals to other clinical programs.
  • Collaborates with multidisciplinary teams to promote Molina Care Model.
  • Adheres to UM policies and procedures.
  • Occasional travel to other Molina offices or hospitals as requested, may be required. This can vary based on the individual State Plan.

 
Required Qualifications 
• At least 2 years experience, including experience in hospital acute care, inpatient review, prior authorization, managed care, or equivalent combination of relevant education and experience. 
• Registered Nurse (RN). License must be active and unrestricted in state of practice. 
• Ability to prioritize and manage multiple deadlines. 
• Excellent organizational, problem-solving and critical-thinking skills. 
• Strong written and verbal communication skills. 
• Microsoft Office suite/applicable software program(s) proficiency. 
Preferred Qualifications 
• Certified Professional in Healthcare Management (CPHM). 
• Recent hospital experience in an intensive care unit (ICU) or emergency room. 
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. 
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $26.41 - $51.49 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

What Molina Healthcare employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Molina Healthcare logo

About Molina Healthcare

Sourced by ZipRecruiter

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Long Beach, CA, US

Year founded

1980

Social media

FacebookTwitter

View All Molina Healthcare Jobs

Apply