In this position you will be reviewing patient charts to determine if pre-elective surgical cases ... Previous utilization management or case management experience preferred. CERTIFICATIONS/LICENSURES ...
In this position you will be reviewing patient charts to determine if pre-elective surgical cases ... Previous utilization management or case management experience preferred. CERTIFICATIONS/LICENSURES ...
In this position you will be reviewing patient charts to determine if pre-elective surgical cases ... Previous utilization management or case management experience preferred. CERTIFICATIONS/LICENSURES ...
In this position you will be reviewing patient charts to determine if pre-elective surgical cases ... Previous utilization management or case management experience preferred. CERTIFICATIONS/LICENSURES ...
Utilization Management Coordinator
Troy, MI · On-site +1
$19/hr
Enter UM authorizations review requests in UM platform using ICD-10 and HCPCS codes * Verify ... Initiate appeal cases and forward to UM Nurses for completion * Meet internal and regulator ...
New
Utilization Management Coordinator
Troy, MI · On-site +1
$19/hr
Enter UM authorizations review requests in UM platform using ICD-10 and HCPCS codes * Verify ... Initiate appeal cases and forward to UM Nurses for completion * Meet internal and regulator ...
New
RN Care Manager - PRN
Almont, MI · Remote
$41.20 - $62.17/hr
Demonstrated experience in case management, utilization review, value-based care, and/or discharge ... If applying for a remote or hybrid role, this includes remote work expectations related to ...
RN Care Manager - PRN
Almont, MI · Remote
$41.20 - $62.17/hr
Demonstrated experience in case management, utilization review, value-based care, and/or discharge ... If applying for a remote or hybrid role, this includes remote work expectations related to ...
... Nurse (RN) to serve our patient population in the navigation, prevention and management of their ... Welcome patients into continuous care program(s) and review benefits and services included
... Nurse (RN) to serve our patient population in the navigation, prevention and management of their ... Welcome patients into continuous care program(s) and review benefits and services included
Director of Utilization Management
Troy, MI · On-site +1
$160K - $160K/yr
Prepare and maintain Utilization Review Plan policies and procedures * Obtain or maintain ... Career development opportunities Remote Opportunities We are actively seeking new colleagues in:
Director of Utilization Management
Troy, MI · On-site +1
$160K - $160K/yr
Prepare and maintain Utilization Review Plan policies and procedures * Obtain or maintain ... Career development opportunities Remote Opportunities We are actively seeking new colleagues in:
Registered Nurse - Progressive Care
Detroit, MI · On-site +1
$81K - $139K/yr
... outcomes utilization. Practice includes directing other providers. Partners with the patient ... The Nurse II Progressive Care Registered Nurse (RN) is responsible for providing competent ...
Registered Nurse - Progressive Care
Detroit, MI · On-site +1
$81K - $139K/yr
... outcomes utilization. Practice includes directing other providers. Partners with the patient ... The Nurse II Progressive Care Registered Nurse (RN) is responsible for providing competent ...
Registered Nurse (RN) Community Living Center (PMs and Nights)
Iron Mountain, MI · On-site +1
$69K - $131K/yr
... after review of the EDRP application. Former EDRP participants ineligible to apply. Learn more ... outcomes utilization consultation. Demonstrates leadership in delivering and improving holistic ...
Registered Nurse (RN) Community Living Center (PMs and Nights)
Iron Mountain, MI · On-site +1
$69K - $131K/yr
... after review of the EDRP application. Former EDRP participants ineligible to apply. Learn more ... outcomes utilization consultation. Demonstrates leadership in delivering and improving holistic ...
Registered Nurse (RN) VA Community Care
Iron Mountain, MI · On-site +1
$69K - $131K/yr
... process, clinical review criteria, utilization management standards, clinical documentation ... All Registered Nurses must be a graduate of a school of professional nursing approved by the ...
Registered Nurse (RN) VA Community Care
Iron Mountain, MI · On-site +1
$69K - $131K/yr
... process, clinical review criteria, utilization management standards, clinical documentation ... All Registered Nurses must be a graduate of a school of professional nursing approved by the ...
Department: Care Coordinator RN (Remote in Michigan) Position Summary: As an advocate for the ... teach warning signs, review discharge instructions, coordination of care, and problem solve ...
Department: Care Coordinator RN (Remote in Michigan) Position Summary: As an advocate for the ... teach warning signs, review discharge instructions, coordination of care, and problem solve ...
Registered Nurse (RN) Community Living Center (CLC) Day Shift
Iron Mountain, MI · On-site +1
$69K - $131K/yr
... after review of the EDRP application. Former EDRP participants ineligible to apply. Learn more ... outcomes utilization consultation. Demonstrates leadership in delivering and improving holistic ...
Registered Nurse (RN) Community Living Center (CLC) Day Shift
Iron Mountain, MI · On-site +1
$69K - $131K/yr
... after review of the EDRP application. Former EDRP participants ineligible to apply. Learn more ... outcomes utilization consultation. Demonstrates leadership in delivering and improving holistic ...
Care Coordinator RN (Remote in Michigan) Shift: Part-Time Days 8:00am-3:00pm (Tuesdays and ... teach warning signs, review discharge instructions, coordination of care, and problem solve ...
Care Coordinator RN (Remote in Michigan) Shift: Part-Time Days 8:00am-3:00pm (Tuesdays and ... teach warning signs, review discharge instructions, coordination of care, and problem solve ...
Assess whether a review is needed for a member's return to their own occupation, and identify the ... Work Environment You will be working in an approved remote environment within the states of:
Assess whether a review is needed for a member's return to their own occupation, and identify the ... Work Environment You will be working in an approved remote environment within the states of:
Review claims data, clinical records, and assessment tools to evaluate member needs and benefit ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Review claims data, clinical records, and assessment tools to evaluate member needs and benefit ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Review claims data, clinical records, and assessment tools to evaluate member needs and benefit ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Review claims data, clinical records, and assessment tools to evaluate member needs and benefit ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Review claims data, clinical records, and assessment tools to evaluate member needs and benefit ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Review claims data, clinical records, and assessment tools to evaluate member needs and benefit ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Review claims data, clinical records, and assessment tools to evaluate member needs and benefit ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Review claims data, clinical records, and assessment tools to evaluate member needs and benefit ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Review claims data, clinical records, and assessment tools to evaluate member needs and benefit ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Review claims data, clinical records, and assessment tools to evaluate member needs and benefit ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Review claims data, clinical records, and assessment tools to evaluate member needs and benefit ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Review claims data, clinical records, and assessment tools to evaluate member needs and benefit ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Review claims data, clinical records, and assessment tools to evaluate member needs and benefit ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Review claims data, clinical records, and assessment tools to evaluate member needs and benefit ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Remote Rn Utilization Review Nurse information
See Michigan salary details
$18.65 - $22.42
2% of jobs
$22.42 - $26.19
9% of jobs
$28.77 is the 25th percentile. Wages below this are outliers.
$26.19 - $29.96
21% of jobs
The median wage is $33.01 / hr.
$29.96 - $33.73
23% of jobs
$33.73 - $37.50
13% of jobs
$40.44 is the 75th percentile. Wages above this are outliers.
$37.50 - $41.28
10% of jobs
$41.28 - $45.05
8% of jobs
$45.05 - $48.82
5% of jobs
$48.82 - $52.59
5% of jobs
$52.59 - $56.36
2% of jobs
$56.36 - $60.13
2% of jobs
$18
$36
$60
How much do remote rn utilization review nurse jobs pay per hour?
As of Aug 14, 2026, the average hourly pay for remote rn utilization review nurse in Michigan is $36.85, according to ZipRecruiter salary data. Most workers in this role earn between $29.13 and $42.31 per hour, depending on experience, location, and employer.
What is the difference between Remote Rn Utilization Review Nurse vs Remote Rn Case Manager?
| Aspect | Remote Rn Utilization Review Nurse | Remote Rn Case Manager |
|---|---|---|
| Certifications | RN license, possibly UR or CCM certification | RN license, CCM or other case management certification |
| Work Environment | Reviewing medical records, insurance guidelines, and authorizations | Coordinating patient care, discharge planning, and resource management |
| Employer & Industry Usage | Health insurance companies, third-party administrators | Hospitals, 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 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 are the key skills and qualifications needed to thrive as a Remote RN Utilization Review Nurse?
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 are popular job titles related to Remote Rn Utilization Review Nurse jobs in Michigan?
For Remote Rn Utilization Review Nurse jobs in Michigan, the most frequently searched job titles are:
- Optum Clinical Claim Review Nurse
- Telecommute Hedis Review Nurse
- Medicare Review Nurse
- Night Shift Remote Utilization Review Nurse
- Utilization Management
- Weekend Physician Advisor Utilization Review
- Clinical Review Nurse Remote
- Registered Nurse Utilization Review
- No Experience Utilization Review Nurse
- Full Time Physician Advisor Utilization Review
What job categories do people searching Remote Rn Utilization Review Nurse jobs in Michigan look for?
The top searched job categories for Remote Rn Utilization Review Nurse jobs in Michigan are:
- Cigna Utilization Review Nurse
- Optum Utilization Review Nurse
- Case Manager Utilization Review Nurse
- Rn Utilization Review Nurse
- Lpn Utilization Review
- Aetna Utilization Review Nurse
- Temporary Aetna Utilization Review Nurse
- Therapy Utilization Review
- Remote Preservice Review Nurse
- Utilization Review No Experience
What cities in Michigan are hiring for Remote Rn Utilization Review Nurse jobs?
Cities in Michigan with the most Remote Rn Utilization Review Nurse job openings:
Coordinator-Utilization Review(Clinical Coding)/Full Time/Remote
Troy, MI • On-site, Remote
Full-time
Re-posted 19 days ago
Henry Ford Health rating
7.0
Based on 565 frontline employees who took The Breakroom Quiz
416th of 887 rated healthcare providers
Job description
In this position you will be reviewing patient charts to determine if pre-elective surgical cases should be boarded as inpatient instead of outpatient. You will also review the CPTs that were boarded for meeting inpatient on the CMS inpatient list and the InterQual inpatient list based on payer criteria used.
Hours are Monday - Friday from 830am until 5pm with no weekends
EDUCATION AND EXPERIENCE:
CERTIFICATIONS/LICENSURES REQUIRED:
Hours are Monday - Friday from 830am until 5pm with no weekends
EDUCATION AND EXPERIENCE:
- RHIT, RHIA, or related coding certification required.
- Minimum 3-5 years of clinical experience preferred.
- Previous utilization management or case management experience preferred.
CERTIFICATIONS/LICENSURES REQUIRED:
- RHIT, RHIA, or related coding certification required.
What Henry Ford Health employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom
About Henry Ford Health
Sourced by ZipRecruiter
Henry Ford Health provides a full continuum of services from Primary and Preventative care, to Complex and Cpecialty care, Health Insurance, a full suite of home health offerings, Virtual care, Pharmacy, Eye care and other Healthcare retail. It is one of the Nation’s leading Academic Medical Centers, recognized for Clinical excellence in Cancer care, Cardiology and Cardiovascular Surgery, Neurology and Neurosurgery, Orthopedics and Sports medicine, and Multi organ transplants. Consistently ranked among the top five NIH funded institutions in Michigan, Henry Ford Health engages in more than 2,000 research projects annually. Equally committed to educating the next generation of Health Professionals, Henry Ford Health trains more than 4,000 Medical students, Residents and fellows every year across 50+ accredited programs. With more than 33,000 valued team members, Henry Ford Health is also among Michigan’s largest and most Diverse employers, including nearly 6,000 physicians and researchers from the Henry Ford Medical Group, Henry Ford Physician Network and Jackson Health Network.
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
Detroit, MI, US
Year founded
1915