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Remote Rn Utilization Review Nurse Jobs in Minnesota

Ourhrconnect

Active, unrestricted RN licensure from the United States and in the state of hire, OR active ... Three years-utilization/medical review, quality assurance, OR home health, plus 5 years clinical ...

Ourhrconnect

Active, unrestricted RN licensure from the United States and in the state of hire, OR active ... Three years-utilization/medical review, quality assurance, OR home health, plus 5 years clinical ...

Cassia

RN After Hours Assisted Living

Edina, MN · On-site +1

$36/hr

Position Type: Part-Time, Remote Shifts Available: Evening (Every other week) Friday: 5:00 pm to 12:00 am and Saturday/Sunday 5:00 pm to 10:00 pm Pay: $36 / hour After-Hours RN Responsibilities:

Allina Health

RN Triage

Minneapolis, MN · On-site +1

Fully remote position, including orientation. Occasional onsite requirements. * Cross trained to ... Resource Utilization. * Incorporates factors related to safety, effectiveness, cost, and impact on ...

Essentia Health

RN - Nurse Care Line

Duluth, MN · On-site +1

$33.94 - $50.91/hr

Looking for an RN with 2 years of experience in telephone triage, transitional care management ... Remote Shift Rotation: Day/Eve Rotation (United States of America) Shift Start Time: 0600 am Shift ...

Varsity Tutors

NCLEX-RN Tutor

Saint Paul, MN · Remote

$18 - $40/hr

Adapts instruction using UWorld, Kaplan, or ATI practice question banks, content review materials, and test-taking strategy workshops to support BSN and ADN graduates preparing for registered nurse ...

Varsity Tutors

NCLEX-RN Tutor

Edina, MN · Remote

$18 - $40/hr

Adapts instruction using UWorld, Kaplan, or ATI practice question banks, content review materials, and test-taking strategy workshops to support BSN and ADN graduates preparing for registered nurse ...

Varsity Tutors

NCLEX-RN Tutor

Minneapolis, MN · Remote

$18 - $40/hr

Adapts instruction using UWorld, Kaplan, or ATI practice question banks, content review materials, and test-taking strategy workshops to support BSN and ADN graduates preparing for registered nurse ...

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Remote Rn Utilization Review Nurse information

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

As of Aug 25, 2026, the average hourly pay for remote rn utilization review nurse in Minnesota is $41.41, according to ZipRecruiter salary data. Most workers in this role earn between $32.74 and $47.55 per hour, depending on experience, location, and employer.

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 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 popular job titles related to Remote Rn Utilization Review Nurse jobs in Minnesota?

For Remote Rn Utilization Review Nurse jobs in Minnesota, the most frequently searched job titles are:

What job categories do people searching Remote Rn Utilization Review Nurse jobs in Minnesota look for?

The top searched job categories for Remote Rn Utilization Review Nurse jobs in Minnesota are:

What cities in Minnesota are hiring for Remote Rn Utilization Review Nurse jobs?

Cities in Minnesota with the most Remote Rn Utilization Review Nurse job openings:

Remote Rn Utilization Review Nurse jobs near you
Infographic showing various Remote Rn Utilization Review Nurse job openings in Minnesota as of August 2026, with employment types broken down into 20% As Needed, 60% Full Time, and 20% Contract. Highlights an 100% Remote job distribution, with an average salary of $86,136 per year, or $41.4 per hour.

Medical Review Nurse

Mendota Heights, MN • On-site, Remote

ST CROIX HOSPICE LLC
Nursing and Residential Care Facilities • 1 - 5K employees

8.5

Company rating: 8.5 out of 10

Based on 33 frontline employees who took The Breakroom Quiz

5th of 46 rated hospices

Great coworkers

People enjoy working here

Good employer

Learn more about ST CROIX HOSPICE LLCexternal

Full-time

Posted 4 days ago

Job description

Work Where You Matter!
At St. Croix Hospice we guide patients and families through the end-of-life journey. Through compassionate care, we focus on our patient's quality of life, empowering them to make the most of their time with dignity, comfort and respect. If you are ready to be part of an extraordinary team of caregivers, then come work where you matter.
Medical Review Nurse
Position Overview
The Medical Review Nurse is an experienced nurse responsible for the monitoring, implementation and evaluation of processes and programs to ensure they meet regulatory, accreditation and standards of practice.
Essential Functions and Skills
  • Responsible for the implementation and monitoring of the organization's quality assessment performance improvement (QAPI) program.
    • Monitors and measures activities related to QAPI as assigned.
    • Implements quality improvement activities utilizing continuous quality improvement principles and methodologies.
    • Implements established schedule for clinical record review and data collection.
    • Compiles, trends, and reports quality data in the following areas: patient care, safety, risk management, infection control, outcomes, and customer satisfaction.
    • Works collaboratively with nursing department to assure documentation is complete and consistent with care and reflects regulatory/legal requirements.
  • Responsible for implementing processes to monitor and evaluate safety, risk management and infection control programs.
    • Implements monitoring activities for safety, risk management, and infection control.
    • Assists with mandatory in-service programs on OSHA regulations for safety and infection control as requested.
    • Acts as resource to staff in identifying safety and risk management issues for patients and staff.
    • Reviews all incident reports for completeness, risk, standard of care determination and appropriate follow-up. Trends data and makes recommendations related to trends identified.
    • Maintains current knowledge related to home care safety and infection control standards.
  • Monitor organization compliance with regulatory and accreditation standards.
    • Maintains current knowledge related to Medicare Conditions of Participation and the Community Health Accreditation Program's (CHAP) standards to ensure that the organization is compliant with state, federal and accreditation guidelines.
    • Participates in review of policies and procedures and makes recommendations for policy changes to the Director of Quality Assurance.
    • Acts as a resource to the clinical team regarding standards, policies, and regulations.
  • Acts as a clinical resource to staff.
    • Maintains updated nursing knowledge and skills.
    • Assists with patient visits as needed.
  • Promote self-growth and collegial relationships with others in the home care industry.
    • Maintains professional and technical knowledge by attending educational workshops, reviewing professional publications, establishing personal and professional networks and participating in professional organizations or societies.
  • Reviews Medical Records to ensure standards and compliance are being met across the organization.
  • Reviews live discharges to ensure appropriateness and compliance.
  • Completes audits as required by survey or self- identified to ensure compliance in medical records.
  • Performs other duties as assigned.

Requirements/Qualifications
  • Must have a current Registered Nurse (RN) license in state(s) of practice.
  • 2+ years of Nursing experience.
  • Nurses holding a multistate license can practice in other states without obtaining additional licenses while maintaining their Registered Nurse (RN) license in their primary state of residence (PSOR). Minnesota, Michigan, and Illinois are not in the Nursing Licensure Compact.
  • Graduate of an accredited school of professional nursing.
  • If Driving: Valid State Driver's License, access to an automobile in good working order, automobile insurance in accordance with state and organizational requirements, and an acceptable driving record required.
  • Ability to pass DHS background study

Physical Requirements
The physical requirements described are representative of those that must be met to successfully perform the essential responsibilities of this position. Reasonable accommodation may be made.
  • Pushing/Pulling and Lifting/carrying up to 30 pounds. Occasionally up to 50 pounds.
  • Prolonged periods sitting at a desk and working on a computer.
  • Ability to adapt to a variety of work conditions to ensure the highest quality of patient care in a home setting.
  • May be exposed to infections and contagious diseases. Contact with patients under wide variety of circumstances. May be exposed to/occasionally exposed to patient elements. Subject to varying and unpredictable situations. Travel required. OSHA exposure category: Category I - Position includes tasks that involve exposure to blood, body fluids, tissues. Category II - Position includes tasks that involve no exposure to blood, body fluids, tissues, but employment may require unplanned Category I tasks. Category III - Position includes tasks that involve no exposure to blood, body fluids, tissues; would not be required to perform Category I tasks.

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