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Remote Rn Utilization Review Nurse Jobs in Forney, TX

U1402

Project Audit RN

Dallas, TX · Remote

Project Audit RN Full Time, Remote WHY UT SOUTHWESTERN? With over 75 years of excellence in Dallas ... Experience 5 years of clinical experience as a RN including 2 years performing utilization review ...

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Remote Rn Utilization Review Nurse information

See Forney, TX salary details

$19

$38

$62

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

As of Sep 9, 2026, the average hourly pay for remote rn utilization review nurse in Forney, TX is $38.09, according to ZipRecruiter salary data. Most workers in this role earn between $30.10 and $43.75 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 Forney, TX?

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

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

The top searched job categories for Remote Rn Utilization Review Nurse jobs in Forney, TX are:

What cities near Forney, TX are hiring for Remote Rn Utilization Review Nurse jobs?

Cities near Forney, TX 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 Forney, TX as of September 2026, with employment types broken down into 56% Full Time, and 44% Contract. Highlights an 100% Remote job distribution, with an average salary of $79,227 per year, or $38.1 per hour.

Utilization Review Nurse-Remote-Contract

Dallas, TX • Remote

HireOps Staffing, LLC
51 - 200 employees
Learn more about HireOps Staffing, LLCexternal

$40/hr

Full-time

Re-posted 4 days ago

Job description

$40/hour - Contract for 6 months
Must reside in TX

Full time remote
Candidates must be based in TX.
RN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and appropriateness of the treatment plan.
pay rate is $40/hour
This position is responsible for performing initial, concurrent review activities; discharge care coordination for determining efficiency, effectiveness and quality of medical/surgical services and serving as liaison between providers and medical and network management divisions. Collects clinical and non-clinical data. Verifies eligibility. Determines benefit levels in accordance to contract guidelines. Provides information regarding utilization management requirements and operational procedures to members, providers and facilities.
Registered Nurse (RN) with valid, current, unrestricted license in the state of operations.
* 3 years of clinical experience in a physician office, hospital/surgical setting or health care insurance company.
* Knowledge of medical terminology and procedures.
* Verbal and written communication skills.
PREFERRED JOB REQUIREMENTS:
* Utilization management experience
* MCG or InterQual experience