ZipRecruiter

Log In

2

Remote Rn Utilization Review Nurse Jobs in Forney, TX

Elara Caring

Senior Compliance Auditor - RN

Dallas, TX · Remote

Senior Compliance Auditor - RN (Remote) At Elara Caring, we care where you are and believe the best ... Provide secondary review/oversight of PCS policy development, revisions and reviews for new and ...

YO AI Labs

Hospitalist Physician - Remote

Dallas, TX · Remote

$70 - $100/hr

Remote Job Overview We are seeking experienced Hospitalist Physicians to contribute their medical ... Experience with utilization review, medical coding, or healthcare quality assurance. * Familiarity ...

Altegra Health

Remote Certified Coder

Dallas, TX · Remote

$22.25 - $30.50/hr

Altegra's nationwide network of registered nurses and certified coders professionally acquire ... Remote Certified Coders review medical records and apply appropriate ICD-9-CM diagnostic codes and ...

Altegra Health

Remote Certified Coder

Dallas, TX · On-site +1

$22.25 - $30.50/hr

Altegra's nationwide network of registered nurses and certified coders professionally acquire ... Remote Certified Coders review medical records and apply appropriate ICD-9-CM diagnostic codes and ...

Gentell

Certified Wound Care Clinician/Nurse

Dallas, TX · On-site +1

... utilization of wound care products - Understanding Medicare documentation and reimbursement ... (RN, LPN, PT, OTR-L, DPM or similar) preferred but could be certified in the first year of hire ...

Lantern

Oncology Nurse Navigator

Dallas, TX · On-site +1

$90K - $105K/yr

Remote days require a private, secure home workspace free from other employment, caregiving, or ... Active RN license in a compact state with unencumbered ability to be licensed in all 50 states

previous page

Showing results 41-60

All JobsRn Utilization Review Nurse JobsRemote Rn Utilization Review Nurse JobsRemote Rn Utilization Review Nurse Jobs in Forney, TX

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 12, 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 1% As Needed, 78% Full Time, 17% Part Time, 1% Temporary, and 3% Contract. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution, with an average salary of $79,227 per year, or $38.1 per hour.

Clinical Knowledge Base Manager | Remote | NantHealth

Dallas, TX • Remote

nant
See more jobs at nantexternal

$64K - $88K/yr

Full-time

Posted 4 days ago

Job description

We're adding a Clinical Knowledge Base Manager  to our Medical Affairs team. Our Clinical Knowledge Base Managers are nurses who develop and maintain the oncology Eviti evidence-based libraries. We are seeking nurses to develop and manage our libraries that are used to support utilization management, quality of care, and reimbursement. The applicant will have the opportunity to build exciting and new enhanced products using knowledge and expertise.

The Clinical Knowledge Base Manager is a detail-oriented, experienced nurse who loves learning and using their knowledge. The successful applicant will review FDA labels, clinical research, national clinical practice guidelines, and client medical policies to build and maintain the Eviti libraries. The Clinical Knowledge Base Manager is responsible for the accuracy and comprehensiveness of the library.

Responsibilities include, but are not limited to:

  • Build and review oncology treatment regimens for the Library based on clinical studies and oncology clinical practice guidelines
  • Facilitate ongoing review and update of Library regimens based on NCCN guideline and FDA label changes
  • Perform Annual Reviews as assigned to ensure Library is up to date
  • Work with manager, mentor, and senior team members to prioritize, plan, and execute Library management
  • Collaborate extensively with colleagues to evaluate, develop, and review Library content to ensure accuracy, currency, and appropriateness
  • Conduct medical literature searches and review results 
  • Work with teammates to ensure Library changes accommodate Medical Policy and Pathways
  • Analyze Medical Policy and create rules to enable client Medical Policy, Oncology Pathways, and Medicare coverage determinations
  • Participate on project teams to improve Eviti’s clinical content and software functionality

Education & Experience Requirements:

  • 3-5 years prior clinical experience in oncology, Bachelor’s degree in nursing, strongly preferred 
  • Research and writing experience
  • Current active unrestricted registered nursing (RN) license
  • Oncology nursing certification, preferred

Required Knowledge, Skills, and Abilities:

  • Reviews Library content and collaborates with colleagues to identify conflicts and problems within the Library
  • Provides solutions through execution of clinical decision-making processes and efficiency improvements
  • Suggests process improvement that may improve effectiveness of job area
  • Ability to work independently under close supervision
  • Executes clinical processes to manage and curate the Eviti Library, including medical policy
  • Explains facts, policies and practices related to job area to contacts within the job area
  • Works to achieve operational and project timelines and objectives
  • Ability to effectively communicates with teammates and medical staff to review and discuss Library issues and questions
  • Ability to communicates with IT staff to report and troubleshoot problems and request new functionality

Apply