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Remote Rn Utilization Review Nurse Jobs in Raleigh, NC

NeighborHealth Center

Nurse (RN or LPN)

Raleigh, NC · On-site +1

Ability to work onsite Mondays through Fridays. * Ability to read, write, speak, and comprehend English fluently; knowledge of Spanish is helpful. * RN or LPN Licensure in the state of North Carolina

Scribe-X

Remote Medical Scribe

Durham, NC · Remote

$14 - $17/hr

Anyone looking to begin a career in medicine (MD, DO, PA, NP, or RN) should consider becoming a ... Review completed charts with the provider between patients or at the completion of shift * Update ...

Scribe-X

Medical Scribe (Remote)

Raleigh, NC · Remote

$14 - $17/hr

Anyone looking to begin a career in medicine (MD, DO, PA, NP, or RN) should consider becoming a ... Review completed charts with the provider between patients or at the completion of shift * Update ...

Reparo Health

Supervising Psychiatrist (Remote)

Durham, NC · Remote

$500 - $3K/mo

Our team of skilled therapists and psychiatric nurse practitioners works collaboratively to meet ... Review and approve treatment plans, documentation, and medication management strategies. * Ensure ...

Reparo Health

Supervising Psychiatrist (Remote)

Durham, NC · Remote

$500 - $3K/mo

Our team of skilled therapists and psychiatric nurse practitioners works collaboratively to meet ... Review and approve treatment plans, documentation, and medication management strategies. * Ensure ...

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Remote Rn Utilization Review Nurse information

See Raleigh, NC salary details

$20

$41

$67

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

As of Jun 8, 2026, the average hourly pay for remote rn utilization review nurse in Raleigh, NC is $41.10, according to ZipRecruiter salary data. Most workers in this role earn between $32.50 and $47.21 per hour, depending on experience, location, and employer.

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 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, 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 are the most commonly searched types of Rn Utilization Review Nurse jobs in Raleigh, NC? The most popular types of Rn Utilization Review Nurse jobs in Raleigh, NC are:
What are popular job titles related to Remote Rn Utilization Review Nurse jobs in Raleigh, NC? For Remote Rn Utilization Review Nurse jobs in Raleigh, NC, the most frequently searched job titles are:
What job categories do people searching Remote Rn Utilization Review Nurse jobs in Raleigh, NC look for? The top searched job categories for Remote Rn Utilization Review Nurse jobs in Raleigh, NC are:
What cities near Raleigh, NC are hiring for Remote Rn Utilization Review Nurse jobs? Cities near Raleigh, NC with the most Remote Rn Utilization Review Nurse job openings:
Remote Rn Utilization Review Nurse jobs near you
Nurse (RN or LPN)

Nurse (RN or LPN)

NeighborHealth Center

Raleigh, NC • On-site, Remote

Full-time

Posted 23 days ago

Job description

Position Summary
The Clinic Nurse is key to providing support for our providers, safe care for our patients, strengthening operational quality, and ultimately improving clinical patient outcomes. The Clinic Nurse assists in the care coordination of our patient's healthcare needs, and serves as a teacher, advocate, and navigator for these patients within the context of the care team. This nurse will be responsible for providing direct nursing care, performing nursing assessments, participating in the continuity of patient care, being a servant-leader, and helping improve patient outcomes within the role of a clinic nurse.
Principal Duties and Responsibilities*
  • Provides clinical and administrative support for providers within the care team model. This includes:
    • Serving as a liaison between providers and their patients
    • Communicating abnormal lab results and treatment plans to patients as outlined by the provider and/or protocols
    • Providing patient education in areas such as chronic disease, medications, prenatal care, and wellness
    • Working with other members of the care team to coordinate patient care, referrals, DME orders, care management, and hospital/ER follow-up
    • Executing nursing care under the direction of the provider, such as: medication injections, wound care and dressing changes, and assisting in procedures
    • Navigating medication changes and prior authorizations due to insurance requirements under standing orders and the guidance of the provider
    • Obtaining pre-authorizations for diagnostic testing as required by insurance
  • Manages the clinical phone line. Assists pharmacies, responds to patient requests, conducts triage, and conveys messages to and from providers, clinics, specialists, and other care team members.
  • Directs the assessment of acutely ill patients who present to the clinic in person or via phone to ensure efficient workflow.
  • Provides nursing care to patients who present through the Nurse Visit Schedule. This may include, among other types of visits: BP checks, wound care, diabetes patient education, medication administration, triage, pregnancy tests/counseling, and conveying test results.
  • Collaborates with medical support staff and assists with prioritizing clinical tasks to ensure efficient workflow.
  • Assists with training and competency verification of medical support staff.
  • Ensures all emergency equipment and clinic use medications are properly stocked, stored, and logged (as applicable) for the care of patients at their clinic site.
  • Participates in care team meetings and quality meetings and other meetings as directed by the Chief Medical Officer.
  • Documents all activity appropriately in the Electronic Medical Record.

Requirements
Required Skills or Abilities*
  • Computer literacy in internet use and Windows environment, including Outlook, Word, and Excel with keyboarding skills of at least 45 wpm.
  • Ability to cultivate and develop inclusive and equitable working relationships with co-workers and community members.
  • Ability to serve as an advocate for individuals of all ethnicities, genders, ages, and backgrounds.
  • Strong patient assessment skills required including ability to triage patients. Ability to use the nursing process to guide patient encounters and care.
  • Communicate effectively with patients in a manner that protects their confidentiality and is sensitive to their culture and to their physical/emotional/spiritual condition.
  • Flexibility to adapt to changing or stressful conditions, including unanticipated changes to working schedules or locations.
  • Good physical stamina and an ability to be standing/active/in motion most of the day. Strength and dexterity to move patients, handle equipment, and move quickly within the clinical area to fulfill job responsibilities.
  • Good interpersonal skills are a necessity, including an ability to work well with the variety of ages, cultures, and temperaments represented among NHC staff and patients, treating others with kindness and professionalism in all they do.
  • Commitment to demonstrating personal integrity through punctuality, honesty, an ability to follow instructions, proper attention to detail in all work matters, and a willingness learn from others.
  • An ability to work independently, take initiative, and set priorities in accordance with the needs and mission of the clinic.
  • Clear and concise written and verbal communication skills for communicating coherently and professionally with patients and co-workers.
  • Conscientious of departmental and organizational policies and procedures, and able to embrace and personify the mission of the NHC.
  • Strong ability to be a clinical leader in the organization and guide a team of medical support personnel. Ability to delegate appropriate tasks to medical support staff.
  • Proficiency in basic clinical nursing hands-on skills such as venipuncture, medication administration, and wound care.

Required Knowledge, Experience, or Licensure/Registration
  • Ability to work onsite Mondays through Fridays.
  • Ability to read, write, speak, and comprehend English fluently; knowledge of Spanish is helpful.
  • RN or LPN Licensure in the state of North Carolina
  • Vaccines as required
  • CPR Certification.
  • Clinical experience preferred (desirably in a clinic, acute care, or triage setting).

This is a full-time, non-exempt position.
*To comply with the Americans with Disabilities Act of 1990 (ADA), which prohibits discrimination against qualified individuals on the basis of disability, it is necessary to specify the physical, mental and environmental conditions of the essential duties of the job.
NeighborHealth Center is an Equal Opportunity Employer, including veterans and disability. NHC is dedicated to building a culturally diverse staff committed to serving a diverse patient population.

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