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Remote Rn Utilization Review Nurse Jobs in Raleigh, NC

Senture

Medical Director

Raleigh, NC · Remote

While this position allows remote work, the individual must reside within the state of North ... Minimum three (3) years of experience supporting policy interpretation, utilization review ...

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 ...

Amerihealth Caritas

Quality Perform Spec Clinical

Raleigh, NC · On-site +1

$31.25 - $41.75/hr

Remote based position with a strong preference for a North Carolina resident * Monday through ... An active and unencumbered Registered Nurse license required Skills and Abilities * Strong ...

Centene

Psychologist Reviewer

Durham, NC · On-site +1

$87K - $157K/yr

Centene is Hiring - Remote Psychologist Reviewers (ABA) Centene is seeking Remote Psychologist ... Interact with network practitioners to provide education on best practice models and utilization ...

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All JobsRn Utilization Review Nurse JobsRemote Rn Utilization Review Nurse JobsRemote Rn Utilization Review Nurse Jobs in Raleigh, NC

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 Sep 5, 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 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 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:

Remote Rn Utilization Review Nurse jobs near you
Infographic showing various Remote Rn Utilization Review Nurse job openings in Raleigh, NC as of August 2026, with employment types broken down into 100% Contract. Highlights an 100% Remote job distribution, with an average salary of $85,491 per year, or $41.1 per hour.

National Nurse Compliance Surveyors - Home Health or Hospice

Community Health Accreditation Partner

Raleigh, NC • Remote

$50.25/hr

Part-time

Retirement, PTO

Re-posted 28 days ago

Job description

Anticipated Orientation: Late October

If you are a home health or hospice nursing professional, with a strong compliance background and passion for improving the quality of patient care, this is a great opportunity for you to make an impact on a national scale. 

At Community Health Accreditation Partner (CHAP), you’re not just taking on a role. You’re becoming part of a mission-driven organization committed to excellence, integrity, and flexibility. We cultivate a supportive, collaborative culture where your expertise is valued, and your work truly makes a difference.


This is a nationwide, travel-based, per-diem position. All assignments will require travel to a home health or hospice agency being surveyed for accreditation/certification. CHAP Site Visitors are responsible for conducting, planning, organizing, and coordinating healthcare accreditation and/or certification surveys in the community setting. These visits must be performed in accordance with the CHAP Standards of Excellence, in strict confidentiality unless otherwise required by law, and within compliance of the policies and procedures that govern the accreditation/certification process.


Qualified candidates must possess a strong working level knowledge of the CMS Home Health or Hospice Conditions of Participation and resources related to the CoPs (conditions of participation) and the survey process. This position requires strong attention to detail and ability to deliver accurate, complete, and well-written documentation. Candidates must be able to work autonomously, apply critical thinking, and be adaptable to change.


Qualifications:

  • Bachelor's degree in Nursing or a related healthcare field required.
  • Active Registered Nurse (RN) license required.
  • Minimum of five (5) years of experience in a compliance or regulatory role within the home health or hospice industry required.
  • Minimum of one (1) year of leadership experience required, including responsibility for supervising staff and/or direct reports.

Availability Requirements:

  • A minimum of 10 survey days of availability per month is required (required travel days are not included in the 10 survey days).

Pay Structure:

  • Survey days: $402/day
  • Travel days: $175/day (1 travel day paid per assigned survey)
  • Site Visit prep time: $75/per site visit
  • Other: $60/per day in meal per diem per site visit day, $30 per day in meal per diem for travel day.
  • Estimated Minimum monthly pay: $5,590 (gross) to include meal stipends *(based on 10 survey days, 4 travel days, meal per diems & prep).
  • Travel: All airfare expenses are paid by CHAP; other travel expenses are reimbursed including mileage at the current IRS Standard Rate of 76 cents per mile.
  • Benefits: Employees are eligible for 401(k) and limited wellness benefits. This position does not accrue paid time off.
  • Training: Must be available for 4-6 consecutive travel weeks during first two months of employment for training (preceptorship).

Apply now and be part of a team that’s improving the quality of care nationwide, one visit at a time!