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Remote Rn Utilization Review Nurse Jobs in Toronto, ON

Foundation Health Canada

Nurse Practitioner

Etobicoke, ON · On-site +1

$65 - $85/hr

Current registration with the College of Nurses of Ontario (CNO) as a Nurse Practitioner (Registered Nurse - Extended Class) in good standing * Completion of one of the following: * Master of Nursing ...

VON Canada (Ontario)

VON Virtual Job Fair

Hamilton, ON · On-site +1

Registered Nurse (RN) * Registered Practical Nurse (RPN) * And many more Nova Scotia Canada Career opportunities with VON include the following: * Continuing Care Assistant (CCA) * Registered Nurse ...

EventMobi

Account Manager - Canada Remote

Toronto, ON · Remote

CA$105K/yr

Maintain a clean and up to date pipeline forecast to be reviewed weekly with your manager ... Nurses Association and Canadian Real Estate Association have trusted EventMobi's suite of software ...

Cayenta

(Remote) Application Consultant

Guelph, ON · Remote

... reviews & documentation, requirements elicitation, allowing the project team to gain a ... to exceptional utilization of assigned resources. * Be a leader in providing subject matter ...

Cayenta

(Remote) Application Consultant

Markham, ON · Remote

... reviews & documentation, requirements elicitation, allowing the project team to gain a ... to exceptional utilization of assigned resources. * Be a leader in providing subject matter ...

Cayenta

(Remote) Application Consultant

Toronto, ON · Remote

... reviews & documentation, requirements elicitation, allowing the project team to gain a ... to exceptional utilization of assigned resources. * Be a leader in providing subject matter ...

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Remote Rn Utilization Review Nurse information

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 Toronto, ON?

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

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

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

Remote Rn Utilization Review Nurse jobs near you
Infographic showing various Remote Rn Utilization Review Nurse job openings in Toronto, ON as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 13% Part Time, 3% Contract, and 1% Nights. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution.

Registered Nurse - Clinical Documentation

Mercor

Toronto, ON • Remote

CA$60 - CA$80/hr

Full-time

Re-posted 24 days ago

Job description

About the job

Mercor connects elite creative and technical talent with leading AI research labs. Headquartered in San Francisco, our investors include Benchmark, General Catalyst, Peter Thiel, Adam D'Angelo, Larry Summers, and Jack Dorsey.

Position: Registered Nurses (Data labelling and training)
Type: Contract
Compensation: $60–$80/hour
Location: Remote

Role Responsibilities

  • Review and assess clinical documentation for accuracy, completeness, and quality.
  • Analyze healthcare workflows and recommend process improvements.
  • Interpret patient records and clinical notes to support product development.
  • Identify documentation gaps, inconsistencies, and edge cases.
  • Collaborate with product, engineering, and operations teams to refine AI-driven healthcare tools.
  • Ensure adherence to healthcare regulations, policies, and best practices.

Qualifications

Must-Have

  • Active Registered Nurse (RN) license.
  • 3–5+ years of clinical nursing experience.
  • Strong understanding of clinical documentation and healthcare workflows.
  • Experience working with EHR systems (Epic, Cerner, Meditech, etc.).
  • Excellent analytical, communication, and problem-solving skills.

Preferred

  • Experience in CDI, case management, utilization review, or quality improvement.
  • Exposure to healthcare technology, AI tools, or digital health products.
  • Ability to collaborate effectively with cross-functional teams.

Application Process (Takes 20–30 mins to complete)

  • Upload resume
  • AI interview based on your resume
  • Submit form

Resources & Support

  • For details about the interview process and platform information, please check: https://talent.docs.mercor.com/welcome
  • For any help or support, reach out to: support@mercor.com

PS: Our team reviews applications daily. Please complete your AI interview and application steps to be considered for this opportunity.