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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 ...

eStruxture

Operations Field Engineer

Toronto, ON · Remote

Conduct comprehensive technical reviews and approvals of all high-risk and complex Methods of ... remote troubleshooting capabilities. * Capacity Planning Subject Matter Expert (SME) ensures ...

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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 September 2026, with employment types broken down into 87% Full Time, and 13% Part Time. Highlights an 100% Remote job distribution.

Nurse Practitioner (Remote)

Etobicoke, ON • Remote

Foundation Health Canada
See more jobs at Foundation Health Canadaexternal

CA$65 - CA$85/hr

Part-time

Re-posted 25 days ago

Job description

Position Summary

Foundation Health is seeking a highly skilled and compassionate Nurse Practitioner to join our interdisciplinary team. The exciting and entrepreneurial role focuses on clinic-based and virtual primary care in an innovative and growing healthcare group.

Run by entrepreneurs with years of healthcare experience, Foundation Health is constantly reimagining how we can deliver care in more effective and patient-centric ways. In this job, you will be exposed to a fast-growing startup culture of a healthcare company that is doing things differently.

The successful candidate will be central to managing and shaping the new Nurse Practitioner division within our clinics. They will provide direct patient care as a Nurse Practitioner while supporting the oversight, coordination, and quality management of Foundation Health's nursing programs. This role is ideal for an NP with strong primary care and leadership capabilities, and a passion for community-based healthcare who wants to grow with a dynamic business that is looking to create some of the most unique healthcare offerings in Canada.

Think of this role as being the leader of a new and critically important division focused on patient-centric care in a company where innovation and building new models of healthcare that are lacking in Canada are the focus.

Qualifications & Requirements

  • 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 Nurse Practitioner (MN-NP)

    • Primary Health Care Nurse Practitioner Certificate (PHNCP)

    • Master of Nursing / Primary Health Care Nurse Practitioner (MN/PHCNP)

    • Or related Nurse Practitioner Master's Degree

  • Demonstrated experience in primary care working in multidisciplinary teams

  • Experience in geriatric care, home care, community care, or care coordination is an asset

  • Leadership or supervisory experience is considered a strong asset

  • Excellent clinical assessment, communication, and organizational skills

Key Responsibilities Nurse Practitioner Primary Care 

  • Provide comprehensive assessments and ongoing primary care within the clinic setting

  • Diagnose, treat, and manage acute and chronic health conditions

  • Develop and implement individualized treatment and care plans

  • Prescribe medications and order diagnostic testing within NP scope of practice

  • Collaborate with physicians, allied health professionals, and community partners

  • Promote preventative care, health education, and chronic disease management

  • Occasionally support continuity of care between clinic, geriatric, and home care divisions

  • Virtually triage patients and conduct comprehensive patient assessments as required

Staff Management

  • Assist with recruitment, interviewing, and hiring of staff as we add more clinics

  • Provide onboarding, mentorship, and clinical training as needed

  • Ensure compliance with regulatory, professional, and safety standards


    What We Offer

    • Flexible, part-time and hybrid (in clinic and virtual) schedule

    • Supportive and collaborative team-focused environment

    • Opportunity for leadership growth within a rapidly expanding healthcare organization

    • Meaningful opportunity to improve patient outcomes in both clinic and community settings

    • Ability to develop and shape clinical nursing services