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OU Health

Care Management Utilization Review RN

Remote Eligibility: Candidates must reside and work full-time in AR, KS, MO, OK, or TX before their ... Evaluates patient clinical information, utilizes Evidence based criteria tool and collaborates with ...

OU Health

Care Management Utilization Review RN

Remote Eligibility: Candidates must reside and work full-time in AR, KS, MO, OK, or TX before their ... Evaluates patient clinical information, utilizes Evidence based criteria tool and collaborates with ...

Knexus

HR Manager (Remote)

Review and maintain company handbooks, employment agreements, and state-specific compliance ... Smart Tool Utilization: Sensibly evaluate and integrate modern tools (including AI and HRIS ...

Axxys Technologies, Inc.

Support Specialist

Plano, TX · Remote

Monitor remote service board in PSA tool for new tickets, and upon arrival evaluates the tickets ... Review PSA entries for documentation and assist with standardizing information for each client, and ...

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How much do remote tool reviewer jobs pay per hour?

As of Aug 6, 2026, the average hourly pay for remote tool reviewer in the United States is $29.88, according to ZipRecruiter salary data. Most workers in this role earn between $22.60 and $36.54 per hour, depending on experience, location, and employer.

How does a remote tool reviewer typically collaborate with product teams while working remotely?

As a Remote Tool Reviewer, collaboration with product teams is mostly achieved through virtual meetings, project management tools, and detailed feedback reports. You’ll often participate in video calls to discuss tool functionalities, user experiences, and potential improvements directly with developers and designers. Clear written communication and timely updates are essential, as your insights help shape the direction of tool updates and features. While you may work independently on testing and reviewing, regular interaction with the wider team ensures alignment on priorities and expectations.

What skills and qualifications are needed to thrive as a remote tool reviewer?

To thrive as a Remote Tool Reviewer, you need excellent analytical skills, a strong understanding of digital tools or software, and experience in writing clear, unbiased reviews. Familiarity with content management systems, usability testing platforms, and sometimes certifications in user experience or digital marketing are beneficial. Outstanding communication, attention to detail, and the ability to work independently are crucial soft skills. These abilities ensure accurate, trustworthy evaluations and clear feedback that help users and organizations make informed decisions about tools.

What is the difference between Remote Tool Reviewer vs Remote Software Tester?

AspectRemote Tool ReviewerRemote Software Tester
Required CredentialsBasic tech knowledge, sometimes certifications in testing or quality assuranceTechnical skills, certifications in software testing or quality assurance often preferred
Work EnvironmentPrimarily remote, reviewing tools and software interfacesRemote, testing software applications, identifying bugs and issues
Employer & Industry UsageTech companies, software firms, review platformsSoftware development companies, QA teams, tech firms
Search & Comparison IntentUnderstanding roles, responsibilities, and qualificationsDistinguishing testing roles, skills, and job expectations

While both roles are remote and involve working with software, Remote Tool Reviewers focus on evaluating tools and interfaces, whereas Remote Software Testers actively test applications for bugs. Understanding these differences helps job seekers find the right position aligned with their skills and career goals.

What is a remote tool reviewer?

Remote tool reviewers are professionals who evaluate and provide feedback on digital tools, software, or applications that are used for remote work. Their job typically involves testing various features, assessing usability, reporting bugs, and sharing insights to help improve the product. These reviewers often work from home and may collaborate with development teams or publish their findings online. The role requires strong communication skills, technical knowledge, and attention to detail.
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Remote Tool Reviewer jobs near you
Infographic showing various Remote Tool Reviewer job openings in the United States as of August 2026, with employment types broken down into 88% Full Time, 8% Part Time, 3% Contract, and 1% Nights. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution, with an average salary of $62,159 per year, or $29.9 per hour.

Care Management Utilization Review RN

OU Health

Remote

Other

Medical, Dental, Retirement, PTO

Posted 5 days ago

OU Health rating

7.1

Company rating: 7.1 out of 10

Based on 148 frontline employees who took The Breakroom Quiz

377th of 887 rated healthcare providers

Job description

Position Title:
Care Management Utilization Review RN
Department:
OUMC Utilization Review
Job Description:
New to OU Health? Ask your recruiter about our competitive wages and total rewards package including a sign-on bonus and possible relocation assistance!
**This position may be filled as a Level 1, 2, or 3 depending on specific education, experience, and license requirements.**
Remote Eligibility: Candidates must reside and work full-time in AR, KS, MO, OK, or TX before their first day of employment .
***Please be aware that you will need a private HIPAA-compliant space to work in due to the nature of the work***
The RN Care Manager Utilization Review I is an entry level position that collaborates with health care providers to ensure patients receive appropriate care while adhering to healthcare regulations. This work is performed through evaluation of medical necessity, collaboration with insurance companies, patients, patient families and providers and securing payor authorization for hospital stays.
Essential Responsibilities
Responsibilities listed in this section are core to the position. Inability to perform these responsibilities with or without an accommodation may result in disqualification from the position.
  • Conducts comprehensive assessments of patients' health status, medical history, and ongoing care needs utilizing evidence-based criteria tools.
  • Coordinates with the interdisciplinary healthcare team, Payors, patients and families to ensure appropriate status and financial reimbursement.
  • Provides education to patients and their families regarding their healthcare stay and appropriate status in compliance with mandated regulatory and financial expectations.
  • Coordinates and facilitates communication between patients, families, healthcare providers, and Payor sources to optimize appropriate patient and healthcare system financial reimbursement outcomes.
  • Evaluates patient clinical information, utilizes Evidence based criteria tool and collaborates with Payors as required.
  • Evaluates healthcare utilization patterns and identifies opportunities for improving efficiency and cost-effectiveness based on Payor contracts and Healthcare Mandated regulatory guidelines.
  • Advocates for appropriate status to meet patient and system needs while adhering to regulatory guidelines and reimbursement criteria.
  • Collaborates with insurance providers, Interdisciplinary teams, and other stakeholders to ensure timely authorization of services and coverage for patient hospital care and treatment.
  • Monitors and evaluates patient and healthcare system financial outcomes and processes to identify areas for improvement.
  • Participates in quality improvement initiatives and interdisciplinary care conferences to promote evidence-based practices and enhance patient safety and satisfaction.
  • Ensures compliance with federal, state, and local regulations, as well as accreditation requirements related to Nursing care management and patient continuum of care.
  • Implements approved strategies to minimize readmissions, prevent financial complications, and optimizes appropriate financial reimbursement processes.
  • Maintains a HIPPA compliant work environment to protect Patient Protected Health Information while working from home. Must provide secure Internet and Cellular phone services.
  • Maintains continuing Education with approved Evidence based criteria tool and Departmental Process Competencies and participates in Quality Audit review findings.
General Responsibilities
  • Performs other duties as assigned.
Minimum Qualifications (level 1)
Education: Associate's Degree in Nursing required.
Experience: 0-3 years of RN experience required, experience in Care Management preferred.
License/Certification/Registration: Current Registered Nurse License (RN License issued by the Oklahoma State Board of Nursing, or a current multistate compact Registered Nurse (eNLC).
Minimum Qualifications (level 2)
Education: Bachelor's Degree in Nursing required.
Experience: At least 3 years of Care Management experience required.
License/Certification/Registration: Current Registered Nurse License (RN License issued by the Oklahoma State Board of Nursing, or a current multistate compact Registered Nurse (eNLC).
Minimum Qualifications (level 3)
Education: Bachelor's Degree in Nursing required.
Experience: 5 or more years of Care Management experience required.
License/Certification/Registration: Current Registered Nurse License (RN License issued by the Oklahoma State Board of Nursing, or a current multistate compact Registered Nurse (eNLC).
Knowledge/Skills/Abilities Required
  • Demonstrates expertise in regulatory requirements regarding the Utilization Nursing care management discipline.
  • Strong communication, interpersonal, and leadership skills.
  • Detailed- oriented with excellent organizational skills.
  • Commitment to fostering a culture of continuous learning, quality improvement, and patient-centered care.
  • Strong assessment, critical thinking, and problem-solving skills
  • Strong knowledge of healthcare regulations, including CMS guidelines and Payor Contractual agreements
  • Show clear understanding of utilization management principles and integrate these with Nursing care management responsibilities.
  • Serve as liaison between patients, families, Payors and healthcare providers.
  • Demonstrates HIPPA compliance in a Work from home environment to safeguard PHI.
  • Proficiency in utilizing electronic health records (EHR) and care management software
  • Strong assessment, critical thinking, and problem-solving skills.

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Current OU Health Employees - Please click HERE to login.
OU Health is an equal opportunity employer. We offer a comprehensive benefits package, including PTO, 401(k), medical and dental plans, and many more. We know that a total benefits and compensation package, designed to meet your specific needs both inside and outside of the work environment, create peace of mind for you and your family.

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About OU Health

Sourced by ZipRecruiter

OU Health is a leading company in the healthcare industry, based in Oklahoma City, OK, US. As the state's only comprehensive academic health system, OU Health provides a full spectrum of medical care, from world-class cancer treatments to life-saving emergency care. Founded with a mission to advance healthcare, medical education, and research across the state, the company has a solid reputation for clinical excellence and a patient-centered approach. Upholding its core values of compassion, integrity, and innovation, OU Health has remarkably made a significant contribution to medical research and education and raised the standard of care across a broad range of specialties.

Industry

Hospitals

Company size

10,000+ Employees

Headquarters location

Oklahoma City, OK, US

Year founded

2020

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