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Remote Utilization Management Nurse Jobs in Minnesota

Harris

$10/hr

Improve revenue by creating billable Care Management episodes, increasing visits for management of ... Graduates from accredited Schools of Nursing (LPN, LVN, RN, BSN, etc.) * Current COMPACT license to ...

Harris

$10/hr

Improve revenue by creating billable Care Management episodes, increasing visits for management of ... Graduates from accredited Schools of Nursing (LPN, LVN, RN, BSN, etc.) * Current COMPACT license to ...

Allianz

Counsel | Remote

Minneapolis, MN · On-site +1

AZRA has specific expertise in run-off management of U.S. legacy insurance liabilities. It services ... Utilization of artificial intelligence tools and resources (e.g. generative Al). What you bring:

Optomec Inc

Support Manager

Saint Paul, MN · Remote

Produce and present operational reports and dashboards (SLA compliance, MTTR, FTF rate, utilization ... Remote customer communication and stakeholder management * Analytical reporting and continuous ...

MDS Solutions

REMOTE MDS Coordinator

Saint Cloud, MN · On-site +1

$34 - $43.25/hr

This role requires a RN license, LPN will not meet the minimum qualifications. What do we offer you ... Provide Medicare, Medicaid (case mix), and Managed Care oversight to ensure appropriate clinical ...

MDS Solutions

REMOTE MDS Coordinator

Minneapolis, MN · On-site +1

$35.75 - $45.75/hr

This role requires a RN license, LPN will not meet the minimum qualifications. What do we offer you ... Provide Medicare, Medicaid (case mix), and Managed Care oversight to ensure appropriate clinical ...

MDS Solutions

REMOTE MDS Coordinator

Duluth, MN · On-site +1

$38.25 - $48.75/hr

This role requires a RN license, LPN will not meet the minimum qualifications. What do we offer you ... Provide Medicare, Medicaid (case mix), and Managed Care oversight to ensure appropriate clinical ...

MDS Solutions

REMOTE MDS Coordinator

Minneapolis, MN · On-site +1

$35.75 - $45.75/hr

This role requires a RN license, LPN will not meet the minimum qualifications. What do we offer you ... Provide Medicare, Medicaid (case mix), and Managed Care oversight to ensure appropriate clinical ...

MDS Solutions

REMOTE MDS Coordinator

Minneapolis, MN · Remote

$35.75 - $45.75/hr

This role requires a RN license, LPN will not meet the minimum qualifications. What do we offer you ... Provide Medicare, Medicaid (case mix), and Managed Care oversight to ensure appropriate clinical ...

MDS Solutions

REMOTE MDS Coordinator

Rochester, MN · On-site +1

$33.50 - $42.75/hr

This role requires a RN license, LPN will not meet the minimum qualifications. What do we offer you ... Provide Medicare, Medicaid (case mix), and Managed Care oversight to ensure appropriate clinical ...

MDS Solutions

REMOTE MDS Coordinator

Saint Cloud, MN · On-site +1

$34 - $43.25/hr

This role requires a RN license, LPN will not meet the minimum qualifications. What do we offer you ... Provide Medicare, Medicaid (case mix), and Managed Care oversight to ensure appropriate clinical ...

MDS Solutions

REMOTE MDS Coordinator

Rochester, MN · On-site +1

$33.50 - $42.75/hr

This role requires a RN license, LPN will not meet the minimum qualifications. What do we offer you ... Provide Medicare, Medicaid (case mix), and Managed Care oversight to ensure appropriate clinical ...

MDS Solutions

REMOTE MDS Coordinator

Rochester, MN · Remote

$33.50 - $42.75/hr

This role requires a RN license, LPN will not meet the minimum qualifications. What do we offer you ... Provide Medicare, Medicaid (case mix), and Managed Care oversight to ensure appropriate clinical ...

MDS Solutions

REMOTE MDS Coordinator

Saint Cloud, MN · Remote

$34 - $43.25/hr

This role requires a RN license, LPN will not meet the minimum qualifications. What do we offer you ... Provide Medicare, Medicaid (case mix), and Managed Care oversight to ensure appropriate clinical ...

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All JobsUtilization Management Nurse JobsRemote Utilization Management Nurse JobsRemote Utilization Management Nurse Jobs in Minnesota

Remote Utilization Management Nurse information

See Minnesota salary details

$20

$41

$67

How much do remote utilization management nurse jobs pay per hour?

As of Sep 4, 2026, the average hourly pay for remote utilization management nurse in Minnesota is $41.41, according to ZipRecruiter salary data. Most workers in this role earn between $32.74 and $47.55 per hour, depending on experience, location, and employer.

What is a remote utilization management nurse?

A Remote Utilization Management Nurse is a registered nurse who works from a remote location, such as their home, to review patient medical records and determine the necessity, appropriateness, and efficiency of healthcare services. They collaborate with healthcare providers and insurance companies to ensure that patients receive appropriate care while managing costs. Their main responsibilities include reviewing clinical documentation, conducting pre-authorization reviews, and ensuring compliance with healthcare regulations and insurance guidelines.

What does a remote utilization management nurse do?

As a remote utilization management nurse, you work from home to perform a variety of duties and responsibilities, such as corresponding with and interviewing physicians, modifying patient treatment plans, analyzing investigation information, and auditing patient records. As a UM nurse, you may also deal with other clinical tasks, referrals, authorizations, and reviews. You usually work for insurance companies and healthcare providers to help to determine if patients should receive authorization for needed treatments or for those that they already receive. In some cases, you may monitor processes to ensure that hospital patients are getting what they need during their stay.

What are the key skills and qualifications needed to thrive as a remote utilization management nurse?

To thrive as a Remote Utilization Management Nurse, you need a valid RN license, clinical experience (often in acute care), and a solid understanding of utilization review and healthcare regulations. Familiarity with case management software, electronic medical records (EMRs), and tools like InterQual or Milliman Care Guidelines is typically required. Strong analytical skills, attention to detail, and effective written and verbal communication are essential soft skills for successful remote collaboration and decision-making. These skills ensure accurate assessments, compliance with standards, and the delivery of cost-effective, quality patient care from a remote setting.

What are some common challenges faced by remote utilization management nurses, and how can they be addressed?

Remote Utilization Management Nurses often face challenges such as maintaining effective communication with interdisciplinary teams, staying updated on changing insurance guidelines, and managing a high volume of case reviews. To address these issues, it's helpful to establish regular virtual check-ins with team members, utilize digital tools for efficient documentation, and participate in ongoing training on payer requirements. Developing strong organizational skills and proactively seeking clarification on complex cases can also contribute to success in this role.

What is the difference between Remote Utilization Management Nurse vs Remote Case Manager?

AspectRemote Utilization Management NurseRemote Case Manager
CredentialsRN license, certifications like CCM or ANCCRN license, certifications like CCM or similar
Work EnvironmentHealthcare organizations, insurance companies, telehealthInsurance companies, healthcare providers, telehealth
Job FocusReviewing medical necessity, authorizations, and utilizationCoordinating patient care, discharge planning, resource management

Both roles require RN licensure and similar certifications, often working remotely within healthcare or insurance settings. The main difference lies in focus: Utilization Management Nurses primarily review medical necessity and authorization requests, while Case Managers coordinate patient care and discharge planning. Understanding these distinctions helps job seekers identify the role that best matches their skills and career goals.

More about Remote Utilization Management Nurse jobs

What are popular job titles related to Remote Utilization Management Nurse jobs in Minnesota?

For Remote Utilization Management Nurse jobs in Minnesota, the most frequently searched job titles are:

What job categories do people searching Remote Utilization Management Nurse jobs in Minnesota look for?

The top searched job categories for Remote Utilization Management Nurse jobs in Minnesota are:

What cities in Minnesota are hiring for Remote Utilization Management Nurse jobs?

Cities in Minnesota with the most Remote Utilization Management Nurse job openings:

Remote Utilization Management Nurse jobs near you
Infographic showing various Remote Utilization Management Nurse job openings in Minnesota as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution, with an average salary of $86,136 per year, or $41.4 per hour.

Director Inpatient Clinical Documentation Integrity | CentraCare

CentraCare Health

Saint Cloud, MN • Remote

$117K - $175K/yr

Full-time

Medical, Dental, Retirement, PTO

Re-posted 14 days ago

CentraCare rating

6.9

Company rating: 6.9 out of 10

Based on 156 frontline employees who took The Breakroom Quiz

454th of 898 rated healthcare providers

Job description

Shape strategy. Drive outcomes. Elevate care.

If you're passionate about leading transformative initiatives that connect clinical excellence, quality outcomes, patient safety, regulatory compliance, and financial performance, we invite you to join CentraCare as our Director of Inpatient Clinical Documentation Integrity (CDI).  Reporting within the Population Health Division, this leadership role provides strategic and operational oversight of CentraCare's inpatient CDI program. You'll partner with clinical and operational leaders across the organization to advance documentation excellence, improve quality outcomes, support value-based care initiatives, and strengthen organizational performance.  This is an opportunity to shape documentation strategy across a growing health system while collaborating with physician leaders and interdisciplinary teams to improve patient care, organizational quality, and financial sustainability. 

Core functions of the role:

  • Collaborates closely with physician leaders, quality, coding, finance, revenue cycle, case management, and operational leaders to ensure accurate, complete, and clinically supported documentation that reflects the severity of illness, risk of mortality, resource utilization, and quality of care delivered across the system.
  • Accountable for advancing documentation strategies that positively influence publicly reported quality metrics, CMS, and payer reimbursement methodologies, risk-adjusted outcomes, performance rankings, denials management, and organizational financial targets.
  • Leverages analytics, clinical expertise, and industry best practices to drive strategic initiatives, monitor program performance, identify opportunities for improvement, and align CDI efforts with CentraCare's strategic and operational priorities.
  • Partners with the CDI Physician Champions to foster a culture of documentation excellence, clinical validity, continuous learning, and performance improvement while ensuring compliance with regulatory requirements and industry standards.
  • Directs daily operations of the CDI program, including staffing, productivity, workflow optimization, technology utilization, compliance, and program performance.
     

 Schedule

  • Full time | 80 hours every two weeks
  • Monday-Friday | 8:00 a.m. - 4:30 p.m.
  • Majority remote with occasional on-site meetings in St. Cloud MN (approximately quarterly)


Pay and Benefits

  • Starting pay begins at $117,104 per year; exact wage determined by years of related experience
  • Salary range: $117,104 - $175,676.80 per year
    • Salary and salary range are based on a 1.0 FTE, reduced FTE will result in a prorated offer rate
  • Full-time benefits: medical, dental, PTO, retirement, employee discounts and more!


Qualifications

  • Minimum of a Bachelors degree in Nursing is required; Masters in healthcare, nursing leadership, or health administration is preferred
  • Current Registered Nurse license with the State of Minnesota is required
  • CCDS - Certified Clinical Documentation Specialist through the Associate of Clinical Documentation Integrity Specialists (ACDIS) is required
  • Minimum of 5+ years of experience in acute care setting, at least 3 years in clinical documentation integrity is required
  • Minimum of 2+ years of management experience (at a manager or director level) is required
  • The ability for investigation, find the financial story, and focus on quality are essential
  • Using critical thinking skills and understanding story telling is vital    

CentraCare has made a commitment to diversity in its workforce. All individuals including, but not limited to, individuals with disabilities, are encouraged to apply. CentraCare is an EEO/AA employer.

What CentraCare employees say

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Benefits

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Get the full story on Breakroom

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About CentraCare

Sourced by ZipRecruiter

CentraCare has grown to meet the needs of the communities and is now one of the largest health systems in Minnesota. This means we are able to offer the latest advancements in care, technology and treatments close to home. But what makes CentraCare special is not our facilities or technology. It is our people. We live in the communities we serve. We are neighbors, friends and family. And when you need us, we are here for you.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

St. Cloud, MN, US

Year founded

1886

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