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Remote Utilization Review Nurse Jobs in Ohio (NOW HIRING)

$41.20 - $62.17/hr

Demonstrated experience in case management, utilization review, value-based care, and/or discharge ... If applying for a remote or hybrid role, this includes remote work expectations related to ...

RN Care Manager PRN

Cleveland, OH · Remote

$41.20 - $62.17/hr

Demonstrated experience in case management, utilization review, value-based care, and/or discharge ... If applying for a remote or hybrid role, this includes remote work expectations related to ...

$41.20 - $62.17/hr

Demonstrated experience in case management, utilization review, value-based care, and/or discharge ... If applying for a remote or hybrid role, this includes remote work expectations related to ...

Clinical Director

Cincinnati, OH · On-site +1

$76K - $104K/yr

Coordinate and collaborate with the contracted billing company and any internal utilization review ... Remote & Field-Based Work Expectations * Travel to assigned facility locations as needed for direct ...

Clinical Data Coder

Cincinnati, OH · On-site +1

$18 - $22.75/hr

Produce coding reports for team review and utilization *Stable schedule with no weekends, no work on Medpace holidays, and flexible work schedule* Qualifications * BSN and RN with applicable ...

Remote Pharmacist

Columbus, OH · On-site +1

$58 - $60/hr

We are a long-term care pharmacy providing pharmaceutical services to skilled nursing facilities ... Review, verify, and approve high-volume medication orders for long-term care residents. * Perform ...

Remote Pharmacist

Columbus, OH · Remote

$56.25 - $67.50/hr

We are a long-term care pharmacy providing pharmaceutical services to skilled nursing facilities ... Review, verify, and approve high-volume medication orders for long-term care residents. * Perform ...

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Showing results 1-20

Remote Utilization Review Nurse information

See Ohio salary details

$20

$40

$65

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

As of Aug 30, 2026, the average hourly pay for remote utilization review nurse in Ohio is $40.20, according to ZipRecruiter salary data. Most workers in this role earn between $31.78 and $46.15 per hour, depending on experience, location, and employer.

What is a remote utilization review nurse?

A Remote Utilization Review Nurse is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services and treatments, typically from a remote location such as their home. They review patient medical records, apply clinical guidelines, and collaborate with providers and insurance companies to ensure patients receive appropriate care while managing healthcare costs. This role often involves making coverage determinations, conducting pre-authorizations, and participating in appeals processes. Remote Utilization Review Nurses play a critical role in improving patient outcomes and resource allocation within the healthcare system.

What does a remote utilization review nurse do?

As a remote utilization nurse, your duties are to work from home or a remote location to review patient medical records and prepare a range of paperwork for different types of actions a hospital or health care provider can take. Your responsibilities are to determine patient coverage, carry out denial of service authorizations, and negotiate different treatment options and hospital stay length for patients. You rely on your knowledge of treatment options and diseases to determine the level of appropriate care for a patient. Because you telecommute, you also need good technical skills.

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

To thrive as a Remote Utilization Review Nurse, you need a current RN license, clinical experience, and a solid understanding of medical necessity criteria and healthcare regulations. Familiarity with utilization management software, EHR systems, and certifications like CCM or URAC are highly valued. Strong analytical thinking, attention to detail, and effective communication skills enable success in evaluating clinical documentation and collaborating with providers remotely. These skills and qualifications are essential to ensure efficient, compliant care decisions that optimize patient outcomes and resource use.

How does a remote utilization review nurse collaborate with physicians and other healthcare team members while working remotely?

As a Remote Utilization Review Nurse, collaboration with physicians, case managers, and other healthcare professionals is primarily conducted through secure digital platforms such as email, video conferencing, and electronic health record systems. Effective communication is essential to discuss patient care plans, clarify medical necessity, and ensure compliance with utilization policies. Nurses in this role often participate in virtual meetings or case conferences to present findings and recommendations. Building strong working relationships remotely requires proactive communication, responsiveness, and familiarity with digital collaboration tools.

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

AspectRemote Utilization Review NurseRemote Case Manager
CertificationsRN license, possibly CCM or UR certificationsRN license, CCM or case management certifications
Work EnvironmentHealthcare facilities, insurance companies, telehealthInsurance companies, healthcare organizations, telehealth
Job FocusReview medical necessity, approve or deny servicesCoordinate patient care, arrange services, discharge planning

Remote Utilization Review Nurses primarily evaluate medical necessity for services, while Remote Case Managers coordinate patient care and discharge planning. Both roles require nursing credentials and work in healthcare or insurance settings, but their core responsibilities differ. Understanding these distinctions helps job seekers find the best fit for their skills and career goals.

What are the most commonly searched types of Utilization Review Nurse jobs in Ohio?

The most popular types of Utilization Review Nurse jobs in Ohio are:

What cities in Ohio are hiring for Remote Utilization Review Nurse jobs?

Cities in Ohio with the most Remote Utilization Review Nurse job openings:

Infographic showing various Remote Utilization Review Nurse job openings in Ohio as of August 2026, with employment types broken down into 50% Full Time, and 50% Part Time. Highlights an 100% Remote job distribution, with an average salary of $83,610 per year, or $40.2 per hour.

$41.20 - $62.17/hr

Part-time

Re-posted 3 days ago


Job description

Job Description:

The RN Hospital Care Manager I delivers comprehensive care management services to designated patients, leveraging clinical expertise for screenings, assessments, and evaluations. This role involves developing and implementing patient-centered care plans with shared goals and tailored interventions. The Care Manager collaborates seamlessly with patients, families/caregivers, healthcare providers, payers, community-based providers, and other stakeholders to ensure efficient, effective, and patient-focused care management. This position spans various departments, including both Inpatient and Outpatient areas.

Essential Functions

  • Assessment: Identifies patients using screening criteria and conduct comprehensive evaluations.
  • Care Planning: Develops, adjusts, and coordinates care plans to address medical and social needs.
  • Patient Support: Guides self-management using motivational interviewing and coaching.
  • Education & Advocacy: Provides education to healthcare teams and patients, advocate for patient rights, and support self-care.
  • Collaboration: Works with multidisciplinary teams to ensure timely, high-quality care.
  • Process Improvement: Leads initiatives to enhance care transitions and policy adherence.
  • Advanced Care Planning: Provides Goals of Care education for informed decision-making.
  • Data Analysis & Compliance: Tracks key metrics, analyze trends, and ensure regulatory compliance.

Skills

  • Assessment
  • Care Planning
  • Motivational Interviewing
  • Critical Thinking
  • Time Management
  • Customer Service
  • Patient Education
  • Communication
  • Prioritization

Minimum Qualifications

  • Current Registered Nurse (RN) license in state of practice.
  • Bachelor of Science in Nursing (BSN) from an accredited institution (degree verification required). RNs hired or promoted into this role must obtain their BSN within four (4) years of their hire or promotion date. If there is an existing education agreement, that agreement will take precedence.
  • Demonstrated clinical nursing experience in an inpatient hospital setting, and familiarity with hospital patient-related terminology and processes.
  • Demonstrated understanding of disease management including treatment, length of stay, identifying barriers to delivery of care and any variation.

Preferred Qualification

  • Bachelor of Science in Nursing (BSN) from an accredited institution.
  • Case Management Certification
  • Demonstrated experience in case management, utilization review, value-based care, and/or discharge planning.
  • Basic computer skills, including proficiency in word processing and spreadsheet software. Intermediate knowledge of word processing and Excel software.

Physical Requirements

  • Ongoing need for employee to see and read information, labels, documents, monitors, identify equipment and supplies, and be able to assess customer needs.
  • Frequent interactions with providers, colleagues, customers, patients/clients, and visitors that require employee to verbally communicate as well as hear and understand spoken information, needs, and issues quickly and accurately.
  • Manual dexterity of hands and fingers to manipulate complex and delicate supplies and equipment with precision and accuracy. This includes frequent computer use for typing, accessing needed information, etc.
  • Mental stamina and flexibility- ability to handle high stress situations, make quick decisions, and manage multiple tasks simultaneously.
  • For roles requiring driving: Expected to drive a vehicle which requires sitting, seeing, and reading signs, traffic signals, and other vehicles.

Location:

Good Samaritan Hospital

Work City:

Lafayette

Work State:

Colorado

Scheduled Weekly Hours:

0

The hourly range for this position is listed below. Actual hourly rate dependent upon experience.

$41.20 - $62.17

We care about your well-being - mind, body, and spirit - which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.


Learn more about our comprehensive benefits package here.


By applying for a position with Intermountain, I acknowledge that I will comply with all applicable Intermountain policies and expectations. If applying for a remote or hybrid role, this includes remote work expectations related to confidentiality, information security, work schedules, conflicts of interest, and use of company equipment. I further acknowledge that outside employment or activities may not interfere with job responsibilities or create a conflict of interest with Intermountain. Actual or reasonably perceived conflicts may be grounds for disqualification from consideration or, if hired, corrective action up to and including termination of employment.


Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.


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