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Remote Utilization Review Nurse Jobs in Decatur, IL

Remote Utilization Review Nurse information

See Decatur, IL salary details

$20

$41

$66

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

As of Aug 21, 2026, the average hourly pay for remote utilization review nurse in Decatur, IL is $41.01, according to ZipRecruiter salary data. Most workers in this role earn between $32.40 and $47.12 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 job categories do people searching Remote Utilization Review Nurse jobs in Decatur, IL look for?

The top searched job categories for Remote Utilization Review Nurse jobs in Decatur, IL are:

What cities near Decatur, IL are hiring for Remote Utilization Review Nurse jobs?

Cities near Decatur, IL with the most Remote Utilization Review Nurse job openings:

Infographic showing various Remote Utilization Review Nurse job openings in Decatur, IL as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 14% Part Time, 3% Contract, and 1% Nights. Highlights an 91% Physical, 2% Hybrid, and 7% Remote job distribution, with an average salary of $85,305 per year, or $41 per hour.

Full-Time Licensed Clinical Social Worker for Remote Detox Center in Decatur, IL

Company Confidential

Decatur, IL • Remote

Full-time

Medical, Dental, Vision

Posted 2 days ago

New


Job description

Position Overview

Gotham Enterprises Ltd. is excited to announce an opening for a Licensed Clinical Social Worker (LCSW) to join our dedicated team. This full-time remote position focuses on providing essential mental health services within our Detox Center, where you will play a critical role in supporting clients undergoing substance use treatment. We are searching for a professional who is passionate about creating positive change and improving the overall well-being of our patients.

About the Organization

At Gotham Enterprises Ltd., we pride ourselves on our commitment to excellence in delivering healthcare services with a significant emphasis on mental health and addiction recovery. Our Detox Center is part of a larger medical facility in Decatur, Illinois, known for its integrated approach to treatment. We combine various therapeutic modalities to support our patients' recovery journeys, demonstrating our dedication to holistic care.

Work Environment

This role offers the flexibility of a remote work setting, allowing you to manage your own schedule while maintaining a full caseload. You will collaborate with a multidisciplinary team of healthcare professionals, including psychiatrists, nurses, and addiction specialists, facilitating a supportive and comprehensive treatment atmosphere. Our work culture promotes continuous learning and peer support, fostering professional growth and teamwork.

Key Responsibilities
  • Conduct thorough clinical assessments to identify individual client needs and develop personalized treatment plans.
  • Implement evidence-based therapeutic interventions, such as cognitive-behavioral therapy (CBT) and motivational interviewing, to assist clients in overcoming barriers to recovery.
  • Maintain accurate and timely clinical documentation, ensuring compliance with state regulations and organizational standards.
  • Actively participate in regular case reviews with a multidisciplinary treatment team to adapt care strategies and improve patient outcomes.
  • Provide educational resources and emotional support to patients and their families, empowering them to make informed decisions about their treatment.
  • Stay abreast of the latest research and trends in mental health and addiction treatment to continually enhance service delivery.
Patient Population / Client Focus

Your primary focus will be on individuals experiencing substance use disorders and co-occurring mental health issues. This demographic often includes diverse backgrounds, presenting unique challenges and requiring tailored therapeutic approaches. Your expertise will help clients navigate their recovery paths, moving toward healthier, more fulfilling lives.

Qualifications
  • A Master’s degree in Social Work from an accredited institution.
  • A valid LCSW license to practice in the state of Illinois.
  • Demonstrated knowledge of solution-focused and evidence-based practices in psychotherapy.
  • Exceptional communication skills, with the ability to empathize and connect with clients from various backgrounds.
  • Strong problem-solving abilities, ensuring effective intervention strategies are developed and implemented.
Preferred Experience
  • A minimum of two years of experience in a mental health or substance use treatment setting.
  • Experience with remote counseling and teletherapy approaches is a plus, as this role utilizes digital platforms for patient interaction.
  • Familiarity with electronic health record (EHR) systems to manage patient information efficiently.
Compensation and Benefits

The salary range for this position is competitive, ranging from USD 80,000 to 100,000 annually, commensurate with experience. In addition, we offer a comprehensive benefits package that includes:

  • Medical, dental, and vision insurance options to support your health and well-being.
  • Life and disability insurance to provide additional security for you and your loved ones.
  • Professional liability insurance to protect you as you provide care.
  • An employee assistance program that offers mental health support and resources for you and your family.
  • A focus on minimal paperwork, allowing you to spend more time with your clients.
  • Access to a full caseload that ensures a busy and fulfilling work schedule.
Career Growth Opportunities

Gotham Enterprises Ltd. is committed to the professional development of our employees. We offer ongoing training and mentorship programs designed to enhance clinical skills and foster career advancement. As a member of our team, you will have opportunities to take on leadership roles within new initiatives, engage in professional certifications, and attend workshops and conferences to further your knowledge in the field.

Why Join Our Team

If you are a compassionate and dedicated LCSW looking to make a significant impact in the lives of individuals struggling with addiction and mental health issues, this is the perfect opportunity for you. You'll be part of a supportive organization that values its employees and prioritizes high-quality patient care. Join us at Gotham Enterprises Ltd. and be a vital part of a team that fosters healing and transformation.

Application Information

If you are ready to embark on a rewarding career path and make a positive difference, we invite you to submit your application today. Please include your resume and a cover letter detailing your qualifications and interest in the role. We look forward to welcoming you to our team as we work together to improve the lives of our patients.