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Remote Utilization Review Nurse Jobs in Raleigh, NC

SalvoHealth

Bi-Lingual, RN Care Coordinator

Raleigh, NC · Remote

$25 - $26/hr

... Remote Patient Monitoring ("RPM") to bill under the patient's insurance. This is a major step ... reviewing applications, analyzing resumes, or assessing responses and identifying potential ...

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Remote Utilization Review Nurse information

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$20

$41

$67

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

As of Sep 7, 2026, the average hourly pay for remote utilization review nurse in Raleigh, NC is $41.10, according to ZipRecruiter salary data. Most workers in this role earn between $32.50 and $47.21 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.

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Remote Utilization Review Nurse jobs near you
Infographic showing various Remote Utilization Review Nurse job openings in Raleigh, NC as of August 2026, with employment types broken down into 1% As Needed, 83% Full Time, 12% Part Time, 3% Contract, and 1% Nights. Highlights an 87% Physical, 2% Hybrid, and 11% Remote job distribution, with an average salary of $85,491 per year, or $41.1 per hour.

Bi-Lingual, RN Care Coordinator

SalvoHealth

Raleigh, NC • Remote

$25 - $26/hr

Full-time

Medical, Dental, Vision, PTO

Posted 12 days ago

Job description

Salvo Health is taking a new approach to help millions of Americans facing chronic health conditions, centered on chronic gut health and metabolic conditions from IBS to obesity. Our patients are assigned a “whole patient” care team and have seven day a week access to app-based care, using Remote Patient Monitoring (“RPM”) to bill under the patient’s insurance. This is a major step forward to go beyond episodic appointments to continuous care at home, and deliver interdisciplinary wraparound care in partnership with the patient’s existing local doctor.
 
Salvo is backed by leading health care investors from innovators like Livongo, Ro, Ginger, Brightline, Tia, and others. Salvo care draws on expertise from Board-certified specialty physicians, registered dietitians, nurses, psychologists, and therapists who have developed our evidence-based protocols, for a personalized, multi-month journey to better health.
 
Salvo is the first to bring a scalable and tech-enabled, more integrative approach to these chronic conditions, going beyond treating only the symptoms in order to identify and address the root causes of chronic illness.
What You Will do:
  • Provide exceptional care, disease management and health education to patients
  • Support goal setting for individual patients asynchronously to help them better manage their chronic conditions
  • Create personalized action plans with guidelines to reduce or eliminate unwanted behaviors
  • Help clients understand their motivations and create behavior change plans 
  • Conduct regular outreach to patients, based on their needs and preferences, to support engagement and elicit behavior change
  • Coordinate with other clinical team members to provide an exceptional patient experience
  • Develop and maintain professional, support-oriented working relationships with patients and team members
  • Create and distribute health education materials to individual members as necessary
  • Work with a cross-functional product team to develop and constantly improve our in-app patient experience
Qualifications:
  • RN Compact state license required, additional licensing may be needed
  • Bilingual (Spanish speaking, reading, and writing) REQUIRED
  • 2+ year of experience as Registered Nurse 
  • 2+ years of experience in patient-facing or customer-facing roles
  • Excellent customer relation skills, as well as written and verbal communication skills
  • Knowledge of medical terminology and proficiency of general medical office procedures
  • Familiarity with digital applications like Slack, Coda, Google Workspace, etc.
  • Strong analytical and proactive problem solving skills
  • Self-motivated, results-oriented and strategic thinker 
  • Personal passion for health and wellness topics
  • Must be authorized to work in the United States
  • Experience working in telehealth or healthcare startup environment preferred
  • Bonus: Experience working in GI, weight management, and/or with anti-obesity medications such as GLP-1s
Benefits:
  • Health, Vision, & Dental benefits for full-time employees and dependents
  • 200 hours (25 days) of paid time off and 12 paid holidays throughout the year
  • Annual CEU stipend
  • Annual coverage of RN maintenance fee
  • Clinical leadership support to enhance clinical expertise in GI and/or metabolic health

We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.