... review complex records and identify relevant data points. * The ability to work independently, manage multiple tasks, and maintain organized records is necessary. Required Education * RN preferred.
New
... review complex records and identify relevant data points. * The ability to work independently, manage multiple tasks, and maintain organized records is necessary. Required Education * RN preferred.
New
... review complex records and identify relevant data points. * The ability to work independently, manage multiple tasks, and maintain organized records is necessary. Required Education * RN preferred.
New
... review complex records and identify relevant data points. * The ability to work independently, manage multiple tasks, and maintain organized records is necessary. Required Education * RN preferred.
New
Remote Utilization Review Nurse information
See Remote, OR salary details
$21.37 - $25.70
2% of jobs
$25.70 - $30.02
9% of jobs
$32.98 is the 25th percentile. Wages below this are outliers.
$30.02 - $34.34
21% of jobs
The median wage is $37.84 / hr.
$34.34 - $38.66
23% of jobs
$38.66 - $42.99
13% of jobs
$46.35 is the 75th percentile. Wages above this are outliers.
$42.99 - $47.31
10% of jobs
$47.31 - $51.63
8% of jobs
$51.63 - $55.95
5% of jobs
$55.95 - $60.28
5% of jobs
$60.28 - $64.60
2% of jobs
$64.60 - $68.92
2% of jobs
$21
$42
$68
How much do remote utilization review nurse jobs pay per hour?
As of Sep 6, 2026, the average hourly pay for remote utilization review nurse in Remote, OR is $42.24, according to ZipRecruiter salary data. Most workers in this role earn between $33.37 and $48.51 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?
| Aspect | Remote Utilization Review Nurse | Remote Case Manager |
|---|---|---|
| Certifications | RN license, possibly CCM or UR certifications | RN license, CCM or case management certifications |
| Work Environment | Healthcare facilities, insurance companies, telehealth | Insurance companies, healthcare organizations, telehealth |
| Job Focus | Review medical necessity, approve or deny services | Coordinate 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.
More about Remote Utilization Review Nurse jobs
What are the most commonly searched types of Utilization Review Nurse jobs in Remote, OR?
The most popular types of Utilization Review Nurse jobs in Remote, OR are:
What are popular job titles related to Remote Utilization Review Nurse jobs in Remote, OR?
For Remote Utilization Review Nurse jobs in Remote, OR, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review Nurse jobs in Remote, OR look for?
The top searched job categories for Remote Utilization Review Nurse jobs in Remote, OR are:
What cities near Remote, OR are hiring for Remote Utilization Review Nurse jobs?
Cities near Remote, OR with the most Remote Utilization Review Nurse job openings:
Full-time
Posted 3 days ago
New
Bay Area Hospital rating
8.6
Based on 15 frontline employees who took The Breakroom Quiz
43rd of 1,065 rated hospitals
Job description
Time Type:
Full timeHours per Pay Period:
80Shift:
Day ShiftMinimum:
$34.96 USDMaximum:
$47.29 USD(This represents the rate for an individual with significant experience in this job)Department:
AccreditationCurrent Bay Area Hospital Employee: If you are a current Bay Area Hospital employee, please apply through the Workday internal career site.
The future looks bright at Bay Area Hospital, and we are always searching for quality people to join our team. We offer a great atmosphere, competitive pay, a wide array of benefits, and many growth opportunities for our employees.
Job Description:
Clinical AbstractorA Clinical Data Abstractor reviews, analyzes, and summarizes relevant patient information from medical records. The data is then compiled into a structured format for various purposes, including quality improvement initiatives, regulatory reporting, clinical research, and billing.0.5 FTE assigned to Trauma
Remaining time assigned to Core/Sepsis abstraction
Principal Duties and Responsibilities
- Extracts and abstracts specific clinical data points from medical records, electronic health records (EHRs), and other medical documentation according to established protocols and definitions.
- Reviews abstracted data to ensure its accuracy, consistency, and completeness, often performing quality audits to maintain data integrity.
- Prepares and submits accurate and timely data to various registries or quality reporting systems, such as those related to specific procedures, disease processes, or national measures (e.g., Core Measures).
- Identifies and communicates opportunities and trends based on data findings to improve clinical processes and patient safety.
- Communicates and collaborates with clinical staff, management, and other healthcare professionals to clarify documentation and resolve data discrepancies.
- Aids in the collection and organization of data for research, clinical trials, epidemiological studies, or other data-driven initiatives.
- Arrays data for presentation in a format that is clear and understandable to audience.
- Maintains an interrater reliability at or above 95%.
Skills and Abilities
- A strong understanding of medical terminology, anatomy, disease processes, and medical coding systems (e.g., ICD-10) is essential.
- Familiarity with Epic EHR, data abstraction software, and data management tools like Microsoft Excel is preferred.
- Excellent attention to detail and a high standard of accuracy are crucial for ensuring the reliability of data.
- Strong analytical and problem-solving skills are needed to review complex records and identify relevant data points.
- The ability to work independently, manage multiple tasks, and maintain organized records is necessary.
Required Education
- RN preferred.
- Association of the Advancement of Automotive Medicine's Abbreviated Injury Scale (AIS) course required within 6 months of hire.
- Trauma registry course required within 6 months of hire.
- ICD-10 course within 6 months of hire and/or an ICD-10 refresher course every 5 years required.
- Accrue 24 hours of trauma-related CE during the trauma verification cycle (3 years) required.
- Certified Professional in Healthcare Quality (CPHQ) or Certified Professional in Patient Safety (CPPS) within 2 years.
Principal Duties and Responsibilities
- Extracts and abstracts specific clinical data points from medical records, electronic health records (EHRs), and other medical documentation according to established protocols and definitions.
- Reviews abstracted data to ensure its accuracy, consistency, and completeness, often performing quality audits to maintain data integrity.
- Prepares and submits accurate and timely data to various registries or quality reporting systems, such as those related to specific procedures, disease processes, or national measures (e.g., Core Measures).
- Identifies and communicates opportunities and trends based on data findings to improve clinical processes and patient safety.
- Communicates and collaborates with clinical staff, management, and other healthcare professionals to clarify documentation and resolve data discrepancies.
- Aids in the collection and organization of data for research, clinical trials, epidemiological studies, or other data-driven initiatives.
- Arrays data for presentation in a format that is clear and understandable to audience.
- Maintains an interrater reliability at or above 95%.
Skills and Abilities
- A strong understanding of medical terminology, anatomy, disease processes, and medical coding systems (e.g., ICD-10) is essential.
- Familiarity with Epic EHR, data abstraction software, and data management tools like Microsoft Excel is preferred.
- Excellent attention to detail and a high standard of accuracy are crucial for ensuring the reliability of data.
- Strong analytical and problem-solving skills are needed to review complex records and identify relevant data points.
- The ability to work independently, manage multiple tasks, and maintain organized records is necessary.
Required Education
- RN preferred.
- Association of the Advancement of Automotive Medicine's Abbreviated Injury Scale (AIS) course required within 6 months of hire.
- Trauma registry course required within 6 months of hire.
- ICD-10 course within 6 months of hire and/or an ICD-10 refresher course every 5 years required.
- Accrue 24 hours of trauma-related CE during the trauma verification cycle (3 years) required.
- Certified Professional in Healthcare Quality (CPHQ) or Certified Professional in Patient Safety (CPPS) within 2 years.
Compensation Grade:
GCompensation Grade Profile:
G- HourlyBay Area Hospital is an Equal Opportunity Employer.
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What Bay Area Hospital employees say
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Benefits
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About Bay Area Hospital
Sourced by ZipRecruiter
Industry
Health care and social assistance
Company size
1,001 - 5,000 Employees
Headquarters location
Coos Bay, OR, US
Year founded
1974