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Remote Utilization Review Nurse Jobs in Reno, NV

Scribe-X

Remote Medical Scribe

Reno, NV · Remote

$14 - $17/hr

Anyone looking to begin a career in medicine (MD, DO, PA, NP, or RN) should consider becoming a ... Review completed charts with the provider between patients or at the completion of shift * Update ...

Renown Health

Coding Lead

Reno, NV · Remote

This list is to include Acute Inpatient, Level II Trauma, Rehab Facility, Skilled Nursing, Home ... Incumbent will also perform highly complex and specialized coding, including review analysis. The ...

Renown Health

Coding Lead

Reno, NV · Remote

This list is to include Acute Inpatient, Level II Trauma, Rehab Facility, Skilled Nursing, Home ... Incumbent will also perform highly complex and specialized coding, including review analysis. The ...

All JobsUtilization Review Nurse JobsRemote Utilization Review Nurse JobsRemote Utilization Review Nurse Jobs in Reno, NV

Remote Utilization Review Nurse information

See Reno, NV salary details

$21

$42

$68

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

As of Jul 29, 2026, the average hourly pay for remote utilization review nurse in Reno, NV is $42.16, according to ZipRecruiter salary data. Most workers in this role earn between $33.32 and $48.41 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Remote Utilization Review Nurse, and why are they important?

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 to make $300,000 as a nurse online?

A remote utilization review nurse can potentially earn $300,000 annually by gaining specialized certifications, gaining extensive experience, and working for high-paying healthcare organizations or as a contractor. Building a strong reputation and handling complex cases can also increase earning potential, often through overtime or consulting opportunities. However, reaching this income level typically requires advanced skills, a flexible schedule, and continuous professional development.

How do I become a utilization review nurse?

To become a utilization review nurse, you typically need to hold a registered nurse (RN) license and have experience in clinical nursing or case management. Many employers prefer candidates with knowledge of healthcare policies, insurance processes, and utilization review procedures, and some roles may require certification such as the Certified Professional in Healthcare Quality (CPHQ).

What does a remote utilization review nurse do?

A remote utilization review nurse evaluates medical records and treatment plans to determine the necessity, appropriateness, and efficiency of healthcare services. They work remotely, often using electronic health records and communication tools, to ensure that patient care aligns with insurance or healthcare guidelines. Certification in case management or utilization review is typically required for this role.

How to become a remote nurse reviewer?

To become a remote utilization review nurse, candidates typically need a registered nurse (RN) license, relevant clinical experience, and knowledge of insurance or healthcare policies. Additional certifications such as Certified Case Manager (CCM) or Utilization Review Certification (URAC) can enhance prospects, and strong communication skills are essential for reviewing medical records and making determinations remotely.

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 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.

More about Remote Utilization Review Nurse jobs
What are the most commonly searched types of Utilization Review Nurse jobs in Reno, NV? The most popular types of Utilization Review Nurse jobs in Reno, NV are:
What are popular job titles related to Remote Utilization Review Nurse jobs in Reno, NV? For Remote Utilization Review Nurse jobs in Reno, NV, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review Nurse jobs in Reno, NV look for? The top searched job categories for Remote Utilization Review Nurse jobs in Reno, NV are:
What cities near Reno, NV are hiring for Remote Utilization Review Nurse jobs? Cities near Reno, NV with the most Remote Utilization Review Nurse job openings:
Remote Utilization Review Nurse jobs near you
Infographic showing various Remote Utilization Review Nurse job openings in Reno, NV as of July 2026, with employment types broken down into 2% As Needed, 61% Full Time, 17% Part Time, and 20% Contract. Highlights an 99% Physical, and 1% Remote job distribution, with an average salary of $87,689 per year, or $42.2 per hour.

Registered Nurse

Premier Home Health Providers Inc.

Truckee, CA • On-site, Remote

$110 - $130/hr

Part-time

Re-posted 15 days ago

Job description

At Premier Home Health Providers Inc., our compassionate and experienced clinicians are certified and expertly trained to help you manage your condition, prevent rehospitalizations, and improve your health and quality of life in the comfort and familiarity of your own home.
Our mission is to ensure a smooth transition for patients returning home from medical facilities by offering expert guidance throughout their recovery journey. As a Registered Nurse with Premier Home Health Providers, you will play a key part in ensuring the accuracy and quality of clinical documentation, helping our patients receive the right care at the right time. You'll collaborate closely with clinical staff, contribute to quality improvement initiatives, and help uphold our commitment to regulatory compliance.
We value teamwork, empathy, and a commitment to high-quality service, all aimed at putting patients and their families at ease during their recovery. If you are passionate about making a positive impact in patients' lives and working in a supportive and family-oriented atmosphere, we encourage you to join us in providing exceptional home health care.
Please note that this role is per diem with a rate of $110 - $130 per visit.
Responsibilities
  • Review OASIS assessments for completeness, appropriateness, and compliance with federal and state regulations.
  • Ensure accurate ICD-10 coding and sequencing based on each patient's medical condition and co-morbidities.
  • Partner with clinical staff to resolve documentation and data integrity issues.
  • Monitor visit utilization and flag potential financial risks or underutilization to clinical management.
  • Identify and communicate trends that impact agency outcomes and process measures.
  • Conduct OASIS inter-rater reliability visits with clinical team members.
  • Participate in Quality Improvement and Corporate Compliance activities.
  • Stay current with best practices through ongoing education and professional development.
  • Perform other duties as required for patient services.

Requirements
  • Active Californian RN license in good standing.
  • 1-2 years of clinical home health experience.
  • Working knowledge of OASIS assessments and ICD-10 coding.
  • Knowledge of federal regulations and state licensure requirements.
  • Strong communication skills and a keen eye for detail.
  • Ability to work independently and manage priorities with minimal supervision.
  • Proficiency with computer systems and electronic health records.
  • Current CPR certification with AHA.
  • Valid driver's license, reliable insured vehicle.

Nice to Have
  • OASIS certification (COS-C).
  • OASIS Home Health ICD-10 coding certification.

Benefits
  • Flexible Schedule
  • Ability to Convert to Full-Time Based On Performance If Interested
  • Paid Sick Days
  • Paid Bereavement Leave
  • Skills Training & Development
  • Company Social Events
  • Mileage Reimbursement for Patient to Patient Visits
  • Referral Bonus

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