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Remote Utilization Review Nurse Jobs in Rochester, MN

DataAnnotation

RN

Rochester, MN · Remote

$40 - $60/hr

MDs, PAs, and Nurses. Benefits ... This a full-time or part-time REMOTE position * You'll be able to choose which projects you want to ...

Pride Health

Clinical Document Specialist

Rochester, MN · Remote

$60 - $65/hr

CDI Specialist I (Clinical Documentation Integrity) Location: 100% Remote (U.S. Based) - Rochester ... Key Responsibilities: • Perform concurrent and retrospective reviews of inpatient medical records ...

Scribe-X

Remote Medical Scribe

Rochester, MN · 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 ...

City of Rochester

Energy Market Analyst

Rochester, MN · On-site +1

$103K - $151.47K/yr

This position may be eligible for remote work up to two days a week after the initial 6-month ... Understand and review MISO settlement statements with Manager Perform other duties as assigned or ...

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Remote Utilization Review Nurse information

See Rochester, MN salary details

$21

$42

$70

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

As of May 28, 2026, the average hourly pay for remote utilization review nurse in Rochester, MN is $42.98, according to ZipRecruiter salary data. Most workers in this role earn between $33.94 and $49.38 per hour, depending on experience, location, and employer.

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, 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 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 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 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.

More about Remote Utilization Review Nurse jobs
What are the most commonly searched types of Utilization Review Nurse jobs in Rochester, MN? The most popular types of Utilization Review Nurse jobs in Rochester, MN are:
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What cities near Rochester, MN are hiring for Remote Utilization Review Nurse jobs? Cities near Rochester, MN with the most Remote Utilization Review Nurse job openings:
Remote Utilization Review Nurse jobs near you
PRN Remote MDS Coordinator Minnesota

PRN Remote MDS Coordinator Minnesota

Eden Senior Care

Rochester, MN • Remote

$36 - $43/hr

Part-time

Posted 8 days ago

Job description

Eden Senior Care, founded in 2016, is a growing Healthcare Management company focused on managing and operating Skilled Nursing, Rehabilitation, and Assisted Living communities in Minnesota, Wisconsin, Ohio, Pennsylvania and Illinois. Our mission with each community is to support their success by providing strong leadership, corporate support, and the resources and tools to realize their goals. Eden promotes and encourages the success of each of its employees and values the individual experience of its guests and their families.


Position: PRN Remote MDS Coordinator Minnesota

We are seeking a PRN Remote MDS Coordinator to support our Minnesota facilities. This is a remote, as-needed position ideal for an experienced MDS professional who is flexible and well-versed in clinical reimbursement processes.

Preferably located in the Minnesota area. Candidates must hold a Minnesota RN license, as Minnesota is not part of the Nurse Licensure Compact.


Qualifications:

  • Must have an active RN license in Minnesota
  • Active RN license in Illinois and Wisconsin is a plus
  • Minimum 3 years of MDS experience preferred
  • Strong knowledge of ICD-10 coding, RAI Manual, and Medicare Chapter 8 guidelines
  • Proficient in PointClickCare (PCC)
  • Strong organizational, written, and verbal communication skills
  • Experience with Excel, Microsoft Teams, and Zoom is a plus

Key Responsibilities:

  • MDS scheduling, setup, and completion
  • Manage new admission authorizations, updates, and communication with families, insurance providers, and case managers
  • Perform ICD-10 coding for new admissions and ongoing updates for LTC residents
  • Participate in the development and review of resident care plans
  • Attend and communicate with families and residents regarding care plans, insurance, and discharge needs
  • Educate the Interdisciplinary Team (IDT) on MDS requirements and skilled care services
  • Ensure proper documentation through staff education and audits
  • Support Quality Measures and the QAPI process
  • Conduct chart reviews and audits as needed
  • Assist the IDT during survey processes

Keywords:

MDS, Reimbursement, RAI, Minimum Data Set, Medicare, Insurance, Medicaid, RNAC, AANAC, RAC-CT, RNAC-CE