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Remote Utilization Review Nurse Jobs in Rochester, MN

Remote micro1 is engaging Pharmacovigilance Experts to contribute their advanced drug safety ... Author and review evaluation tasks based on DSURs, PSURs/PBRERs, and associated safety data and ...

Remote micro1 is engaging Pharmacovigilance Experts to contribute their advanced drug safety ... Author and review evaluation tasks based on DSURs, PSURs/PBRERs, and associated safety data and ...

Remote Medical Scribe

Rochester, MN · Remote

$14 - $17/hr

  • Medical

  • PTO

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 ...

Senior Accountant

Rochester, MN · Remote

$85K - $90K/yr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

We currently operate four nurse-managed clinics, two mobile medical units, and two victim advocacy ... We are searching for a Full-time Remote Senior Accountant to join our Rochester, MN team.The Senior ...

Senior Accountant

Rochester, MN · Remote

$72K - $90K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

We currently operate four nurse-managed clinics, two mobile medical units, and two victim advocacy ... We are searching for a Full-time Remote Senior Accountant to join our Rochester, MN team. The ...

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 Aug 16, 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 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 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 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:

What are popular job titles related to Remote Utilization Review Nurse jobs in Rochester, MN?

For Remote Utilization Review Nurse jobs in Rochester, MN, the most frequently searched job titles are:

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:

Infographic showing various Remote Utilization Review Nurse job openings in Rochester, MN as of August 2026, with employment types broken down into 7% As Needed, 72% Full Time, 7% Part Time, and 14% Contract. Highlights an 100% Remote job distribution, with an average salary of $89,397 per year, or $43 per hour.

Associate Medical Editor - Remote

American Cancer Society

Rochester, MN • Remote

$85K - $90K/yr

Full-time

Medical, Dental, Retirement, PTO

Re-posted 2 days ago


American Cancer Society rating

7.8

Company rating: 7.8 out of 10

Based on 12 frontline employees who took The Breakroom Quiz

157th of 772 rated non-profit organizations


Job description

At the American Cancer Society, we'reworking to end cancer as we know it, for everyone.Our employees and 1.3 million volunteersare raising the bar every single day. We are a culture comprised of diverse backgrounds and experience, to better serve our communities.
The people who work at the American Cancer Society focus their diverse talents on our lifesaving mission. It is a calling. And the people who answer it are fulfilled.

The Associate Medical Editor is a licensed oncology registered nurse, preferably with a master's degree and oncology certification. The Associate Medical Editor performs literature searches, writes, reviews, and edits evidence-based cancer information tailored to multiple literacy levels and audience needs that covers the trajectory of care from risk and prevention to diagnosis, treatment, survivorship, and end-of-life. This role requires great attention to detail and follow-up, ensuring cancer information is current, accurate, evidence-based, understandable, and actionable. Serves as a knowledgeable oncology clinician and patient care resource for the organization.
This position plays a key role in the creation of accurate, relevant, and timely medical content, which is critical to protecting organizational reputation, ensuring compliance, and reducing risk.

This is a fully remote position and can be based anywhere within the U.S.

ESSENTIAL FUNCTIONS:

  • Develops, reviews, updates, and edits cancer information, ensuring all content reflects current and emerging evidence, is accurate and understandable, aligns with ACS and other clinical guidelines, and reflects the ACS mission. (75%)

  • Analyzes and consistently improves readability of ACS medical content, regularly applying adult learning and health equity principles and health literacy best practices. (5%)

  • Uses data reports to lead and manage assigned print-based patient education projects and serves as liaison with inventory teams and vendors. (5%)

  • Maintains editorial integrity of content, applying and ensuring consistency with accessibility standards, applicable ACS messaging, guidelines, policies, and processes. (5%)

  • Provides as-needed support for constituent-related requests, responding to cancer-related inquiries escalated from the Cancer Helpline (NCIC) and Customer Experience teams. (5%)

  • Acts as consultant and collaborative, clinical resource for mission priorities, partnerships, and special projects and content review requests. (5%)

EXPERIENCE/QUALIFICATIONS:

  • Minimum Degree Required: Bachelor's Degree in nursing

  • Preferred Degree: Master's Degree in nursing

  • Required License(s): Active, unrestricted RN license

  • Preferred Certification(s): Oncology certification (OCN, AOCN, etc.) or eligibility for exam

  • Years of experience: 5+ years in clinical oncology nursing practice

KNOWLEDGE, SKILLS, AND ABILITY:

  • Knowledge of clinical oncology and evidence-based medicine, including cancer risk, prevention, screening, diagnosis, treatment, and survivorship, along with end-of-life issues.

  • Clinical experience administering cancer treatments, providing verbal and written patient education, and directly managing the care and treatment side effects of people with cancer throughout the continuum of care, with an understanding of current and emerging therapies, clinical pathways, guidelines, and standards of care.

  • Knowledge of current clinical oncology trends, health policy, and public health initiatives and issues.

  • Ability to perform literature searches and apply findings to content development and review.

  • Demonstrated ability to develop original patient education materials, communicating complex medical/scientific information in plain language, applying health literacy best practices, adult learning principles, health equity considerations, needs of special populations in content development and review.

  • Working knowledge of AMA writing style and referencing standards.

  • Knowledge of the issues and potential impacts of applying artificial intelligence (AI) and search engine optimization (SEO) in content work.

  • Ability to complete assigned projects with attention to detail, adhering to ACS processes and timelines, and addressing follow-up needs for each project.

  • Self-motivated, organized, creative, and able to manage, lead, and follow-up on multiple projects simultaneously.

  • Ability to collaborate well across disciplines and interact/communicate professionally with internal and external partners.

TRAVEL REQUIREMENTS:

  • Periodic travel may be required to attend team meetings and participate in conferences or training sessions that support organizational goals and objectives.

PHYSICAL REQUIREMENTS:

  • Work is normally performed in a typical interior/office work environment.

  • No or very limited physical effort required.

  • No or very limited exposure to physical risk.

The starting rate is $85,000 to $90,000. The final candidate's relevant experience/skills will be considered before an offer is extended. Actual starting pay will vary based on non-discriminatory factors including, but not limited to, geographic location, experience, skills, specialty, and education.

ACS provides staff a generous paid time off policy; medical, dental, retirement benefits, wellness programs, and professional development programs to enhance staff skills. Further details on our benefits can be found on our careers site at: jobs.cancer.org/benefits. We are a proud equal opportunity employer.


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