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Remote Utilization Review Nurse Jobs in Romeoville, IL

Silver Cross Hospital

Utilization Review Nurse

New Lenox, IL · On-site +1

$34.73 - $45.15/hr

Nurse, Registered (RN) licensure * BSN preferred. 2-5 years previous Utilization Review experience ... Days, Primarily remote; onsite orientation requirement; weekend and holiday rotation; on site ...

Med-Metrix

Physician Advisor - Remote

Chicago, IL · On-site +1

Provides consultation to attendings, nurses, and case management staff regarding complex clinical ... Board Certification by the American Board of Quality Assurance and Utilization Review Physicians ...

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Remote Utilization Review Nurse information

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$21

$43

$70

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

As of Jul 30, 2026, the average hourly pay for remote utilization review nurse in Romeoville, IL is $43.11, according to ZipRecruiter salary data. Most workers in this role earn between $34.09 and $49.52 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 popular job titles related to Remote Utilization Review Nurse jobs in Romeoville, IL? For Remote Utilization Review Nurse jobs in Romeoville, IL, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review Nurse jobs in Romeoville, IL look for? The top searched job categories for Remote Utilization Review Nurse jobs in Romeoville, IL are:
What cities near Romeoville, IL are hiring for Remote Utilization Review Nurse jobs? Cities near Romeoville, IL 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 Romeoville, IL as of July 2026, with employment types broken down into 2% As Needed, 62% Full Time, 16% Part Time, and 20% Contract. Highlights an 99% Physical, and 1% Remote job distribution, with an average salary of $89,671 per year, or $43.1 per hour.

Utilization Review Nurse

Silver Cross Hospital

New Lenox, IL • On-site, Remote

$34.73 - $45.15/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 19 days ago

Silver Cross Hospital rating

6.9

Company rating: 6.9 out of 10

Based on 51 frontline employees who took The Breakroom Quiz

553rd of 1,053 rated hospitals

Job description

Silver Cross Hospital is an extraordinary place to work. We're known for our culture of excellence and delivery of unrivaled experiences for our patients, their families, the communities we serve...and for each other. Come join us! It's the way you want to be treated.
Position Summary: Performs medical record review for severity of illness and intensity of service; liaison function with external review agencies to ensure compliance with regulations affecting financial reimbursement; identifies variance from established pathways
Essential Duties and Responsibilities:
  • Collects information from clinical medical record for severity of illness and intensity of service and documents such in clinical database
  • Monitors all levels of care for appropriateness and communicates variance; evaluates plan of care to ensure it is based on accepted standards
  • Provides information to external review organizations, documents pertinent communications
  • Refers to designated physician advisor those patients not meeting criteria as well as quality of care concerns
  • Maintains knowledge and incorporates current standards into practice

Required Qualifications: Knowledge of clinical norms; excellent communication skills; critical thinking skills; organized and efficient time management skills
Education and Training:
  • Nurse, Registered (RN) licensure
  • BSN preferred. 2-5 years previous Utilization Review experience preferred.
  • Current CPR
  • Relevant hospital nursing; hospital case management; insurance case management or utilization management experience preferred

Work Shift Details:
Days, Primarily remote; onsite orientation requirement; weekend and holiday rotation; on site requirement for meetings and mandatory training
Department:
CONTINUUM OF CARE
Benefits for You
At Silver Cross Hospital, we care about your health and well-being and that is why we work hard to provide quality and affordable benefit options for you and your eligible family members.
Silver Cross Hospital and Silver Cross Medical Groups offer a comprehensive benefit package available for Full-time and Part-time employees which includes:
• Medical, Dental and Vision plans
• Life Insurance
• Flexible Spending Account
• Other voluntary benefit plans
• PTO and Sick time
• 401(k) plan with a match
• Wellness program
• Tuition Reimbursement
Registry employees who meet eligibility may participate in our 401(k) Savings plan with a potential match. However,registry employees are ineligible for Health and Welfare benefits.
The final pay rate offered may be more than the posted range based on several factors including but not limited to: licensure, certifications, work experience, education, knowledge, demonstrated abilities, internal equity, market data, and more.
The expected pay for this position is listed below:
$34.73 - $45.15

What Silver Cross Hospital employees say

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Hours and flexibility

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About Silver Cross Hospital

Sourced by ZipRecruiter

At Silver Cross, we pride ourselves on delivering unrivaled care to every patient, every time. As a result, our focus on safety, quality and patient experience has earned us numerous national awards over the years. As the needs of our community have grown, so has Silver Cross—in both size and stature. Our many healthcare services rapidly expanded, evolved and increased in complexity. To serve you and your loved ones even better than before, we've proudly partnered with many of Chicago's leading academic medical centers, bringing extraordinarily advanced care close to home.

Industry

Health care and social assistance

Company size

1,001 - 5,000 Employees

Headquarters location

New Lenox, IL, US

Year founded

1895

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