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Remote Utilization Review Nurse Jobs in Romeoville, IL

This is a remote position. ESSENTIAL FUNCTIONS &RESPONSIBILITIES: * Responsible for directing a ... May perform daily, weekly, monthly reviews of various reports, invoices, logs and expenses * May be ...

This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Responsible for directing a ... May perform daily, weekly, monthly reviews of various reports, invoices, logs and expenses * May be ...

Analytics Team - Collaborate on drug trends and utilization data to inform clinical policy ... Clinical Team - Liaise with Clinical team to review clinical data and policy requirements as needed

Care Advocate Nurse

Downers Grove, IL · Remote

$61K - $98K/yr

... ies), reviews medical data in CareMC, validates and secures medical information, assesses and ... This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Initiates and receives telephonic ...

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Remote Utilization Review Nurse information

See Romeoville, IL salary details

$21

$43

$70

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

As of Aug 20, 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 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?

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 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:

Infographic showing various Remote Utilization Review Nurse job openings in Romeoville, IL as of August 2026, with employment types broken down into 1% As Needed, 77% Full Time, 15% Part Time, 5% Contract, and 2% Nights. Highlights an 86% Physical, 2% Hybrid, and 12% Remote job distribution, with an average salary of $89,671 per year, or $43.1 per hour.

National Account Director - Immunology and Gene Therapy - Remote

EVERSANA

Chicago, IL • On-site, Remote

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 8 days ago


Eversana rating

6.7

Company rating: 6.7 out of 10

Based on 14 frontline employees who took The Breakroom Quiz

63rd of 72 rated business consultants


Job description

Company Description
At EVERSANA, we are proud to be a Great Place to Work across the globe. We're fueled by our vision to create a healthier world. How? Our global team of more than 6,000 employees is committed to creating and delivering next-generation commercialization services to the life sciences industry. We are grounded in our cultural beliefs and serve more than 650 clients ranging from innovative biotech start-ups to established pharmaceutical companies. Our products, services and solutions help bring innovative therapies to market and support the patients who depend on them. Our jobs, skills and talents are unique, but together we make an impact every day. Join us!
Across our growing organization, we embrace diversity in backgrounds and experiences. Improving patient lives around the world is a priority, and we need people from all backgrounds and swaths of life to help build the future of the healthcare and the life sciences industry. We believe our people make all the difference in cultivating an inclusive culture that embraces our cultural beliefs. We are deliberate and self-reflective about the kind of team and culture we are building. We look for team members that are not only strong in their own aptitudes but also who care deeply about EVERSANA, our people, clients and most importantly, the patients we serve. We are EVERSANA.
Job Description
*This is a Remote field-based position. Candidates from alternative cities are encouraged to apply but should live in close proximity to a large airport hub.
The National Account Director (NAD) is responsible for implementing a strategic engagement approach at defined accounts within the territory to assure product coverage and access for a first-in-class gene therapy for the treatment of recurrent respiratory papillomatosis (RRP). He/she will identify opportunities and evolving trends that create mutually beneficial collaborations, where patient access to care increases, ultimately improving the quality of care. The NAD is responsible for meeting defined objectives, interactions with targeted accounts, KOLs, Providers, and Administrators in order to understand, educate, and collaborate with key decision makers to drive product understanding and utilization. The NAD is expected to interact routinely and collaboratively with multiple departments and key stakeholders within EVERSANA and our client's organization.
EVERSANA Deployment Solutions offers our employees competitive compensation, paid time off, company paid holidays, excellent training, employee development programs, 401K plan with an employer match, and an incredible list of comprehensive employer benefits that includes medical, dental, and vision insurance along with a whole host of other valuable programs.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
Our employees are tasked with delivering excellent business results through the efforts of their teams. Duties may include, but are not limited to the following:
  • Meet or exceed all defined objectives and expense plan goals and objectives, by developing and implementing strategies specific to the assigned account(s)
  • Co-Leads the development and execution of the Strategic Account Plans with Commercial Leadership
  • Responsible for pull through the payer account plan with Commercial Leadership through routine calls and meetings
  • Responsible for the deployment of value-based healthcare commercial resources that challenge account thinking, elevate care and increase utilization of comprehensive care measures in clinical practice leading to improved outcomes of patients with recurrent respiratory papillomatosis (RRP)
  • Participate/Co-Lead routine cross functional market meetings focusing on account/customer profiling, performance engagement and accountability
  • Ad Boards & Congresses KOL Engagement
  • Customer targets include, but not limited to, PBMs, National Health Plans, Medicare MACs, Regional Health Plans, IDNs, Key Customer C-Suite, Directors, Dept. Heads, Administrations, Finance, Pharmacy, Billing, etc.
  • Understands role of cross-functional partners and works collaboratively with each function to achieve maximum results
  • Demonstrates peer leadership with local field teams, cross-functional partners and internal leadership
  • Responsible for elevating the level of engagement between all Client stakeholders at targeted accounts
  • Accountable for the development of Strategic engagement opportunities with KOLs within assigned customers
  • Provides proactive communication to customer stakeholders (internal and external)
  • Gathers insights from aligned Centers and serves as a rapid conduit of information back Commercial Leadership and the broader organization
  • Aligns disease state /therapeutic activities to the most current sales and marketing direction
  • Conducts Quarterly Business Reviews
  • Proficiency with sales support technology - example Salesforce/Veeva
  • Strong problem solving and analytical skills
  • Demonstrates strong emotional intelligence, strategic focus, ability to build and leverage networks, healthcare business acumen, establish and maintain connections, knowledge of healthcare and managed care policies, knowledge of reimbursement process, and a good understanding of both the Client's product(s) as well as the competition, strategic customer focus, planning ,execution, able to effectively leverage data and information to prioritize business opportunities, balancing stakeholders, business development, impact & influence, decision making, identifying and understanding problems, problem-solving, and thorough understanding of the customer's business environment, able to understand the needs and perspectives of key decision makers.

#LI-CG1
Qualifications
MINIMUM KNOWLEDGE, SKILLS AND ABILITIES:
The requirements listed below are representative of the experience, education, knowledge, skill and/or abilities required.
  • Bachelor's Degree from an accredited college/university required
  • Minimum 10+ years of pharmaceutical/biotech experience
  • 5+ years of current/prior pharmaceutical payer account management and hospital sales experience
  • Experience navigating complex accounts critical for success
  • Technical knowledge of health care reimbursement from a patient and provider perspective
  • Rare Disease, oncology (and/or immunology) with working knowledge of Gene Therapy
  • Cell and Gene Therapy experience strongly preferred
  • Experience with Buy and Bill drug reimbursement dynamics with payers and Medicare MACs
  • Product launch experience, preferably at small to mid-size companies
  • Exceptional interpersonal and communication skills to form strong, trusting partnerships to drive performance
  • Highly adept in both verbal & written communication; applies advanced presentation skills for the delivery of corporate approved materials
  • Advanced business analytical skills to identify trends, opportunities, and threats
  • Ability to identify issues quickly and develop recommendations to resolve in a timely, compliant manner
  • Knowledgeable in current and possible future policies, practices, trends, technology, and information affecting his/her business and organization
  • Ability to clearly and concisely articulate scientific and clinical aspects of disease education & management, mechanism of action (MOA), treatment prescribing information, etc.
  • Expert collaboration with cross-functional partners, including marketing, training, operations, medical, etc.
  • Familiar with legal and regulatory environment; capable of managing others to operate compliantly
  • Comfortable spending ~30%-60% of time traveling; overnight travel required
  • Possess valid driver's license and acceptable driving record

Additional Information
OUR CULTURAL BELIEFS
Patient Minded I act with the patient's best interest in mind.
Client Delight I own every client experience and its impact on results.
Take Action I am empowered and hold myself accountable.
Embrace Diversity I create an environment of awareness and respect.
Grow Talent I own my development and invest in the development of others.
Win Together I passionately connect with anyone, anywhere, anytime to achieve results.
Communication Matters I speak up to create transparent, thoughtful, and timely dialogue.
Always Innovate I am bold and creative in everything I do.
Our team is aware of recent fraudulent job offers in the market, misrepresenting EVERSANA. Recruitment fraud is a sophisticated scam commonly perpetrated through online services using fake websites, unsolicited e-mails, or even text messages claiming to be a legitimate company. Some of these scams request personal information and even payment for training or job application fees. Please know EVERSANA would never require personal information nor payment of any kind during the employment process. We respect the personal rights of all candidates looking to explore careers at EVERSANA.
EVERSANA is committed to providing competitive salaries and benefits for all employees. If this job posting includes a base salary range, it represents the low and high end of the salary range for this position and is not applicable to locations outside of the U.S. Compensation will be determined based on relevant experience, other job-related qualifications/skills, and geographic location (to account for comparative cost of living). More information about EVERSANA's benefits package can be found at eversana.com/careers. EVERSANA reserves the right to modify this base salary range and benefits at any time.
From EVERSANA's inception, Diversity, Equity & Inclusion have always been key to our success. We are an Equal Opportunity Employer, and our employees are people with different strengths, experiences, and backgrounds who share a passion for improving the lives of patients and leading innovation within the healthcare industry. Diversity not only includes race and gender identity, but also age, disability status, veteran status, sexual orientation, religion, and many other parts of one's identity. All of our employees' points of view are key to our success, and inclusion is everyone's responsibility.
Consistent with the Americans with Disabilities Act (ADA) and applicable state and local laws, it is the policy of EVERSANA to provide reasonable accommodation when requested by a qualified applicant or candidate with a disability, unless such accommodation would cause an undue hardship for EVERSANA. The policy regarding requests for reasonable accommodations applies to all aspects of the hiring process. If reasonable accommodation is needed to participate in the interview and hiring process, please contact us at applicantsupport@eversana.com.
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