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Remote Utilization Review Nurse Jobs in Santa Rosa, CA

Madrona Hospice Care Inc.

Registered Nurse

Santa Rosa, CA · Remote

$140 - $150/hr

Review OASIS assessments for completeness, appropriateness, and compliance with federal and state ... Monitor visit utilization and flag potential financial risks or underutilization to clinical ...

Madrona Hospice Care Inc.

Registered Nurse

Petaluma, CA · Remote

$140 - $150/hr

Review OASIS assessments for completeness, appropriateness, and compliance with federal and state ... Monitor visit utilization and flag potential financial risks or underutilization to clinical ...

Madrona Hospice Care Inc.

Registered Nurse

Petaluma, CA · On-site +1

$140 - $150/hr

Review OASIS assessments for completeness, appropriateness, and compliance with federal and state ... Monitor visit utilization and flag potential financial risks or underutilization to clinical ...

IQVIA

Flex Nurse Educator

Santa Rosa, CA · Remote

Deliver remote patient education, including medication administration training and adherence ... Candidates must possess a valid driver's license and will be subject to a review of their driving ...

New

IQVIA

Flex Nurse Educator

Napa, CA · Remote

Deliver remote patient education, including medication administration training and adherence ... Candidates must possess a valid driver's license and will be subject to a review of their driving ...

New

IQVIA

Flex Nurse Educator

Petaluma, CA · Remote

Deliver remote patient education, including medication administration training and adherence ... Candidates must possess a valid driver's license and will be subject to a review of their driving ...

New

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Remote Utilization Review Nurse information

See Santa Rosa, CA salary details

$23

$46

$75

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

As of Aug 18, 2026, the average hourly pay for remote utilization review nurse in Santa Rosa, CA is $46.23, according to ZipRecruiter salary data. Most workers in this role earn between $36.54 and $53.08 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.

More about Remote Utilization Review Nurse jobs

What are the most commonly searched types of Utilization Review Nurse jobs in Santa Rosa, CA?

The most popular types of Utilization Review Nurse jobs in Santa Rosa, CA are:

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For Remote Utilization Review Nurse jobs in Santa Rosa, CA, the most frequently searched job titles are:

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The top searched job categories for Remote Utilization Review Nurse jobs in Santa Rosa, CA are:

What cities near Santa Rosa, CA are hiring for Remote Utilization Review Nurse jobs?

Cities near Santa Rosa, CA 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 Santa Rosa, CA as of August 2026, with employment types broken down into 1% As Needed, 79% Full Time, 14% Part Time, 5% Contract, and 1% Nights. Highlights an 90% Physical, 3% Hybrid, and 7% Remote job distribution, with an average salary of $96,155 per year, or $46.2 per hour.

Remote Telehealth Nurse Practitioner

Sato Inc

Bodega Bay, CA • Remote

Full-time

Re-posted 2 days ago

Job description

We are seeking a compassionate and experienced Nurse Practitioner to provide high-quality virtual care to patients through telehealth consultations. You will conduct assessments, diagnose and manage conditions, prescribe medications when appropriate, and deliver patient-centered care using our digital platform. This role is ideal for someone who is comfortable working independently, enjoys patient interaction, and is committed to improving access to healthcare.

Responsibilities

  • Conduct virtual patient evaluations, including medical history review and symptom assessment.
  • Diagnose and treat common acute and chronic conditions.
  • Provide patient education, follow-up care, and lifestyle guidance.
  • Prescribe medications in accordance with state and federal regulations.
  • Document all encounters accurately within the electronic health record system.
  • Collaborate with physicians and care teams when escalation is required.
  • Maintain strong communication with patients through messaging, video, and phone.

Requirements

  • Active and unrestricted Nurse Practitioner license in multiple states
  • National board certification (FNP, AGNP, or equivalent).
  • 2+ years of clinical experience preferred.
  • Strong communication skills and comfort with virtual care technology.
  • Reliable internet connection and a private workspace.

What We Offer

  • Flexible scheduling
  • Fully remote work
  • Competitive compensation
  • Supportive clinical and administrative team