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Remote Utilization Review Nurse Jobs in Springfield, MO

Scribe-X

Remote Medical Scribe

Springfield, MO · 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 ...

All JobsUtilization Review Nurse JobsRemote Utilization Review Nurse JobsRemote Utilization Review Nurse Jobs in Springfield, MO

Remote Utilization Review Nurse information

See Springfield, MO salary details

$19

$38

$62

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

As of Sep 4, 2026, the average hourly pay for remote utilization review nurse in Springfield, MO is $38.46, according to ZipRecruiter salary data. Most workers in this role earn between $30.38 and $44.18 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.

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The most popular types of Utilization Review Nurse jobs in Springfield, MO are:

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The top searched job categories for Remote Utilization Review Nurse jobs in Springfield, MO are:

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Cities near Springfield, MO 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 Springfield, MO as of August 2026, with employment types broken down into 71% Full Time, and 29% Part Time. Highlights an 100% Remote job distribution, with an average salary of $79,999 per year, or $38.5 per hour.

Home Health Quality Assurance RN

Haven Home Health & Hospice

Ozark, MO • On-site, Remote

$67K - $71K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 18 days ago

Job description

Quality Assurance RN (OASIS Certification Required)
Missouri License Required | Fully Remote
At Haven Home Health & Hospice, we're locally owned and clinician-led. We focus on quality over volume and giving our team the support they need to do the work the right way.
You know who you are.
You're the one clinicians call when they're stuck on OASIS, the one who catches what others miss, and the one who understands how one answer can impact everything from outcomes to reimbursement. This role is built for an RN who wants to use that expertise to support clinicians and strengthen quality across the agency.
About the Role
This is a fully remote position focused on OASIS review, clinical accuracy, and compliance. You'll work closely with clinicians and leadership to ensure documentation tells the right story and meets the highest standards. This isn't field work. This is influence.
What You'll Do
  • Review and validate OASIS (SOC, ROC, Recert, Discharge) with a strong clinical lens
  • Ensure documentation, coding, and OASIS align and accurately reflect the patient's condition
  • Identify gaps that impact reimbursement, outcomes, and compliance
  • Partner with clinicians to provide clear, constructive feedback and support
  • Promote consistency across documentation and interdisciplinary care

What You'll Need
  • Active Missouri RN license
  • OASIS Certification required (COS-C or equivalent)
  • Recent home health RN experience
  • Strong knowledge of OASIS, documentation, and home health regulations
  • Detail-oriented with confident clinical judgment
  • Comfortable working independently in a remote setting

Why Nurses Choose This Role
  • Fully remote position (Missouri-based)
  • No direct patient care, focus on your expertise
  • No productivity pressure, focus on getting it right
  • Opportunity to influence clinical quality and outcomes
  • Work closely with a supportive, clinician-led leadership team
  • Competitive compensation including PTO
  • Health, dental, vision, and pet insurance
  • Mental Health Initiative
  • 401(k) with generous company match

At Haven, we are committed to clear communication, accountability, and doing what is right. This role plays a key part in supporting our clinicians and ensuring every patient receives care that meets the highest standard.
Applicants must have active OASIS certification and recent home health experience to be considered.

Apply