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Remote Utilization Review Nurse Jobs in Springfield, OH

micro1 AI

Clinical Pharmacy Technicians

Dayton, OH · Remote

$70 - $80/hr

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 ...

micro1 AI

Pharmacovigilance Expert

Dayton, OH · Remote

$70 - $80/hr

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 ...

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

Remote Utilization Review Nurse information

See Springfield, OH salary details

$19

$38

$62

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

As of Aug 25, 2026, the average hourly pay for remote utilization review nurse in Springfield, OH is $38.09, according to ZipRecruiter salary data. Most workers in this role earn between $30.10 and $43.75 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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Remote Utilization Review Nurse jobs near you
Infographic showing various Remote Utilization Review Nurse job openings in Springfield, OH as of August 2026, with employment types broken down into 90% Full Time, and 10% Contract. Highlights an 100% Remote job distribution, with an average salary of $79,217 per year, or $38.1 per hour.

Virtual Nurse-RN/ Virtual Nursing

Premier Health

Dayton, OH • On-site, Remote

Full-time

Re-posted 8 days ago

Job description

Position: Virtual Nurse-RN
Department: Virtual Nursing
Facility: Premier System Support
Shift: Full-time 7:00am-7:30pm/ 72 Hours Per Pay
*This is not a remote work from home position*
The Virtual Clinical Nurse is a registered nurse (RN) who works remotely from a centralized location and partners with the bedside nurses and advocates for patients/families/significant others to provide physical, emotional, and spiritual support which impacts patient outcomes in a safe environment. The Virtual RN functions in a versatile role that demonstrates professionalism and promotes excellence and autonomy in the practice of Nursing. The Virtual RN utilizes the nursing process in conjunction with evidence-based principles to care for a diverse caseload of patients within the department scope of service. The Virtual RN collaborates with, and guides care delivered by the inter-professional team. The Virtual RN will perform task that may include admissions, discharges, patient education, rounding on patients, performance improvement, etc. The Virtual RN is accountable for compliance with the Ohio Nurse Practice Act, Nursing Code of Ethics, and applicable regulatory standards.
Education
Minimum Level of Education Required: Associate degree
Additional requirements:
  • Type of degree: Graduation from an accredited school of nursing.
  • Area of study or major: Nursing
  • Preferred educational qualifications: BSN Preferred; BSN Completion or Professional Certification may be required.
  • Position specific testing requirement: N/A

Licensure/Certification/Registration
  • Valid Ohio RN license

Experience
Minimum Level of Experience Required: 3 - 5 years of job related experience
Prior job title or occupational experience: N/A
Prior specific functional responsibilities: N/A
Preferred experience:
Other experience requirements: N/A
Knowledge/Skills
  • Must be able to multitask with constant interruptions while maintaining a pleasant demeanor.
  • Basic computer knowledge
  • Strong organization skills
  • Effective interpersonal and communication skills

Apply