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Remote Utilization Review Rn Jobs (NOW HIRING)

Personify Health

Lead Utilization Review-RN

The RN Utilization Management (UM) Team Lead provides clinical and operational leadership to ... Remote leadership effectiveness: dependable attendance, organization, and ability to troubleshoot ...

Personify Health

Lead Utilization Review-RN

The RN Utilization Management (UM) Team Lead provides clinical and operational leadership to ... Remote leadership effectiveness: dependable attendance, organization, and ability to troubleshoot ...

Pacer Group

Medical Review RN IV

$50/hr

Remote - Candidate Must Reside in California Duration: 6+ Months Contract-to-Hire Schedule: Monday ... Working closely with Medical Directors, Utilization Management teams, Quality, Pharmacy, Claims ...

Oscar Health

Utilization Review Nurse

Tempe, AZ · Remote

$35 - $45.94/hr

This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois ... Active, unrestricted RN licensure from the United States in [state], OR, active compact multistate ...

Bracane Co

Utilization Review Nurse

Plano, TX · Remote

***REMOTE - Candidates must be based in Texas: Austin area - Travis/Williamson Counties or Richardson ... Registered Nurse (RN) with a valid, current, unrestricted license in the state of operations. * 3 ...

Winston Medical Staffing

Be Seen First

Utilization Review Nurse

Newark, NJ · Remote

$38 - $40/hr

Position is 100% remote but will have to go to Newark, NJ to pick up equipment and short ... Serves as mentor/trainer to new RN's and other staff as needed, completes audits, reviews and ...

Enterprise Engineering

Be Seen First

Concurrent Utilization Review (UR) Nurse

OR · Remote

$30 - $38/hr

Concurrent Utilization Review (UR) Nurse Remote Opportunity Contract to Hire Must be licenses in ... Registered Nurse (RN) with an active, unrestricted California nursing license required; BSN ...

Umpqua Health

Utilization Review Nurse

Roseburg, OR · Remote

$85K - $105K/yr

UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR ... Active, unrestricted RN license (BSN or MSN) in Oregon or a compact state * Graduation from an ...

Umpqua Health

Utilization Review Nurse

Roseburg, OR · On-site +1

$85K - $105K/yr

UTILIZATION REVIEW NURSE REMOTE, ability to travel to 3031 NE STEPHENS ST. ROSEBURG, OR 97470, as ... Active, unrestricted RN license (BSN or MSN) in Oregon or a compact state * Graduation from an ...

Cobalt Benefits Group

Utilization Review Nurse

Current, unrestricted RN license (State license required). * Minimum 3 years of clinical nursing experience. * Minimum 1 year of Utilization Management (UM) or Utilization Review (UR) experience.

Franciscan Health

Utilization Review Coordinator

Registered Nurse (RN - Indiana licensure) required * 3 years of nursing/patient care experience ... Utilization Review Coordinator $56971.20-$84749.60 INCENTIVE: Not Applicable EQUAL OPPORTUNITY ...

CorVel

CA Utilization Review Nurse I

$30.64 - $45.80/hr

This is a remote position. Essential Functions & Responsibilities: * Identifies the necessity of ... Current Nursing licensure in the state of operation required; RN is required unless local state ...

WPS Health Solutions

Utilization Management RN

$75K - $100K/yr

Utilization Management RN Our Utilization Management RN (Registered Nurse) evaluates efficiency ... Please review Remote Worker FAQs for additional information Benefits * Remote and hybrid work ...

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

As of Jul 11, 2026, the average hourly pay for remote utilization review rn in the United States is $42.28, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Remote Utilization Review RN, and why are they important?

To excel as a Remote Utilization Review RN, you need a valid RN license, strong clinical judgment, and knowledge of utilization management principles. Familiarity with electronic medical records (EMR), utilization management software, and guidelines such as InterQual or MCG is typically required. Outstanding attention to detail, critical thinking, and effective communication skills help you collaborate with healthcare teams and advocate for appropriate patient care. These competencies are crucial for ensuring medical necessity, regulatory compliance, and optimal resource use in a remote setting.

What is a Remote Utilization Review RN?

A Remote Utilization Review RN is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services provided to patients, typically working from a remote location. They review medical records, apply clinical guidelines, and collaborate with healthcare providers to ensure patients receive the right care at the right time. Their work helps manage healthcare costs and improves patient outcomes by preventing unnecessary treatments or hospital stays. Remote Utilization Review RNs often work for insurance companies, hospitals, or healthcare organizations, and use secure digital platforms to conduct their reviews.

What is the difference between Remote Utilization Review Rn vs Remote Case Manager Rn?

AspectRemote Utilization Review RnRemote Case Manager Rn
CertificationsRN license, Utilization Review certification (e.g., URAC)RN license, Case Management certification (e.g., CCM)
Work EnvironmentReviewing medical records, insurance policies, telehealth platformsCoordinating patient care, discharge planning, telehealth
Employer & IndustryInsurance companies, healthcare organizationsHospitals, insurance providers, healthcare agencies

Remote Utilization Review Rns primarily focus on evaluating medical necessity for insurance coverage, while Remote Case Manager Rns coordinate patient care and discharge planning. Both roles require RN licensure and involve telehealth work, but they serve different functions within healthcare and insurance industries.

What are some common challenges Remote Utilization Review RNs face when working from home, and how can they be addressed?

Remote Utilization Review RNs often encounter challenges such as maintaining clear communication with interdisciplinary teams, managing time efficiently, and staying updated on changing payer guidelines. To address these challenges, it's important to establish consistent check-ins with team members via video or chat platforms, use digital tools to organize and prioritize caseloads, and participate in ongoing training sessions provided by employers. Adhering to a structured daily routine and leveraging available technology can help ensure productivity and high-quality reviews while working remotely.
More about Remote Utilization Review Rn jobs
What cities are hiring for Remote Utilization Review Rn jobs? Cities with the most Remote Utilization Review Rn job openings:
What are the most commonly searched types of Utilization Review Rn jobs? The most popular types of Utilization Review Rn jobs are:
What states have the most Remote Utilization Review Rn jobs? States with the most job openings for Remote Utilization Review Rn jobs include:
What job categories do people searching Remote Utilization Review Rn jobs look for? The top searched job categories for Remote Utilization Review Rn jobs are:
Remote Utilization Review Rn jobs near you
Infographic showing various Remote Utilization Review Rn job openings in the United States as of July 2026, with employment types broken down into 90% Full Time, 7% Part Time, and 3% Contract. Highlights an 40% Physical, 3% Hybrid, and 57% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.
Registered Nurse-Utilization Review

Registered Nurse-Utilization Review

3B Healthcare, Inc.

Remote

Other

Posted 10 days ago

Job description

Registered Nurse – Utilization Review (Remote)

This is a fully remote Utilization Review RN role supporting multiple service lines and levels of care, including Inpatient, Extended Hospital Outpatient, and Observation (OBS).

Minimum of 3 years acute medical Care Management/Utilization Review experience in a hospital setting (experience in health plans or medical groups is not applicable).

InterQual experience is mandatory; candidates without this will not be considered.

Proficient in Epic, with recent use within the last 6–12 months.

Experience working with HMOs, IPAs, and similar managed care organizations.

Strong knowledge of Medicare regulations and associated utilization management processes, including:

  • Condition Code 44 (CC44)
  • Advance Beneficiary Notices (ABNs)
  • Hospital-Issued Notices of Noncoverage (HINNs)
  • Medicare Coverage Status Notices (MCSNs)

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