ZipRecruiter

Log In

2

Remote Utilization Review Rn Jobs (NOW HIRING)

CommonSpirit Health

THIS IS A REMOTE JOB: Responsibilities: * Conducts admission and continued stay reviews per the ... * RN: AZ or Compact License * Ability to pass annual Inter-rater reliability test for Utilization ...

The Recovery Village

Utilization Review Specialist

$50K/yr

We are looking for a Remote Utilization Review Specialist Advanced Recovery Systems is an ... State licensure preferred (Registered Nurse, Licensed Practical Nurse, Licensed Clinical Social ...

next page

Showing results 1-20

People also search for

All JobsRemote Utilization Review Rn Jobs

Remote Utilization Review Rn information

See salary details

$21

$42

$68

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

As of May 29, 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 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.

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.

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

Remote Utilization Review RN - RURR 26-06086

NavitasPartners

Healdsburg, CA • Remote

$40 - $45/hr

Other

Posted 3 days ago

Job description

Job Title: Remote Utilization Review RN

Location: Santa Rosa, CA
Assignment Duration: 13 Weeks
Schedule: Day Shift - 5x8 Hours (8:00 AM - 4:30 PM)

Compensation:
  • Pay Rate: $40-$45/hr based on experience
Position Overview:

We are seeking an experienced Remote Utilization Review Registered Nurse (RN) to support healthcare operations by ensuring the appropriate use of medical services and resources. The ideal candidate will have strong knowledge of medical necessity criteria, payer guidelines, and utilization review processes while working collaboratively with interdisciplinary healthcare teams.

Responsibilities:
  • Perform utilization review activities to ensure appropriate and cost-effective use of healthcare resources
  • Review patient medical records for medical necessity and compliance with payer requirements
  • Collaborate with physicians, case managers, and interdisciplinary healthcare teams
  • Submit, track, and monitor authorizations, approvals, and denials
  • Maintain accurate, timely, and compliant documentation
  • Ensure adherence to healthcare regulations and payer guidelines
  • Communicate effectively with providers and healthcare staff regarding review outcomes
  • Support quality improvement initiatives related to utilization management
Qualifications:
  • Active Registered Nurse (RN) License
  • Recent Utilization Review experience preferred
  • Strong understanding of payer guidelines and medical necessity criteria
  • Excellent communication, critical thinking, and organizational skills
  • Ability to work independently in a remote environment
  • Strong documentation and computer skills
  • Ability to manage multiple tasks in a fast-paced healthcare setting

For more details reach at Aditi.sharma@navitashealth.com or Call / Text at 516-587-6677.

About Navitas Healthcare, LLC: It is a certified WBENC and one of the fastest-growing healthcare staffing firms in the US providing Medical, Clinical and Non-Clinical services to numerous hospitals. We offer the most competitive pay for every position we cater. We understand this is a partnership. You will not be blindsided and your salary will be discussed upfront.

Apply