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Remote Utilization Review Rn Jobs in Illinois (NOW HIRING)

YO AI Labs

Hospitalist Physician - Remote

Chicago, IL · Remote

$70 - $100/hr

Remote Job Overview We are seeking experienced Hospitalist Physicians to contribute their medical ... Experience with utilization review, medical coding, or healthcare quality assurance. * Familiarity ...

Carle Health

RN - Patient Advisory

Champaign, IL · On-site +1

$33.11 - $53.88/hr

Position requires 6 months of in-office training prior to being remote. The office is located in ... Performs essential Charge RN functions in rotation with other team members that directly supports ...

Carle Health

RN - Patient Advisory

Champaign, IL · On-site +1

Position requires 6 months of in-office training prior to being remote. The office is located in ... Performs essential Charge RN functions in rotation with other team members that directly supports ...

Corvel

Case Management Supervisor RN

Downers Grove, IL · Remote

$77K - $120K/yr

This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Responsible for directing a ... May perform daily, weekly, monthly reviews of various reports, invoices, logs and expenses * May be ...

Corvel

Bilingual Medical Case Manager II

Downers Grove, IL · On-site +1

$65K - $98K/yr

CorVel Corporation is hiring a caring, self-motivated, energetic and independent registered nurse ... A cost containment background, such as utilization review or managed care is helpful. * Strong ...

Carle Health

OP Care Management RN

Peoria, IL · On-site +1

$33.11 - $53.88/hr

OP Care Management RN will coordinate care around patient's chronic diseases, coordinate and ... utilization. Conduct holistic health care assessment including health risk assessment, patient ...

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Remote Utilization Review Rn information

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

As of Sep 14, 2026, the average hourly pay for remote utilization review rn in Illinois is $40.97, according to ZipRecruiter salary data. Most workers in this role earn between $32.36 and $47.07 per hour, depending on experience, location, and employer.

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 are the key skills and qualifications needed to thrive as a remote utilization review RN?

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 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 popular job titles related to Remote Utilization Review Rn jobs in Illinois?

For Remote Utilization Review Rn jobs in Illinois, the most frequently searched job titles are:

What job categories do people searching Remote Utilization Review Rn jobs in Illinois look for?

The top searched job categories for Remote Utilization Review Rn jobs in Illinois are:

What cities in Illinois are hiring for Remote Utilization Review Rn jobs?

Cities in Illinois with the most Remote Utilization Review Rn job openings:

Remote Utilization Review Rn jobs near you
Infographic showing various Remote Utilization Review Rn job openings in Illinois as of September 2026, with employment types broken down into 1% As Needed, 84% Full Time, 13% Part Time, and 2% Contract. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution, with an average salary of $85,222 per year, or $41 per hour.

Nurse Auditor - Medical Bill Review (Remote)

Chicago, IL • On-site, Remote

Rising Medical Solutions
Insurance Services • 201 - 500 employees
Learn more about Rising Medical Solutionsexternal

Full-time

Medical, Retirement, PTO

Re-posted 16 days ago

Job description

Have you ever looked a medical bill and immediately noticed something was wrong? Were you itching to use your expertise to fix it? We've been there, too. In fact, that's how our business was born - and continues to thrive. Rising Medical Solutions is looking for a Nurse Auditor who wants to make their mark in the world of medical cost containment.
Join our team and maximize client savings by reviewing medical bills from a nurse perspective, including appropriate billing, coding and treatment, fee schedule compliance, over-utilization, and erroneous charges. We pride ourselves on outstanding customer service and work hard to keep our impeccable reputation in the industry.
In this role, you'll be a part of our mission by giving clients the information they need to determine case value based on evaluation of medical records and medical billing statements, and will:
  • Audit medical and billing records to determine if services provided are reasonable, appropriate and necessary.
  • Clinically identify and evaluate any charges not related to the occurrence.
  • Verify that charges are in accordance with the services ordered and authorized.
  • Initiate appropriate contacts with clients and medical providers as appropriate and necessary.
  • Negotiate bills and conduct re-evaluation reviews as required

All while maintaining a human touch, demonstrating sensitivity to culturally-diverse people and situations.
Requirements
  • RN (or LPN) with active professional license or equivalent within states of operation
  • CPC and/or CPC-H certification(s) strongly desired
  • Specialized training in hospital coding, ortho, neuro, rehab, or ER procedures
  • 3-5 years of clinical experience in acute care, surgery and/or orthopedic
  • Workers' Compensation medical bill review experience a major plus
  • Understanding of CPT and ICD-10 codes and Medicare guidelines
  • Ability to apply knowledge to state fee schedules
  • A customer service orientation, including strong communication skills
  • Experience in any deposition or litigation cases a plus

Benefits
  • Competitive benefits package, including health insurance, 401(k) with company match, paid time off, paid holidays, and more.
  • Flexible hybrid schedule with in-office days reserved for training and collaborative meetings
  • Employment within a firm committed to core values, staff development, emerging technology, private ownership, and controlled growth/reinvestment in the future - we frequently promote from within!
  • Opportunity to make a difference in reducing health care costs and increasing the value of health care to individuals and their employers.
  • A relaxed, yet upbeat work environment
  • And for those in the office: casual dress code with unlimited coffee!

Apply