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Remote Utilization Review Rn Jobs in Iowa (NOW HIRING)

Appeals Pharmacist (Remote)

Des Moines, IA ยท On-site +1

$56.25 - $68.50/hr

Collaborate with physicians, nurses, and medical directors during case reviews. * Track, document ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...

Appeals Pharmacist (Remote)

Davenport, IA ยท On-site +1

$50.75 - $62/hr

Collaborate with physicians, nurses, and medical directors during case reviews. * Track, document ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...

Licensed Mental Health Professionals (APRN, LMFT, LICSW, LPCC, LP) * Licensed Behavior Analysts ... For further information, please review the Know Your Rights notice from the Department of Labor.

Care Advocate Nurse

West Des Moines, IA ยท Remote

$61.05K - $98.33K/yr

... ies), reviews medical data in CareMC, validates and secures medical information, assesses and ... This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Initiates and receives telephonic ...

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Remote Utilization Review Rn information

See Iowa salary details

$20

$39

$64

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

As of May 30, 2026, the average hourly pay for remote utilization review rn in Iowa is $39.71, according to ZipRecruiter salary data. Most workers in this role earn between $31.39 and $45.62 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.

What cities in Iowa are hiring for Remote Utilization Review Rn jobs? Cities in Iowa with the most Remote Utilization Review Rn job openings:

Nurse Practitioner - Remote (Telehealth)

Planned Parenthood North Central States

Des Moines, IA โ€ข Remote

$48 - $60/hr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 13 days ago


Job description

Description

Planned Parenthood North Central States

Minnesota, Iowa, Nebraska, North Dakota, South Dakota

Nurse Practitioner - Remote (Telehealth)

(Nurse Practitioner, Advanced Practice Registered Nurse, Physician Assistant, Clinician)

Pay: The anticipated salary range for this position is $48-$60 per hour, depending on experience and qualifications. Compensation is determined based on a variety of factors, including relevant work experience, the skills required for the role, internal equity, market competitiveness, and budget considerations. We are committed to ensuring fair and competitive pay for all employees
Schedule:
Part-time, 24 hours per week. Eligible for full benefits!
Clinic hours: Varied 4-8 hour shifts. Monday-Friday shifts between 7:45am-8:15pm. Saturday and Sunday shifts between 9:45am-6:30pm. Evenings and weekends assigned on rotation.
Location: Remote
Job type: Hourly/Non-Exempt
Union Membership: This position is represented by SEIU.
Questions? Contact Jobs@ppncs.org.

We are unable to hire remote employees working from the following states: Alabama, California, Delaware, Indiana, Kentucky, Maryland, Michigan, Missouri, New Jersey, New Mexico, Nevada, New York, Ohio, Oklahoma, Pennsylvania, Texas, Washington, or West Virginia.

Job Summary:

Under general administrative supervision of the Telehealth Advanced Practice Clinician (APC) Manager & Telehealth Manager, clinical supervision of and collaboration with the Telehealth APC Manager, Associate Medical Director of Family Planning, the Chief Medical Officer and Program Directors, the Telehealth Clinician provides virtual clinical services, including reproductive and sexual health care, to patients of the PPNCS Virtual Clinics through a direct-to consumer telehealth model of care, site-to-site telehealth support for health centers, and an asynchronous, text-based Telehealth delivery model. Clinicians are advocates in implementing our mission of "Advancing and protecting sexual and reproductive healthcare for all." They may perform other related duties to support Telehealth operations as assigned.

Benefits and Perks:

We offer a comprehensive benefits package, including:

  • Medical, Dental & Vision Insurance with equity-based premium tiers
  • Free, virtual primary care for all employees enrolled in a medical plan:
    • NICE HEALTHCARE. A free, virtual primary care for entire household (in-home available for qualifying locations). Services include: 80 free labs, free x-rays, and physical tests, live, virtual physical therapy, 550+ free medications and more!
    • HealthiestYou - Virtual Care for employees outside of NICE Healthcare's network.

  • Proximal Health - Helps members access high quality, cost-effective, providers for certain services and offers $1,500 tax free benefit when members choose a designated provider for eligible services
  • Employee Assistance Program
  • Continuing Education Reimbursement: up to $2,000 and 4 paid days off annually.
  • Flex Spending Account
  • Life Insurance
  • Eligibility for Federal Student Loan Forgiveness
  • Paid time off: PTO starting at .05769 accrual rate per hour worked.
  • 8 hours volunteer paid time off annually.
  • 8 paid federal holidays & 2 paid floating holidays.
  • Retirement: 403(b) with employer match, 50% for the first 6% deferred
  • 8 weeks Paid Parental Leave
  • Pet Insurance
  • Bereavement Leave
  • Earned Extended Leave
  • Free subscription to Headspace App
  • Time off to vote
  • Employee discounts for electronics, appliances, hotels, gift cards, apparel, cars, fitness memberships, groceries, and at Office Depot, Verizon, AT&T, Dell & more.

We also offer:

  • Start date flexibility.
    • And ability to start training before credentialing process in fully complete.

  • Comprehensive paid training for all health services positions & flexibility with hours per week during training. Training includes classroom, mock clinic, and shadowing shifts.
  • Shift differentials:
    • $1.50/hour (weekend), $3.00/hour (evening), $4.00/hour (float/travel), $2.00/hour (Bilingual)


  • Travel reimbursement.
  • Extra support for new grads.
  • Schedules created & sent out 6 weeks in advance.
  • Option of picking up additional shifts, including at other locations other than your "home" clinic.

Minimum Qualifications:

  • Current active, unencumbered state license as a Registered Nurse and APN in state you are applying for the role, and ability to obtain additional state license(s) upon hire or active license as a Physician Assistant (IA and MN only).
  • Current national board-certification as an Advanced Practice Nurse or a Physician Assistant.
  • DEA license or ability to obtain at hire, and enrollment in Controlled Substance Monitoring Program as applicable in the state you are applying for the role.
  • Advanced degree, minimally master's degree.
  • Current BLS (Basic Life Support) Certification for healthcare providers.

Your Day-to-Day Responsibilities:

Telehealth Clinicians practice according to the PPNCS Medical Standards and Guidelines (MS&G) and as indicated by the patient's status; Telehealth Clinicians practice includes the following:

  • Obtains pertinent patient history as indicated by the visit type.
  • Recognizes and addresses deviations from normal.
  • Performs, orders, and interprets both screening and diagnostic testing; addresses abnormal findings.
  • Develops plan, which may include treatment, medical or other referrals, and/or prescribing of medications.
  • Provides patient instruction regarding plan of care, preventive education, and health promotion and maintenance.
  • Consults with Medical Director or clinician on-call as indicated.
  • Obtains informed consent when indicated.
  • Collaborates with the health care team and other community agencies and resources, as indicated.
  • Assesses interventions and/or referral progress as indicated.
  • Documents accurately and clearly.
  • Supervises support staff regarding routine patient orders.
  • Collaborates with Telehealth Manager and Telehealth APC Manager to meet team goals, productivity benchmarks, and assigned tasks.
  • Provides patient focused care and assures smooth and efficient patient and visit flow processes.
  • Interprets scientific studies based on knowledge of basic research principals; Provides input and current information for the on-going process of protocol development.
  • Stays up to date on reproductive health care developments and maintains CE requirements for required licensure and certification.
  • Meets quality assurance requirements, including the appropriate dispensing of medications.
  • Maintains patient confidentiality and meets compliance requirements, including HIPAA.
  • Meets coding and documentation requirements.
  • Skilled at using computer technology and software as it relates specifically to the Telehealth Clinician role, including comfort with learning new systems and a willingness to become proficient in PPNCS' telehealth platform and EHR systems
  • Recognizes ethical, legal, and professional issues inherent in providing reproductive health care.
  • Communicates clinical and professional issues and questions to the Associate Medical Director of Family Planning.
  • Follows protocol and training requirements for expanding scope of practice and/or learning new procedures, i.e. colposcopy, IUD insertion, ultrasound, MAB services, etc.
  • Works to ensure understanding and acceptance of the Telehealth Clinician role with colleagues, consumers, and the community.
  • Maintains a working knowledge of Planned Parenthood policies and procedures and apply these to patient and clinic services.
  • Prescribes all FDA approved methods of birth control.
  • Provide medication or surgical abortion follow up.
  • Refers patients for medication or surgical abortion, prenatal care, or adoption services.
  • Counsel HIV+ clients.
  • Provide evaluation and management of medication abortion patients.
  • Participates in onboarding of new employees and supports the cross-training of established employees.

About Us:

At PPNCS, we believe all people deserve the right, the freedom, and the opportunity to follow their personal ambitions and choose their own path toward a healthier, more meaningful life. That's why we protect, promote, and provide comprehensive and progressive sexual and reproductive health care for generations of people and families with empathy, care, and respect. We are looking for passionate, dedicated staff who are eager to make positive contributions to their community and to the Planned Parenthood mission. To learn more: Our Mission.

When you work for Planned Parenthood, you make a difference in the lives of those we serve by affirming the human right to reproductive health and freedom.

Planned Parenthood is an affirmative action and equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, sex, gender identity or gender expression, national origin, age, veteran status, marital status, religion, sexual orientation, size, disability, socioeconomic status, or status regarding public assistance. Planned Parenthood is committed to encouraging and promoting diversity as well as providing access, equal opportunity, and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities. Planned Parenthood is dedicated to an equitable and inclusive work environment and encourages all interested candidates to apply regardless of initial skill set.

*Any job offer will be contingent upon the results of a background investigation.*

This position is included in the SEIU bargaining unit, and depending on state law, requires union dues be deducted from employee paychecks in an amount up to 2.25% of gross pay.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights notice from the Department of Labor.