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Remote Utilization Review Rn Jobs in Kentucky (NOW HIRING)

Patient Service Representative

Ashland, KY · Remote

$15.25 - $19.50/hr

Preferred Candidates include (not limited to): RN, EMT, Paramedic, EMS, Firefighter, PA, LPN, MA ... All candidates reviewed on an individual basis. Summary Description: The Cardiac Management ...

... remote patient safety monitoring program. Essential Functions • Recognizes and practices within scope of certification and competency, seeking assistance from supervising RN or LPN as needed. • ...

... remote patient safety monitoring program. Essential Functions • Recognizes and practices within scope of certification and competency, seeking assistance from supervising RN or LPN as needed. • ...

Review and interpret clinical, utilization, and quality data to identify trends, risk areas, and ... Prior leadership experience working with long term care, nursing facilities, assisted living, or ...

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Remote Utilization Review Rn information

See Kentucky salary details

$18

$36

$59

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

As of Jun 22, 2026, the average hourly pay for remote utilization review rn in Kentucky is $36.72, according to ZipRecruiter salary data. Most workers in this role earn between $29.04 and $42.16 per hour, depending on experience, location, and employer.

What is the meaning of the word remote?

In the context of a Remote Utilization Review RN job, 'remote' refers to working outside of a traditional office setting, often from home or another location of the employee's choice. This setup typically involves using digital tools and communication platforms to perform job duties without being physically present in an office environment.

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 meaning of remote in one word?

In the context of a Remote Utilization Review RN role, 'remote' means working from a location outside of a traditional office, typically from home, using digital communication tools. It emphasizes flexibility and virtual access to work systems without physical presence at a healthcare facility.

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.

How to make 2000 a week working from home?

A Remote Utilization Review RN can potentially earn $2,000 weekly by working full-time hours, often 40 hours per week, and gaining experience or certifications that allow for higher billing rates. Increasing income may involve taking on additional cases, specializing in high-demand areas, or working for agencies that offer competitive pay for remote utilization review roles.

What is remote job?

A remote Utilization Review RN job is a healthcare position where the nurse reviews patient cases and insurance claims from a location outside of a traditional office, often working from home. It requires strong communication skills, knowledge of medical documentation, and familiarity with electronic health record systems, with flexible schedules common in remote roles.

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 are the most commonly searched types of Utilization Review Rn jobs in Kentucky? The most popular types of Utilization Review Rn jobs in Kentucky are:
What cities in Kentucky are hiring for Remote Utilization Review Rn jobs? Cities in Kentucky with the most Remote Utilization Review Rn job openings:
Infographic showing various Remote Utilization Review Rn job openings in Kentucky as of June 2026, with employment types broken down into 5% As Needed, 85% Full Time, and 10% Part Time. Highlights an 100% Remote job distribution, with an average salary of $76,384 per year, or $36.7 per hour.
Lead Licensed Practical/Telehealth Clinical Technician

Lead Licensed Practical/Telehealth Clinical Technician

Veterans Health Administration

Lexington, KY • On-site, Remote

$70K - $91K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 4 days ago


Veterans Health Administration rating

8.1

Company rating: 8.1 out of 10

Based on 972 frontline employees who took The Breakroom Quiz

68th of 875 rated healthcare providers


Job description

Summary
We are seeking a highly skilled and motivated LPN to join our progressive team. As a Lead LPN GS-7, you will perform complex nursing assignments and apply comprehensive practical nursing knowledge across a wide range of specialized procedures. This position offers the opportunity to function with greater independence and responsibility, exercising independent technical judgment, while providing patient-centered care that supports Veterans in reaching their maximum functional potential.
Learn more about this agency
Duties
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VA Careers - Licensed Practical Nurse: https://youtube.com/embed/Ae85IP1Oiz4
Total Rewards of a Allied Health Professional
Major Duties:
  • Performs specialized practical nursing care assignments of considerable difficulty under general supervision, demonstrating advanced knowledge and skill beyond the GS-6 level.
  • Applies comprehensive practical nursing knowledge to plan, implement, and evaluate individualized patient care, actively contributing to the Veterans' overall health plan.
  • Collaborates with Registered Nurses (RNs) and other health care providers to promote and demonstrate nursing concepts within the Medical Center.
  • Functions as Lead LPN/LVN/Telehealth Clinical Technician (TCT) by serving as subject matter expert and providing education/training on telehealth platforms (Annie App, MyHealtheVet) to staff and Veterans.
  • Monitors and ensures compliance with connected care and telehealth reports; investigates discrepancies and resolves telehealth encounter issues.
  • Coordinates the creation and modification of telehealth clinics, ensures correct coding, updates clinic profiles, and maintains scheduling accuracy.
  • Supports annual reviews and updates of Facility Telehealth Service Agreements (TSAs) and Terms of Service (TOS).
  • Serves as a recorder for the Connected Care Oversight Committee and conducts outreach to promote telehealth programs.
  • Provides technical training and acts as an SME for the Virtual Health Resource Center.
  • Utilizes VA systems (VISTA, CPRS) for order review, documentation, problem resolution, and clinic management.
  • Prioritizes and triages patient needs; assesses, records, and reports vital signs, neurological signs, weights, and blood glucose levels.
  • Prepares and administers medications; observes and communicates patient responses to assigned treatments.
  • Serves as a tele presenter and imager during clinical video telehealth (CVT) and VA Video Connect (VVC) encounters, including establishing connections, capturing images, and facilitating effective clinical encounters.
  • Provides education and support to Veterans and clinicians on telehealth technologies, ensuring readiness and addressing concerns.
  • Maintains, configures, cleans, and troubleshoots telehealth equipment; coordinates repairs and replacement as necessary.
  • Assists in clinic setup, scheduling, and workload monitoring for telehealth resource-based clinics.
  • Ensures compliance with Joint Commission standards, Office of Connected Care directives, and local policies.
  • Promotes patient safety and maintains a clean, hazard-free environment.
  • Intervenes in medical emergencies within the clinical setting, initiates basic life support, and activates emergency response as needed.
  • Participates in performance improvement activities for telehealth operations and serves as a preceptor for new staff in complex procedures.
  • Manages clinical questionnaires/templates within scope and supports additional duties as assigned.

Pay Scale: V744
Work Schedule: Monday-Friday Day Tour of Duty, such as, 0730-1600 or 0800-1630
Recruitment Incentive (Sign-on Bonus): Not authorized
Permanent Change of Station (Relocation Assistance): Not authorized
Pay: Competitive salary and regular salary increases. When setting pay, a higher step rate of the appropriate grade may be determined after consideration of higher or unique qualifications or special needs of the VA (Above Minimum Rate of the Grade).
Paid Time Off: 37-50 days of annual paid time offer per year (13-26 days of annual leave, 13 days of sick leave, 11 paid Federal holidays per year)
Selected applicants may qualify for credit toward annual leave accrual, based on prior [work experience] or military service experience.
Parental Leave: After 12 months of employment, up to 12 weeks of paid parental leave in connection with the birth, adoption, or foster care placement of a child.
Child Care Subsidy: After 60 days of employment, full time employees with a total family income below $144,000 may be eligible for a childcare subsidy up to 25% of total eligible childcare costs for eligible children up to the monthly maximum of $416.66
Retirement: Traditional federal pension (5 years vesting) and federal 401K with up to 5% in contributions by VA
Insurance: Federal health/vision/dental/term life/long-term care (many federal insurance programs can be carried into retirement)
Telework: Not available
Virtual: This is not a virtual position.
Functional Statement #: 31349F
Permanent Change of Station (PCS): Not authorized
Requirements
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Conditions of employment
  • You must be a U.S. Citizen to apply for this job.
  • All applicants tentatively selected for VA employment in a testing designated position are subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested will be denied employment with VA.
  • Selective Service Registration is required for males born after 12/31/1959.
  • Must be proficient in written and spoken English.
  • Subject to background/security investigation.
  • Selected applicants will be required to complete an online onboarding process. Acceptable form(s) of identification will be required to complete pre-employment requirements (https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents). Effective May 7, 2025, driver's licenses or state-issued identification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment.
  • Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP).
  • Complete all application requirements detailed in the "Required Documents" section of this announcement.

As a condition of employment for accepting this position, you will be required to serve a 1 or 2-year trial period during which we will evaluate your fitness and whether your continued employment advances the public interest. In determining if your employment advances the public interest, we may consider:
  • your performance and conduct;
  • the needs and interests of the agency;
  • whether your continued employment would advance organizational goals of the agency or the Government; and
  • whether your continued employment would advance the efficiency of the Federal service.

Upon completion of your trial period, your employment will be terminated unless you receive certification, in writing, that your continued employment advances the public interest.
Qualifications
Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met.
Basic Requirements:
  • United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy.
  • English Language Proficiency. In accordance with 38 U.S.C. 7402(d), no person shall serve in direct patient care positions unless they are proficient in basic written and spoken English.
  • Education - Graduate of a school of practical or vocational nursing approved by the appropriate State agency and/or accredited by the National League for Nursing Accrediting Commission (NLNAC) at the time the program was completed by the applicant. Exceptions include health care education in the military service or training in the military service which is accepted by the licensing body in the jurisdiction in which the individual is licensed as qualifying for full LPN/LVN licensure will be accepted as meeting the education requirements for VHA employment OR granted a license by a jurisdiction that does not require graduation from an approved school AND have at least one year of successful practice as an LPN/ LVN.
  • Licensure - Active, full, current and unrestricted licensure as a Graduate Licensed Practical or Vocational Nurse in a State, Territory, or Commonwealth (i.e., Puerto Rico), of the United States or the District of Columbia.

May qualify based on being covered by the Grandfathering Provision as described in the VA Qualification Standard for this occupation (only applicable to current VHA employees who are in this occupation and meet the criteria).
Grade Determinations:
GS-7. The GS-7 grade level is for select, complex LPN positions, as established by each health care facility. To be advanced, employees must meet all of the following standards, provided the standard is part of their assignment:
(a) Completion of at least one (1) year of additional qualifying experience at the GS-6 level or equivalent, fully meeting all of the performance requirements for the GS-6 LPN.
(b) Knowledge and skills necessary to carry out more specialized patient care duties, including assignments in selected, more complex inpatient and/or outpatient care settings. Knowledge base promotes the incorporation of current patient care data in actively contributing to the development of the patient's overall health plan and in carrying out assigned nursing interventions.
(c) Ability to assist RN and/or MD/DO to appropriately prioritize overall patient care needs and adjust plans for care delivery. Makes astute observations of subtle, less obvious changes, both physical and emotional, in patient's condition, and accurately and thoroughly documents care delivered and patient's response to care that could require immediate modification of the patient's care plan. Appropriately seeks assistance and guidance by informing RN or MD/DO of changes in patient's condition requiring higher-level intervention. At this grade level, the LPN is expected to participate to a greater degree in prioritizing, and, as appropriate, modifying patient care treatment.
(d) Ability to proactively assist the RN or MD/DO in addressing patient's needs for medication/treatments, accurately administering prescribed medications/treatments according to established policies/procedures and appropriately recording administration and patient's response to medications/treatments received. (This may include restricted medication locally authorized for administration by employees at this grade level.) Demonstrates the knowledge and ability to readily recognize the more subtle signs and symptoms of potential or actual drug reactions, promptly inform the RN or MD/DO of observed changes in patient's condition and initiate appropriate, prescribed interventions. Employees at this grade level demonstrate broader knowledge and skill with respect to these responsibilities than employees at lower grade levels.
(e) Knowledge and skill to promptly recognize potential urgent or emergent patient care situations, seek assistance of the RN and/or MD/DO for appropriate team intervention and effectively intervene, as directed, to assure the continuation of optimal, safe and therapeutic patient care delivery. At this grade level, the LPN must have a broader knowledge of the patient treatment process and exercise judgment that demonstrates the ability to effectively intervene when appropriate.
(f) Assists individuals or groups of patients and their families to take an active role in promoting healthy lifestyles for more positive patient outcomes. Exercises skill in influencing and communicating with unusually difficult to care for or communicate with patients and/or family members who may exhibit problems with lack of self-control, resistant or abusive behaviors, or impediments in their ability to understand or follow instructions. This includes the ability to effectively deal with the above types of patients under very general supervision.
(g) Exhibits skill, creativity and initiative in contributing to the improvement of overall care delivery and patient and/or family satisfaction levels through active participation in committees/task forces, research projects or in developing educational materials/media. Actively promotes and effectively incorporates established customer service standards in all aspects of their practice.
(h) Possess comprehensive practical nursing knowledge and skills in specialized procedures and practices to serve as a resource person for other staff in organizing and implementing more complex/specialized patient care. Serves as a role model and mentor to other nursing staff in the application of more complex technology, effectively guiding and directing their continuing practice in these areas.
(i) Supports the RN or MD/DO in monitoring the practice of unlicensed nursing or non-medical staff in patient care delivery. Promptly reports any deviations from normal practice patterns to the RN or MD/DO. In addition to responsibilities at the lower grade level, the LPN is responsible for monitoring the practice of non-licensed nursing and medical staff.
Preferred Experience: At least 2 years of recent LPN experience in a healthcare setting, with at least one year in telehealth, virtual care, or connected care modalities; Proficiency with VA electronic health record systems and telehealth equipment; Experience in facilitating training and education for staff and patients in telehealth or virtual care settings - Annie App and MyHealtheVet
Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/.
The full performance level of this vacancy is GS-7. The actual grade at which an applicant may be selected for this vacancy is GS-7.
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About Veterans Health Administration

Sourced by ZipRecruiter

The Veterans Health Administration (VHA) is the largest integrated health care system in the United States, serving millions of Veterans each year. Located in Phoenix, AZ, and many other parts of the US, the VHA operates under the Department of Veteran Affairs, as suggested by their official website va.gov. The VHA is dedicated to providing the highest level of comprehensive care to its veterans. The organization offers a broad spectrum of medical, surgical, and rehabilitative care, including mental health services, research, and pharmacy benefits.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Phoenix, AZ, US