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Remote Utilization Review Rn Jobs in Louisiana (NOW HIRING)

Urrly

Telehealth Nurse Practitioner

Baton Rouge, LA · Remote

$600 - $720/day

Location/Type: Louisiana Remote (No travel) * Pay: $600-$720/day (1099 contractor, based on ... Review medications, history, and preventive care needs * Deliver clear care plans and follow-up ...

Venza Care

Clinical Case Manager REMOTE

Center Point, LA · On-site +1

$60/hr

Remote - Clinical Case Manager Location: * Remote Opportunity! Check out our locations at VenzaCare ... Review nursing and therapy documentation to ensure accurate clinical support for skilled rehab ...

BetterHelp

Medical Psychologist - Remote

New Orleans, LA · Remote

$650/wk

Work from the comfort of home (fully remote) * Flexible schedule - you set your own hours. * Free ... Also, we are unable to accept substance abuse counselors, school counselors, registered nurses ...

Ochsner Health

CRNA Site Lead

Crowley, LA · On-site +1

Please refer to the to determine whether the position you are interested in is remote or on-site. Individuals who reside in and will work from the following areas are not eligible for remote work ...

ZOLL Medical

Patient Service Representative

Lafayette, LA · Remote

$16.75 - $21.25/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 ...

Ochsner Health

Physician - Anesthesiology

New Orleans, LA · On-site +1

$384.10K/yr

The Department of Anesthesiology includes 70 anesthesiologists, 100 CRNA's, and >45 house staff ... Please refer to the to determine whether the position you are interested in is remote or on-site.

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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 Louisiana is $36.16, according to ZipRecruiter salary data. Most workers in this role earn between $28.56 and $41.54 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 are popular job titles related to Remote Utilization Review Rn jobs in Louisiana? For Remote Utilization Review Rn jobs in Louisiana, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review Rn jobs in Louisiana look for? The top searched job categories for Remote Utilization Review Rn jobs in Louisiana are:
What cities in Louisiana are hiring for Remote Utilization Review Rn jobs? Cities in Louisiana with the most Remote Utilization Review Rn job openings:
Remote Utilization Review Rn jobs near you
Strategic Clinical Quality Manager - West Louisiana Region

Strategic Clinical Quality Manager - West Louisiana Region

Fresenius Medical Care

Shreveport, LA • On-site, Remote

Full-time

Posted 15 days ago

Fresenius Medical Care rating

6.7

Company rating: 6.7 out of 10

Based on 1,250 frontline employees who took The Breakroom Quiz

526th of 864 rated healthcare providers

Job description

Position location: You will be able to work remotely, from your home location, in the United States
The individual selected must reside in the West Louisiana territory.
80% Travel Required - multiple area assignments
Position covers all 3 modalities
PURPOSE AND SCOPE:
Serves as a quality improvement champion and role model by promoting and supporting the use of Continuous Quality Improvement (CQI) principles, methods, and tools to improve processes and patient outcomes at the facility and area levels. Must have effective communications with the clinic interdisciplinary team (IDT) and must produce effective quality assessment and performance improvement activities which positively influence the assigned dialysis clinics clinical quality outcomes. The scope of the clinical quality oversight of the position covers assigned treatment modalities (e.g. in-center, in-center and Home Modalities, or home hemodialysis and home peritoneal dialysis), and is responsible for the monitoring data/information; prioritizing areas for improvement; determining potential root causes; developing, implementing, evaluating, and revising plans that result in improvements in clinical quality outcomes in dialysis facilities within a geography.
PRINCIPAL DUTIES AND RESPONSIBILITIES:
  • Facilitates the implementation and integration of the FKC Quality programs and initiatives into the facilities' standard

operating procedures through teamwork and collaboration with the facility clinical, interdisciplinary and operations
teams.
  • Serves as a subject matter expert for clinical quality matters when collaborating with other RNs and members of the Clinic IDT. Identifies clinical quality improvement opportunities in the assigned area to achieve CMS Conditions for Coverage and FMS quality program requirements.
  • Manages the execution of Quality and other clinical initiatives, interventions and standardized education materials with

Clinic teams within the assigned area(s).
  • Provides general direction, nursing and clinical guidance related to appropriate theoretical perspectives and feedback based

upon professional standards and FMCNA guidelines to support facility RNs within the assigned area in achieving the desired
outcomes in the following: quality, patient satisfaction, teamwork, unit culture, and employee satisfaction.
  • Collaborates with appropriate stakeholders including but not limited to the Clinical Quality leadership, Education, Clinical Services, Nutritional Services, Social Work Services Regulatory and Compliance to take the appropriate steps to facilitate achievement of quality goals and ongoing patient safety improvement.
  • Mentors and trains staff to collect, trend, and analyze data on a day-to-day basis to monitor the effectiveness of their clinical

and operational processes to impact patient centered care resulting in improved patient outcomes and satisfaction and
decreased morbidity and mortality.
  • Utilizes evidence based and best demonstrated practices to address barriers to quality improvement. This includes

promoting the adoption and utilization of Medical Advisory Board Recommended Algorithms and Standing Orders,
clinical pathways and clinical policies and procedures to improve care coordination and care delivery.
  • Leverages available tools, resources and informatics technology to focus on targeted patient populations.
  • Applies current knowledge of FMS clinical and administrative policies and procedures, available internal resources, working knowledge of CMS Conditions of Coverage for ESRD facilities, Value Based Payer Programs, knowledge of quality

improvement concepts, principles and practices to perform tasks and duties.
  • Utilizes quality improvement techniques to promote collaboration between facilities and areas to share processes and

strategies for success. Mentors and assists facilities in identifying effective practices applicable to their needs, in testing for
desired results, and the adoption and implementation of these practices.
  • Under the direction of Clinical Quality leadership, provides guidance, interpretation and subject matter expertise to clinical and

operations teams regarding quality related clinical policies and procedures, clinical standards, quality improvement tools and
electronic applications.
  • Performs desk review of facility Quality Assessment and Performance Improvement (QAPI) documentation and attends QAPI

meetings at a frequency determined by Clinical Quality leadership.
  • Collaborates with facility management staff to evaluate the effectiveness of the facility QAPI Program and CQI activities utilizing the following processes.
  • Reviews completion of facility QAPI activities including but not limited to adherence to the QAPI calendar, completion of QAPI

minutes, attendance, tools and electronic applications
  • Attends and participates in regional, area, facility and team meetings as appropriate which may include quality team building

and staff development and other meetings as appropriate.
  • Collaborates with appropriate management staff as needed to achieve effective inter-disciplinary, intra-disciplinary and clinic relationships.
  • Identifies risk areas and opportunities for improvement.
  • Assists with root cause analysis and action plan development and evaluation as needed.
  • Provides written or verbal recommendations to facility and area management.
  • Utilizes adult education principles in the execution of education programs and processes that facilitate the implementation

and incorporation of the company's quality standards and the practice of Continuous Quality Improvement in facility standard
procedures.
  • Accountable for outstanding customer service to all external and internal customers, including patients, staff, physicians, field

management and staff, and payers, including disease management entities.
  • Develops and maintains exceptional working relationships through effective and timely communication with all customers
  • Under the direction of Clinical Quality leadership, assists with various projects as assigned.
  • Performs other related duties as assigned.

PHYSICAL DEMANDS AND WORKING CONDITIONS:
  • The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
    • Day-to-day work includes desk and personal computer work and interaction with facility staff and physicians.
  • The work environment is characteristic of a health care facility with air temperature control and moderate

noise levels. May be exposed to infectious and contagious diseases/materials.
  • The position requires travel between assigned facilities and various locations within the community, approx. 60%.
    • Travel to Regional, Division and Corporate meetings may be required.

SUPERVISION:
None
EDUCATION AND REQUIRED CREDENTIALS:
  • Registered Nurse required
  • Certification in Nephrology Nursing or quality preferred.

EXPERIENCE AND SKILLS:
• 3+ years dialysis experience required.
• 3+ years management experience in a clinical leadership role.
• Strong organizational, critical thinking and customer service skills.
• Demonstrated leadership competencies and adaptability to changes in priorities.
  • Ability to work collaboratively with other members of the team, gain support and input while participating in quality improvement activities

• Strong verbal and written communications skills,
• Ability to analyze and propose alternate solutions, assist in resolving sensitive to complex issues
If your location allows for pay/benefit transparency, please click the link below to request further information on this position.
Pay Transparency Request Form
Fresenius Medical Care is an equal opportunity employer and does not discriminate on the basis of race, color, religion, sexual orientation, gender identity, parental status, national origin, age, disability, military service, or other non-merit-based factors

What Fresenius Medical Care employees say

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About Fresenius Medical Care

Sourced by ZipRecruiter

We are a Team of more than 70,000 with one guiding Principle Patients First. This promise starts with providing the most comprehensive care for people living with Chronic Kidney Disease and extends to Innovative Solutions that are redefining Healthcare and setting the industry standard. From evolving home Dialysis and Patient education programs to improving patient care to providing World Class Research and Data driven insights. Our vertically integrated network tirelessly seeks new ways to improve the quality of our Patients' lives. We believe each of us can make an impact and together we can change an industry. Our Mission is to Provide Superior care that improves the quality of life of every patient, every day, setting the standard by which others in the Healthcare Industry are judged. And none of us does it alone. We bring together the brightest minds in kidney care to Dream, Research, and Innovate.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Waltham, MA, US

Year founded

1996

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