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Remote Utilization Review Rn Jobs in Minnesota (NOW HIRING)

illumifin

Care Manager- LSW or RN

Eden Prairie, MN · On-site +1

$60K/yr

This position is responsible for gathering and reviewing requirements for the purpose of ... Minimum Qualifications * RN Nursing or Social Work license. * 3 years work experience with older ...

MatrixCare

Review Specialist, OASIS & 485

Bloomington, MN · Remote

$62K - $80K/yr

OASIS Review Coding Specialist This is a remote position that provides flexibility and control over ... Graduate of accredited school of professional nursing and BSN preferred. * 2 years of home health ...

ResMed

Review Specialist, OASIS & 485

Bloomington, MN · Remote

$62K - $80K/yr

OASIS Review Coding Specialist This is a remote position that provides flexibility and control over ... Graduate of accredited school of professional nursing and BSN preferred. * 2 years of home health ...

Resmed

Review Specialist, OASIS & 485

Bloomington, MN · Remote

$62K - $80K/yr

OASIS Review Coding Specialist This is a remote position that provides flexibility and control over ... Graduate of accredited school of professional nursing and BSN preferred. * 2 years of home health ...

Essentia Health

RN Pre-Service Authorization

Duluth, MN · On-site +1

$70K - $105K/yr

Working remote * Epic * Insurance knowledge/Prior authorization Licensure/CertificationQualifications: Current nursing licensure in state(s) of employment FTE: 1 Possible Remote/Hybrid Option: Remote ...

Allianz

Counsel | Remote

Minneapolis, MN · On-site +1

Responsibilities includes preparation, review and negotiation of prospective reinsurance term ... Utilization of artificial intelligence tools and resources (e.g. generative Al). What you bring:

Scribe-X

Remote Medical Scribe

Rochester, MN · Remote

$14 - $17/hr

Anyone looking to begin a career in medicine (MD, DO, PA, NP, or RN) should consider becoming a ... Review completed charts with the provider between patients or at the completion of shift * Update ...

Scribe-X

Remote Medical Scribe

Minneapolis, MN · Remote

$14 - $17/hr

Anyone looking to begin a career in medicine (MD, DO, PA, NP, or RN) should consider becoming a ... Review completed charts with the provider between patients or at the completion of shift * Update ...

Scribe-X

Remote Medical Scribe

Saint Paul, MN · Remote

$14 - $17/hr

Anyone looking to begin a career in medicine (MD, DO, PA, NP, or RN) should consider becoming a ... Review completed charts with the provider between patients or at the completion of shift * Update ...

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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 Aug 17, 2026, the average hourly pay for remote utilization review rn in Minnesota is $41.41, according to ZipRecruiter salary data. Most workers in this role earn between $32.74 and $47.55 per hour, depending on experience, location, and employer.

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

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

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

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

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

Cities in Minnesota 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 Minnesota as of August 2026, with employment types broken down into 1% As Needed, 87% Full Time, 10% Part Time, and 2% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $86,136 per year, or $41.4 per hour.

Care Manager- LSW or RN

illumifin

Eden Prairie, MN • On-site, Remote

$60K/yr

Full-time

Posted 20 days ago

Illumifin rating

8.1

Company rating: 8.1 out of 10

Based on 21 frontline employees who took The Breakroom Quiz

112th of 244 rated software companies

Job description

The nation's leading administrator of long term care insurance services is looking for YOU. This is your opportunity to join a company with a culture that promotes respect for people, integrity, learning and initiative.
WE ARE THE KIND OF EMPLOYER YOU DESERVE.
illumifin is a leading provider of business process outsourcing for the insurance industry, managing long-term care policies for the nation's largest insurers. We also provide clients with unique risk management insight built upon our proprietary long term care databases.
This position is responsible for gathering and reviewing requirements for the purpose of determining initial and ongoing claimant and provider eligibility.
RESPONSIBILITIES
1. Assess claimant eligibility by reviewing medical records from all current providers and conducting phone assessments with the claimant or legal representative. In the event of noted inconsistencies in the claimant eligibility, coordinate a benefit eligibility assessment in order to make a final determination.
2. In conjunction with plan language upon initial assessment and ongoing recertification, determine legitimacy and eligibility of service providers by requesting and reviewing provider licensing credentials, state-specific regulations, internet searches and phone assessments with the servicing provider.
3. Effectively communicate, verbal and written, all aspects of the claim benefit determination process.
4. Assist claimants with modifications to their current care plan, including changes in care needs as well as changes in provider.
5. Monitor daily, weekly and monthly reports to ensure claims are handled timely and appropriately.
6. Attend case conferences, internally and with the client, to present claims recommendations.
7. Meet quality and production metrics as established and communicated by the department.
8. Reviews Care Coordinator decision recommendations on tax qualified policies.
9. Other duties as assigned.
Minimum Qualifications
* RN Nursing or Social Work license.
* 3 years work experience with older adult population.
* Intermediate level experience with Microsoft Office products.
* Required to uphold the principles of compliance as outlined in the Code of Conduct, Employee Handbook and related policies and procedures. Supports and participates in the mandatory Corporate Compliance Program training initiative on an annual or more frequent basis, as required.
Preferred Qualifications
* Care planning experience preferred.
* Experience with insurance contract interpretation preferred.
* Excellent verbal and written communication skills.
The annual compensation target is at $60,000 depending on experience and qualifications

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