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Remote Utilization Review Rn Jobs in Missouri (NOW HIRING)

Centene

Supervisor, Utilization Management (RN)

Columbia, MO · On-site +1

$75K - $135K/yr

Supervises Prior Authorization, Concurrent Review, and/or Retrospective Review Clinical Review team ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...

New

Corvel

Telephonic Case Manager I

Saint Louis, MO · Remote

$63K - $95K/yr

Current RN Licensure in state of operation * 3 or more years of recent clinical experience ... Strong cost containment background, such as utilization review or managed care helpful

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Remote Utilization Review Rn information

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$39

$64

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

As of Jul 20, 2026, the average hourly pay for remote utilization review rn in Missouri is $39.66, according to ZipRecruiter salary data. Most workers in this role earn between $31.35 and $45.53 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 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 Missouri? For Remote Utilization Review Rn jobs in Missouri, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review Rn jobs in Missouri look for? The top searched job categories for Remote Utilization Review Rn jobs in Missouri are:
What cities in Missouri are hiring for Remote Utilization Review Rn jobs? Cities in Missouri 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 Missouri as of July 2026, with employment types broken down into 89% Full Time, 8% Part Time, and 3% Contract. Highlights an 40% Physical, 3% Hybrid, and 57% Remote job distribution, with an average salary of $82,494 per year, or $39.7 per hour.
RN, Utilization Review - PRN

RN, Utilization Review - PRN

Saint Luke's Hospital of Kansas City

Kansas City, MO • Remote

Part-time

Posted 2 days ago

New

Saint Luke's Health System (Kansas City) rating

7.1

Company rating: 7.1 out of 10

Based on 109 frontline employees who took The Breakroom Quiz

374th of 886 rated healthcare providers

Job description

Job DescriptionSaint Luke's is looking to add to the UR team!

Schedule: Day Shift

Status: PRN - 1 shift required every 2 weeks

  • MO/KS RN license required

  • Case Management experience preferred

  • Min of 2 years bedside experience preferred

  • Remote position; will cover all campuses

The Opportunity:

The Utilization Review RN is responsible for assuring the receipt of high quality, cost efficient medical outcomes through utilization review and management. This position includes monitoring patient charts and utilization of health care services. Collaborates and communicates with physicians, Care Coordinators, Social Workers and other members of the multidisciplinary and revenue cycle teams.

  • Completes initial and concurrent reviews; identifies appropriate level of service and length of stay, using clinical guidelines (InterQual).

  • Complies with CMS regulation regarding utilization review/management.

  • Obtains and manages insurance authorizations and proactively works denials to help mitigate financial impact.

  • Submits referrals for secondary level review as appropriate and follows through on process.

  • Documents communication and work in electronic medical record.

  • Works with physicians and members of the multidisciplinary and revenue cycle teams to ensure appropriate level of service, level of care and billing.

Why Saint Luke's?

  • We believe in work/life balance.

  • We are dedicated to innovation and always looking for ways to improve.

  • We believe in creating a collaborative environment where all voices are heard.

  • We are here for you and will support you in achieving your goals.

Job Requirements

Applicable Experience:

Less than 1 yearRegistered Nurse - VariousAssociate DegreeJob DetailsPRNDay (United States of America)

The best place to get care. The best place to give care. Saint Luke's 12,000 employees strive toward that vision every day. Our employees are proud to work for the only faith-based, nonprofit, locally owned health system in Kansas City. Joining Saint Luke's means joining a team of exceptional professionals who strive for excellence in patient care. Do the best work of your career within a highly diverse and inclusive workspace where all voices matter.

Join the Kansas City region's premiere provider of health services. Equal Opportunity Employer.

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