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Remote Utilization Review Rn Jobs in Missouri (NOW HIRING)

Ellisville Rehabilitation and Nursing

MDS RN

Ballwin, MO · On-site +1

$34.75 - $45.50/hr

Part-Time MDS RN - Partial Remote Option - Ellisville Rehabilitation and Nursing Ellisville, MO | Skilled Nursing Facility | Flexible Part-Time/Remote Option Ellisville Rehab and Nursing is seeking a ...

Centene

Remote Medical Director, Appeals

Jefferson City, MO · On-site +1

$236.50K - $449.30K/yr

Performs medical review activities pertaining to utilization review, quality assurance, and medical ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...

Centene

Remote Medical Director, Appeals

Kansas City, MO · On-site +1

$236.50K - $449.30K/yr

Performs medical review activities pertaining to utilization review, quality assurance, and medical ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...

Centene

Remote Medical Director, Appeals

Florissant, MO · On-site +1

$236.50K - $449.30K/yr

Performs medical review activities pertaining to utilization review, quality assurance, and medical ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...

Centene

Remote Medical Director, Appeals

Columbia, MO · On-site +1

$236.50K - $449.30K/yr

Performs medical review activities pertaining to utilization review, quality assurance, and medical ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...

Centene

Remote Medical Director, Appeals

Saint Louis, MO · On-site +1

$236.50K - $449.30K/yr

Performs medical review activities pertaining to utilization review, quality assurance, and medical ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...

Corvel

Telephonic Case Manager I

Saint Louis, MO · Remote

$62.31K - $93.12K/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

Corvel

Telephonic Case Manager I

Saint Louis, MO · Remote

$62.31K - $93.12K/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

CorVel

Telephonic Case Manager I

Saint Louis, MO · Remote

$62.31K - $93.12K/yr

... Current RN Licensure in state of operation 3 or more years of recent clinical experience ... utilization review or managed care helpful Certification as a CIRS or CCM preferred Pay Range ...

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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 May 30, 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 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 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

Remote Utilization Review Nurse - CA Licensed (LVN/RN)

Astrana Health

California, MO • Remote

$30 - $34/hr

Full-time

Posted 5 days ago

Job description

A healthcare services company is seeking an experienced Utilization Review Nurse to work remotely. The ideal candidate must hold an active LVN license in California and have experience in outpatient utilization management. Responsibilities include approving or denying medical services based on established criteria.

Competitive hourly compensation ranges from $30.00 to $34.00. Join our dedicated team committed to putting patients first. #J-18808-Ljbffr

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