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Remote Utilization Review Rn Jobs in Missouri (NOW HIRING)

DRG Reviewer

Florissant, MO ยท On-site +1

$70K - $126K/yr

Remote Role: 4+ years experience of performing MS-DRG and APR-DRG coding required. In-patient and ... CCDS Certified Clinical Documentation Specialist required or: RN - Registered Nurse - State ...

DRG Reviewer

Jefferson City, MO ยท On-site +1

$70K - $126K/yr

Remote Role: 4+ years experience of performing MS-DRG and APR-DRG coding required. In-patient and ... CCDS Certified Clinical Documentation Specialist required or: RN - Registered Nurse - State ...

DRG Reviewer

Kansas City, MO ยท On-site +1

$70K - $126K/yr

Remote Role: 4+ years experience of performing MS-DRG and APR-DRG coding required. In-patient and ... CCDS Certified Clinical Documentation Specialist required or: RN - Registered Nurse - State ...

DRG Reviewer

Columbia, MO ยท On-site +1

$70K - $126K/yr

Remote Role: 4+ years experience of performing MS-DRG and APR-DRG coding required. In-patient and ... CCDS Certified Clinical Documentation Specialist required or: RN - Registered Nurse - State ...

DRG Reviewer

Saint Louis, MO ยท On-site +1

$70K - $126K/yr

Remote Role: 4+ years experience of performing MS-DRG and APR-DRG coding required. In-patient and ... CCDS Certified Clinical Documentation Specialist required or: RN - Registered Nurse - State ...

NCLEX-RN Tutor

Saint Louis, MO ยท Remote

$18 - $40/hr

Adapts instruction using UWorld, Kaplan, or ATI practice question banks, content review materials, and test-taking strategy workshops to support BSN and ADN graduates preparing for registered nurse ...

NCLEX-RN Tutor

Kansas City, MO ยท Remote

$18 - $40/hr

Adapts instruction using UWorld, Kaplan, or ATI practice question banks, content review materials, and test-taking strategy workshops to support BSN and ADN graduates preparing for registered nurse ...

NCLEX-RN Tutor

Columbia, MO ยท Remote

$18 - $40/hr

Adapts instruction using UWorld, Kaplan, or ATI practice question banks, content review materials, and test-taking strategy workshops to support BSN and ADN graduates preparing for registered nurse ...

Showing results 21-40

Remote Utilization Review Rn information

See Missouri salary details

$20

$39

$64

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 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 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 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 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 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 cities in Missouri are hiring for Remote Utilization Review Rn jobs?

Cities in Missouri with the most Remote Utilization Review Rn job openings:

Infographic showing various Remote Utilization Review Rn job openings in Missouri 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 $82,494 per year, or $39.7 per hour.

Regional Manager/Registered Nurse

Alora Supports Missouri LLC

Poplar Bluff, MO โ€ข Remote

Full-time

Posted 4 days ago


Job description

About Alora Supports

Alora Supports provides high-quality, community-based resources and supports for people with disabilities in their preferred communities while creating meaningful employment for the people who support them.

Position Summary

The Regional Manager / Registered Nurse provides both clinical oversight and operational leadership within the assigned region. This role is responsible for ensuring high-quality service delivery, regulatory compliance, and regional growth while overseeing medication administration practices, nursing delegation, and the health and safety of individuals served.

This position supervises the regional Professional Management team, supports workforce development, and serves as the clinical authority for medication management and health-related services in accordance with Missouri Department of Mental Health (DMH) requirements. The role balances strategic leadership, hands-on operational support, and nursing oversight to ensure continuity and excellence of care.

Key Responsibilities

Clinical Oversight and Nursing Services

  • Complete and document assessments, including health status changes, physician orders, and medical visits for individuals requiring medication administration or delegated nursing tasks. 

  • Complete monthly face-to-face assessments for any individual receiving Shared Living services through Alora Supports.

  • Review medication administration records (MARs) monthly for accuracy, trends, and compliance.

  • Communicate medication or health concerns to prescribing providers as appropriate.

  • Provide oversight and supervision of nursing delegation in accordance with Missouri standards.

  • Train and recertify Direct Support Professionals in medication administration.

  • Serve as a clinical resource for managers regarding medical issues and decision-making.

  • Ensure compliance with DMH standards related to medication administration and nursing oversight.

  • Document nursing observations, recommendations, and follow-up actions in a timely manner.

Leadership and Operations

  • Supervise, mentor, and support the regional Professional Management team.

  • Foster a collaborative, high-performance culture focused on quality services and staff engagement.

  • Provide direct operational support during staffing shortages or urgent service needs.

  • Coordinate with the Workforce Manager on hiring and staffing plans.

  • Support staff training, development, and performance management.

Regional Growth and Stakeholder Engagement

  • Lead regional growth efforts through networking, relationship-building, and referral management.

  • Maintain relationships with Support Coordination teams and community stakeholders.

  • Manage referrals, conduct outreach, and participate in choice of provider meetings.

  • Support onboarding and service initiation for new individuals.

Compliance and Quality Assurance

  • Maintain working knowledge of Missouri HCBS requirements and the DD Waiver Manual.

  • Conduct bi-weekly Regional Event Management Reviews and ensure follow-up completion.

  • Complete reportable event investigations as assigned.

  • Identify trends, risks, and areas for quality improvement across services.

  • Ensure adherence to agency policies, regulatory standards, and best practices.


Required Qualifications
  • Current and valid Registered Nurse (RN) license in the State of Missouri.

  • Bachelor’s degree in any field OR five years of relevant supervisory/management experience.

  • At least one year of experience in the Intellectual and Developmental Disabilities (IDD) field.

  • At least one year of supervisory experience.


Preferred Qualifications
  • Bachelor’s degree in nursing or a related human services field.

  • Three or more years of IDD experience.

  • Three or more years of supervisory experience in IDD or HCBS settings.


Skills and Competencies
  • Knowledge of Missouri HCBS and DMH requirements, including medication administration and nursing delegation.

  • Knowledge of the Missouri Medicaid Waiver Manual and related regulations.

  • Strong clinical assessment and documentation skills.

  • Ability to train, coach, and support non-licensed staff.

  • Effective leadership, team-building, and staff development skills.

  • Strong communication and relationship-building abilities.

  • Ability to balance clinical responsibilities with operational leadership.

  • Strong organizational, problem-solving, and time management skills.


Work Schedule and Travel

Typical work hours are 9:00 a.m. to 5:00 p.m., with flexibility to adjust based on participant needs, guardian availability, staffing demands, and regional priorities. This remote role requires regular field-based engagement throughout Southern Missouri and may occasionally require extended workdays or rare overnight travel. Schedule flexibility is an essential requirement of the position.

Work Environment

This position is primarily remote with frequent travel throughout the assigned region. The role requires regular interaction with participants, families, guardians, community professionals, and internal team members in both virtual and in-person settings.

Equal Opportunity Employment

Alora Supports is an equal opportunity employer. The organization does not discriminate on the basis of race, color, religion, sex, including pregnancy, national origin, age, disability, genetic information, marital status, military or veteran status, sexual orientation, gender identity, or any other characteristic protected by federal, state, or local law. This commitment applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, benefits, and training.