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Remote Utilization Review Rn Jobs in Ohio (NOW HIRING)

Medpace, Inc.

Clinical Data Coder

Cincinnati, OH · On-site +1

$18 - $22.75/hr

Produce coding reports for team review and utilization *Stable schedule with no weekends, no work on Medpace holidays, and flexible work schedule* Qualifications * BSN and RN with applicable ...

Varsity Tutors

NCLEX-RN Tutor

Cleveland, OH · Remote

$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 ...

Varsity Tutors

NCLEX-RN Tutor

Akron, OH · Remote

$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 ...

Varsity Tutors

NCLEX-RN Tutor

Columbus, OH · Remote

$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 ...

Varsity Tutors

NCLEX-RN Tutor

Cincinnati, OH · Remote

$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 ...

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Remote Utilization Review Rn information

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$65

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

As of Sep 14, 2026, the average hourly pay for remote utilization review rn in Ohio is $40.20, according to ZipRecruiter salary data. Most workers in this role earn between $31.78 and $46.15 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 are the most commonly searched types of Utilization Review Rn jobs in Ohio?

The most popular types of Utilization Review Rn jobs in Ohio are:

What are popular job titles related to Remote Utilization Review Rn jobs in Ohio?

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

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

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

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

Cities in Ohio 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 Ohio as of September 2026, with employment types broken down into 67% Full Time, and 33% Part Time. Highlights an 100% Remote job distribution, with an average salary of $83,610 per year, or $40.2 per hour.

Director of Managed Care

Garfield Heights, OH • Remote

Nightingale
Recruiting and Staffing Services • 501 - 1,000 employees
Learn more about Nightingaleexternal

Full-time

Posted 19 days ago

Job description

Director of Managed Care

Remote Position

RN/LPN Preferred

Job Summary:

We are seeking an experienced, detail-driven Director of Managed Care to oversee prior authorizations, payer coordination, and utilization management across six skilled nursing facilities in Arkansas and Ohio. As a key member of our team, you will ensure timely authorizations, accurate documentation, and strong communication with payers to optimize reimbursement and resident care.

Responsibilities:

  • Manage and process all prior authorizations for admissions, continued stays, therapy services, and specialty care

  • Serve as the primary contact for managed care organizations, insurance plans, and payer representatives

  • Monitor authorization timelines, length of stay, and payer requirements to ensure compliance

  • Collaborate daily with MDS, nursing leadership, therapy, admissions, and regional leadership

  • Track, resolve, and appeal denials, ensuring complete and accurate documentation

  • Provide clear, consistent communication to facility teams regarding authorization status and next steps

  • Identify trends, barriers, and opportunities to strengthen managed care outcomes

  • Maintain organized workflows and reporting across all six facilities

Requirements:

  • Strong background in Managed Care, Utilization Review, Prior Authorization, or MDS within SNF/LTC

  • Deep understanding of Medicare Advantage, commercial plans, and authorization processes

  • Excellent communication, follow-through, and problem-solving skills

  • Ability to manage multiple facilities, deadlines, and payer relationships

  • Highly organized, tech-savvy, and comfortable working fully remote

  • Proactive, positive, team-focused professional who thrives in a collaborative environment

Your expertise ensures residents receive timely approvals, facilities maintain accurate reimbursement, and teams across Arkansas and Ohio stay aligned and supported. You'll be the central hub that keeps managed care operations running smoothly.

Why Join Us:

  • Fully remote role

  • Supportive, mission-driven leadership

  • Opportunity to impact outcomes across multiple communities

  • Competitive compensation

  • A role where your work directly strengthens resident care and operational success

If you're passionate about managed care excellence and excited to support six dedicated healthcare teams across Arkansas and Ohio, we want to meet you. Apply today and help us continue building strong, high-performing communities.