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Remote Utilization Review Rn Jobs in Ohio (NOW HIRING)

Senior Compliance Auditor - RN (Remote) At Elara Caring, we care where you are and believe the best ... Provide secondary review/oversight of PCS policy development, revisions and reviews for new and ...

Senior Compliance Auditor - RN (Remote) At Elara Caring, we care where you are and believe the best ... Provide secondary review/oversight of PCS policy development, revisions and reviews for new and ...

Nurse

Cincinnati, OH · On-site +1

$73K - $145K/yr

VA Nurse Total Rewards The duties of the Women's Health Clinic Registered Nurse (RN) are but is not ... enhance outcomes utilization. * This incumbent integrates Women's Health knowledge, skills ...

Clinical Director

Cincinnati, OH · On-site +1

$76K - $104K/yr

Coordinate and collaborate with the contracted billing company and any internal utilization review ... Remote & Field-Based Work Expectations * Travel to assigned facility locations as needed for direct ...

Collect, review records, summarize issues and analyze data daily, weekly, monthly, or as needed to ... Licensed healthcare professional in the state of Michigan: LPN, RN, LMSW, LBSW. * Previous Medicare ...

Showing results 21-40

Remote Utilization Review Rn information

See Ohio salary details

$20

$40

$65

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

As of Sep 15, 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 cities in Ohio are hiring for Remote Utilization Review Rn jobs?

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

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.

Afterhours RN Care Manager

Whitehouse, OH • On-site, Remote

$92K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 11 days ago


Job description

Overview

Expand Access. Support Families. Elevate After-Hours Care.

We are seeking a dedicated Afterhours RN Care Manager to provide high-quality, compassionate hospice care outside standard business hours. This role ensures seamless coverage, continuity of care, and strong clinical management for patients and families during nights, weekends, and on-call hours.

About the RoleThe Afterhours Care Manager RN is responsible for assessing and coordinating patient and family needs during after-hours shifts and maintaining primary clinical oversight for assigned patients. This includes routine visits, admissions, death visits, urgent after-hours calls, and any visit assigned per the patient's plan of care. This role serves as an active member of the Interdisciplinary Group (IDG) to ensure coordination between physicians, families, and the hospice team. Clinical administrative responsibilities, workflow auditing, and survey readiness support are also part of this role.

Essential Functions

  • Ensure appropriate delivery of hospice services to eligible patients and families.
  • Provide direct in-person patient care during on-call, weekend, and after-hours shifts, including assessments, admissions, routine visits, death visits, and live discharges.
  • Conduct initial and ongoing assessments of physical, emotional, psychosocial, and spiritual needs.
  • Support the IDG process through chart reviews, plan of care updates, and interdisciplinary communication.
  • Develop and revise the Hospice Plan of Care in collaboration with physicians and IDG members.
  • Educate patients and families on disease progression, symptom management, medications, and hospice philosophy.
  • Communicate significant changes in patient condition promptly to hospice and attending physicians.
  • Maintain accurate, timely clinical documentation including assessments, care plans, and notes.
  • Assist with rescheduled, missed, or reassigned visit requests based on triage direction.
  • Participate in calendar and scheduling modifications, including service codes and clinician assignments.
  • Support administrative and compliance activities including workflow audits, survey readiness tasks, and documentation collection.
  • Assist with TPE reviews, QAPI efforts, and regulatory compliance.
  • Ensure infection control standards and universal precautions are consistently followed.
  • Provide leadership and guidance to field staff; conduct supervisory visits when appropriate.
  • Participate in required meetings, after-hours updates, and trainings.
  • Maintain proficiency in pain and symptom management for hospice and end-of-life care.
  • Promote the organization's core values and maintain a culture of compassion, professionalism, and teamwork.
  • Perform other duties as assigned.

Compensation may vary within the salary range provided based on several factors including but not limited to a candidate's location, experience, education, skills, licensure, certifications and department equity.  Gentiva provides associates with a comprehensive benefits and total rewards package, of which base pay is just one piece.

Salary Range - $83-92k/year

About You

Education and Experience

  • Current RN license in the state of employment
  • Graduate of an accredited nursing program
  • Minimum one year of RN experience in acute care, oncology, long-term care, hospice, or home health
  • Must meet any state-specific requirements

Licenses and Certifications

  • Active RN license
  • CPR certification (in-person)
  • Valid driver's license, reliable transportation, and current auto insurance

Skills and Competencies

  • Strong knowledge of hospice principles, Medicare/Medicaid regulations, and best practices
  • Ability to conduct thorough patient assessments and develop individualized care plans
  • Effective communication with patients, families, physicians, and interdisciplinary team members
  • Strong time-management and prioritization skills in a fast-changing environment
  • Proficiency with EMR systems (HomeCare HomeBase preferred), Microsoft Office, and mobile technologies
  • Ability to maintain confidentiality, demonstrate integrity, and support quality outcomes
  • Leadership skills to support and guide field staff
  • Ability to manage administrative, documentation, and compliance responsibilities accurately

Personal Traits

  • Sensitivity to end-of-life needs and the emotional realities families face
  • Flexibility to shift tasks and respond to urgent needs
  • Professionalism, maturity, teamwork, and resilience under pressure
  • Ability to communicate effectively with individuals from diverse background
We Offer

Benefits for All Associates (Full-Time, Part-Time & Per Diem):

  • Competitive Pay
  • 401(k) with Company Match
  • Career Advancement Opportunities
  • National & Local Recognition Programs
  • Teammate Assistance Fund

 

Additional Full-Time Benefits:

  • Medical, Dental, Vision Insurance
  • Mileage Reimbursement or Fleet Vehicle Program
  • Generous Paid Time Off + 7 Paid Holidays
  • Wellness Programs (Telemedicine, Diabetes Management, Joint & Spine Concierge Care)
  • Education Support & Tuition Assistance (ASN to BSN, BSN to MSN)
  • Free Continuing Education Units (CEUs)
  • Company-paid Life & Long-Term Disability Insurance
  • Voluntary Benefits (Pet, Critical Illness, Accident, LTC)
Legalese
  • This is a safety-sensitive position
  • Employee must meet minimum requirements to be eligible for benefits
  • Where applicable, employee must meet stage specific requirements
  • We are proud to be an EEO employer
  • We maintain a drug-free workplace
LocationHeartland HospiceOur Company

At Heartland Hospice, part of Gentiva, it is our privilege to offer compassionate care in the comfort of wherever our patients call home. We are a national leader in hospice care, palliative care, home health care, and advanced illness management, with nearly 600 locations and thousands of dedicated clinicians across 38 states.

Our place is by the side of those who need us - from helping people recover from illness, injury, or surgery in the comfort of their homes to guiding patients and their families through the physical, emotional, and spiritual effects of a serious illness or terminal diagnosis.

Our nationwide reach is powered by a family of trusted brands that include:

  • Hospice care: Gentiva Hospice, Emerald Coast Hospice Care, Heartland Hospice, Hospice Plus, New Century Hospice, Regency SouthernCare, SouthernCare Hospice Services, SouthernCare New Beacon
  • Palliative care: Empatia Palliative Care, Emerald Coast Palliative Care
  • Home health care: Heartland Home Health
  • Advanced illness management: Illumia Health

With corporate headquarters in Atlanta, Georgia, and providers delivering care across the U.S., we are proud to offer rewarding careers in a collaborative environment where inspiring achievements are recognized - and kindness is celebrated.

Employment Type: FULL_TIME