ZipRecruiter

Log In

2

Remote Utilization Review Rn Jobs in Ohio (NOW HIRING)

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

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

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

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 ...

Pharmacy Careers

Appeals Pharmacist (Remote)

Columbus, OH · On-site +1

$55.25 - $67.25/hr

Collaborate with physicians, nurses, and medical directors during case reviews. * Track, document ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...

Pharmacy Careers

Appeals Pharmacist (Remote)

Cleveland, OH · On-site +1

$55.50 - $67.75/hr

Collaborate with physicians, nurses, and medical directors during case reviews. * Track, document ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...

next page

Showing results 1-20

People also search for

All JobsRemote Utilization Review Rn JobsRemote Utilization Review Rn Jobs in Ohio

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 May 28, 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 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 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
Physician / Oncology / Ohio / Permanent / Associate Medical Director - Oncology - 100% Remote Job...

Physician / Oncology / Ohio / Permanent / Associate Medical Director - Oncology - 100% Remote Job...

eviCore healthcare

Columbus, OH • Remote

Part-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 27 days ago

Job description

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States.Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated.Provides timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions.Maintains necessary credentials and immediately informs eviCore of any adverse actions relating to medical licenses and/or board certifications.Participates in strategic planning for and evaluation of the Care ManagementThe successful candidate will be an M.D. or D.O. with a current, active, U.S.

state medical license and board certified in Oncology, recognized by the American Board of Medical Specialties (ABMS), with recent practice experience in direct patient care (within the past 18 months).Must have a minimum of 5 years clinical experience, beyond residency/fellowship Knowledge of applicable state and federal laws, URAC and NCQA standards a plus, and familiarity with automated processes and computer applications and systems is requiredNo nights, no weekends, not call.Predictable work scheduleFull and part time opportunitiesSalaried position with benefitsSupportive organization with collaborative cultureeviCore healthcare is committed to making a positive impact on healthcare, and also making a positive impact on our employees. eviCore offers a variety of perks and benefits including, but not limited to:Flexible scheduling and work/life balance with remote and work from home opportunities4 weeks of PTO(starting) per year plus paid holidaysOne week of CMEEducation assistance, tuition reimbursement and professional certifications Health, dental, vision, and life benefits with employer funded HSAPaid Volunteer Community Service Days Ample opportunities for growth, advancement, and promotion 401k retirement plan with company match of 50% employee contributions up to 6% eviCore is committed to hiring and retaining a diverse workforce. We are an Equal Opportunity Employer, making decisions without regard to race, color, religion, sex, national origin, age, veteran status, disability, or any other protected class.

Applicants must be able to pass a drug test and background investigation

Apply