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Remote Utilization Review Rn Jobs in Ohio (NOW HIRING)

Miamioh

Clinical Education Coordinator

Hamilton, OH · On-site +1

$85K/yr

Active, unencumbered registered nurse (RN) license in Ohio * Minimum of three years of clinical ... Review of applications will begin two weeks after position posting. Additional Information A ...

Veterans Health Administration

Nurse

Dayton, OH · On-site +1

$76K - $163K/yr

... review of the EDRP application. Former EDRP participants ineligible to apply. Learn more about this agency Duties Help The Dayton, Ohio VA Medical Center is looking for a Registered Nurse (RN) for ...

Carease Health - OH

Nurse Practitioner

Beachwood, OH · On-site +1

Utilize Remote Patient Monitoring (RPM) technology to continuously monitor vital signs and detect ... Documentation review * Excellent communication, collaboration, and teamwork skills Why Join Our ...

Carease Health - OH

Nurse Practitioner

Cleveland, OH · On-site +1

Utilize Remote Patient Monitoring (RPM) technology to continuously monitor vital signs and detect ... Documentation review * Excellent communication, collaboration, and teamwork skills Why Join Our ...

Gentell

Certified Wound Care Clinician/Nurse

Dayton, OH · On-site +1

... utilization of wound care products - Understanding Medicare documentation and reimbursement ... (RN, LPN, PT, OTR-L, DPM or similar) preferred but could be certified in the first year of hire ...

AbsoluteCare

Transitional Care Manager - 2796

Akron, OH · On-site +1

Licensed RN by the state in which practicing and abide by all laws, regulations, and requirements ... Experienced in concurrent review for level of care determinations and taking action to transition ...

SalvoHealth

Medical Assistant, Remote

Cleveland, OH · Remote

$18 - $22/hr

... specialty physicians, registered dietitians, nurses, psychologists, and therapists who have ... reviewing applications, analyzing resumes, or assessing responses and identifying potential ...

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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 Jul 12, 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 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 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 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 July 2026, with employment types broken down into 87% Full Time, 11% Part Time, and 2% Contract. Highlights an 40% Physical, 3% Hybrid, and 57% Remote job distribution, with an average salary of $83,610 per year, or $40.2 per hour.
Pre Access Specialist

Pre Access Specialist

Akron Children's Hospital

Akron, OH • On-site, Remote

Full-time

Posted 16 days ago

Akron Children's Hospital rating

7.2

Company rating: 7.2 out of 10

Based on 95 frontline employees who took The Breakroom Quiz

398th of 1,019 rated hospitals

Job description

Full-time, 40 hours/week
Monday-Friday 11:30am-8pm or 11am-7:30pm
Remote- must be within commutable distance from Mahoning Valley location for 30-60 days onsite training
Summary:
Pre Access Specialist is responsible for performing functions to facilitate the patient's seamless movement through the Revenue Cycle process. This role ensures demographic and insurance requirements are current, supports reimbursement processes, and minimizes claim denials by verifying coverage and communicating details downstream accurately and efficiently.
Responsibilities:
1. Manage Epic work queues and reports for Pre-Access tasks; to make outbound calls or send communications to patients and/or responsibility parties to collect information to update Epic and/or share information within required timeframes, etc.
2. Register complete and accurate demographic, guarantor and financial information to create the patient's record in the system for billing purposes.
3. Verify patient insurance coverage and eligibility using electronic systems or payer portals or phone calls.
4. Process, triage and document incoming calls, voicemails, faxes, and/or emails per standard protocols in the appropriate system or tool.
5. Apply approved scripting for patient interactions and handle unique scenarios professionally.
6. Collaborate with Patient Access team members, clinical departments, case management, utilization review, and clinical teams to gather necessary information and expedite services when needed.
7. Escalate issues related to coverage, status, denials, delays or repeated trends to leadership for review.
8. Create and send estimates as needed or refer cases to Financial Counseling when potential for patient liability exists.
9. Meet departmental standards for productivity, quality, and timeliness.
10. Other Duties as assigned
Other information:
Technical Expertise
1. Knowledge of medical terminology, CPT/ICD-10 codes, and pediatric insurance benefits
2. Strong interpersonal communication skills to support families with empathy and clarity
3. Ability to navigate multiple systems (EHR, payer portals); Epic experience preferred
4. Strong understanding of insurance types (Medicare, Medicaid, commercial, managed care)
5. Excellent communication, organizational, and time management skills
6. Ability to work independently in a fast-paced environment.
7. Familiarity with EHR systems (e.g., Epic, Cerner) and payer portals and guidelines (i.e. Medicaid, managed care, and commercial plans)
Education and Experience
1. High school diploma or equivalent required; associate degree or healthcare certification preferred.
2. Minimum 1 year in a Clinical, Revenue Cycle, Patient Access or Insurance company role that perform work related to; registration, insurance verification, billing, scheduling, patient service rep, customer service, etc. required.
3. Pediatric healthcare access roles preferred.
4. Certification in healthcare access (e.g., CHAA or CMAA) preferred.
5. Experience in hospital admissions or emergency department settings preferred.
• Familiarity with pediatric insurance policies, including Medicaid, managed care, and commercial plans preferred.
Full Time
FTE: 1.000000
Status: Remote

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About Akron Children's Hospital

Sourced by ZipRecruiter

Akron Children's Hospital has been caring for children since 1890, and our pediatric specialties are ranked among the nation's best by U.S. News & World Report. With two hospital campuses, regional health centers and more than 50 primary and specialty care locations throughout Ohio, we're making it easier for today's busy families to find the high-quality care they need. In 2020, our health care system provided more than 1.1 million patient encounters. We also operate neonatal and pediatric units in the hospitals of our regional health care partners. Every year, our Children's Home Care Group nurses provide thousands of in-home visits, and our School Health nurses manage clinic visits for students from preschool through high school. With our Quick Care Online virtual visits and Akron Children's Anywhere app, we're here for families whenever and wherever they need us. Learn more at akronchildrens.org.

Industry

Hospitals

Company size

5,001 - 10,000 Employees

Headquarters location

Akron, OH, US

Year founded

1890

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