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Remote Utilization Review Rn Jobs in Oklahoma (NOW HIRING)

Varsity Tutors

NCLEX-RN Tutor

Oklahoma City, OK · 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 ...

Varsity Tutors

NCLEX-RN Tutor

Stillwater, OK · 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 ...

Varsity Tutors

NCLEX-RN Tutor

Tulsa, OK · 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 ...

Humana

RN Field Care Manager Nurse

Woodward, OK · On-site +1

Reviews, assesses, and completes medical complexity attestations and clinical oversight activities ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...

Humana

RN Field Care Manager Nurse

Woodward, OK · On-site +1

Reviews, assesses, and completes medical complexity attestations and clinical oversight activities ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...

Humana

RN Field Care Manager Nurse

Woodward, OK · On-site +1

Reviews, assesses, and completes medical complexity attestations and clinical oversight activities ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...

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All JobsUtilization Review Rn JobsRemote Utilization Review Rn JobsRemote Utilization Review Rn Jobs in Oklahoma

Remote Utilization Review Rn information

See Oklahoma salary details

$19

$39

$63

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

As of Jul 11, 2026, the average hourly pay for remote utilization review rn in Oklahoma is $39.04, according to ZipRecruiter salary data. Most workers in this role earn between $30.87 and $44.86 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 Oklahoma? The most popular types of Utilization Review Rn jobs in Oklahoma are:
What are popular job titles related to Remote Utilization Review Rn jobs in Oklahoma? For Remote Utilization Review Rn jobs in Oklahoma, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review Rn jobs in Oklahoma look for? The top searched job categories for Remote Utilization Review Rn jobs in Oklahoma are:
What cities in Oklahoma are hiring for Remote Utilization Review Rn jobs? Cities in Oklahoma 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 Oklahoma as of July 2026, with employment types broken down into 88% Full Time, 8% Part Time, 1% Temporary, and 3% Contract. Highlights an 40% Physical, 4% Hybrid, and 56% Remote job distribution, with an average salary of $81,204 per year, or $39 per hour.
Manager, Utilization Management (51741)

Manager, Utilization Management (51741)

GLOBALHEALTH HOLDINGS LLC

Oklahoma City, OK • On-site, Remote

Full-time

Medical

Posted 9 days ago

Job description

WHO WE ARE:
GlobalHealth is a fast-growing Medicare Advantage HMO health insurer. We aspire to be the employer of choice in our industry, attracting and retaining a highly talented workforce. Our passion is Genuine Care and Optimal Health for the members we serve. We are unique by providing high touch, high value and a partnership to our members. We go above and beyond to provide personalized, engaging, and responsive services to our members. We work hard to offer affordable health insurance coverage with the benefits people truly want and need. It is our hope to be more than just a health insurance company we want to be long-term partners with our members. We are looking for future employees who exude our core values of taking accountability through ownership, being driven, innovative and who have a passion for continuous learning.
WHO YOU ARE:
This position, under the guidance of the Vice President, Health Services is responsible for the operational oversight of the Utilization Management department. This includes tracking and trending of utilization data, development and update of policy and procedures, regulatory reporting and supervisory staff. The position also may include collaboration with internal teams and external providers.
ESSENTIAL DUTIES AND RESPONSBILITIES:
  • Accountable for the functions of the Utilization Management department.
  • Develops and oversees policies and procedures, regulatory reporting and clinical practice guidelines.
  • Integrates quality improvement activities within utilization management.
  • Communicates regularly with employees through participation in regular staff meetings to share information appropriate to their job functions and development.
  • Serves as a resource to both lines of business in relation to Utilization Management.
  • Plays an active role in both internal and external committees along with contract delegated responsibilities.
  • Collaborates with network facilities to improve concurrent and discharge plans for our members.
  • Performs retrospective review for the claims department.
  • Assists in providing information for the appeals department.
  • Provides information to reinsurance for members pending transplantation.
  • Must maintain confidentiality of business information, including Protected Health Information (PHI), as required by HIPAA and company policy.

EDUCATION AND EXPERIENCE:
  • Current Oklahoma state RN license
  • Experience in Managed Care, Case Management and Concurrent Review
  • Previous experience in a supervisory role
  • CPHQ, CPUR and previous insurance experience preferred

KNOWLEDGE, SKILLS AND ABILITIES:
  • Ability to communicate, both orally and written, and manage complex working relationships.
  • Excellent organizational, leadership, problem-solving, and decision-making skills.
  • Knowledge of Microsoft software programs including Word, Excel, PowerPoint and Power BI
  • Knowledge of quality improvement and utilization management

WORK ENVIRONMENT:
Current work environment is remote, however, some state exclusions apply.
Must have access to a reliable and secured internet connection source. Work environment must maintain confidentiality of business information, including Protected Health Information (PHI), as required by HIPAA and company policy. This position will also be required to use reasonable and necessary safeguards to protect GlobalHealth records from unauthorized access, disclosure or damage and will adhere to all GlobalHealth privacy and security policies.
TRAVEL:
Travel may be required for this position
SUPERVISORY RESPONSIBILITY:
This position is in a supervisory role over Utilization Management leadership and staff
OTHER DUTIES:
This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

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