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Remote Utilization Review Rn Jobs in Wisconsin (NOW HIRING)

Quartz

RN Complex Care Specialist

Madison, WI · Remote

$72K - $90K/yr

As an RN Complex Care Specialist , you will lead the management and coordination of care for ... Proficiency using Epic systems and remote monitoring programs. * Cultural competence and ...

Harris

$10/hr

EXAMPLE: Chart Review 8 min Outreach Attempts: 6 min Actual Call:11 min Care Coordination:9 min ... Current COMPACT license to practice as an RN/ LVN/LPN held in current state of residence with no ...

Harris

$10/hr

EXAMPLE: Chart Review 8 min Outreach Attempts: 6 min Actual Call:11 min Care Coordination:9 min ... Current COMPACT license to practice as an RN/ LVN/LPN held in current state of residence with no ...

Harris

$10/hr

EXAMPLE: Chart Review 8 min Outreach Attempts: 6 min Actual Call:11 min Care Coordination:9 min ... Current COMPACT license to practice as an RN/ LVN/LPN held in current state of residence with no ...

Harris

$10/hr

EXAMPLE: Chart Review 8 min Outreach Attempts: 6 min Actual Call:11 min Care Coordination:9 min ... Current COMPACT license to practice as an RN/ LVN/LPN held in current state of residence with no ...

Ascension

Registered Nurse Transfer Center

Lannon, WI · On-site +1

$40.41 - $57.05/hr

  • Medical

  • PTO

Remote - Must be within 1 hour of Milwaukee, WI Department: Transfer Center Schedule: Mid shift ... Registered Nurse obtained prior to hire date or job transfer date required. * BLS Provider ...

State of Wisconsin

Licensed Practical Nurse

Green Bay, WI · On-site +1

$38.59/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The LPN is responsible for performing duties assigned by the registered nurse including assisting ... This position is not eligible for remote work. Shifts: (0.75 FTE) Dodge Correctional Institution ...

FROEDTERT HEALTH

RN, Virtual Care Team

Menomonee Falls, WI · On-site +1

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Please note, this position is not remote and requires on-site work environment. Job Summary: The Staff RN VCT assesses, plans, implements, and evaluates nursing care for an identified group of ...

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Remote Utilization Review Rn information

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

As of Aug 16, 2026, the average hourly pay for remote utilization review rn in Wisconsin is $42.68, according to ZipRecruiter salary data. Most workers in this role earn between $33.75 and $48.99 per hour, depending on experience, location, and employer.

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 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 Wisconsin?

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

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

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

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

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

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

Cities in Wisconsin 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 Wisconsin as of August 2026, with employment types broken down into 79% Full Time, 7% Part Time, 7% Temporary, and 7% Contract. Highlights an 100% Remote job distribution, with an average salary of $88,769 per year, or $42.7 per hour.

RN Complex Care Specialist

Quartz

Madison, WI • Remote

$72K - $90K/yr

Full-time

Posted 25 days ago

Job description

Are you a Registered Nurse with experience in complex care and a passion for improving the lives of individuals with high-acuity health needs? Join our team at Quartz, where you’ll play a crucial role in enhancing the health outcomes of our members through specialized care.


As an RN Complex Care Specialist, you will lead the management and coordination of care for members with high-acuity health needs. Your responsibilities will include conducting clinical assessments, developing individualized care plans, and collaborating with providers and families to optimize health outcomes. Additionally, you will evaluate member self-management skills, identify barriers, and utilize shared decision-making models to enhance their ability to manage chronic conditions effectively.

Benefits:

  • 8 am – 5 pm, full-time hours and no weekends or holidays.
  • Supportive and experienced team members to assist with training and complex cases
  • Opportunity to exercise clinical judgement and serve as a trusted Subject Matter Expert to positively impact the care and lives of Quartz patients.
  • Compensation starting pay range: $72,500-$90,600.

  • Conduct thorough assessments to determine member health objectives and obstacles to care.
  • Develop and implement individualized care plans in collaboration with the care team.
  • Act as a strong advocate, valuable resource, and dedicated educator for members and their families.
  • Leverage chronic disease management concepts, including health screenings and other preventive health activities to support member's self-management skills.
  • Coordinate care transitions and ensure continuity across providers, services, and settings.
  • Adhere to relevant NCQA standards to ensure that all outreach, care plans, and assessments fully comply with NCQA requirements.

  • Active WI RN or compact state license is a mandatory requirement.
  • Bachelor or Associates Degree in Nursing.
  • 3 + years in clinical nursing, case management, or care coordination.
  • Experience with complex care or chronic disease management preferred.
  • Strong critical thinking and problem-solving abilities.
  • Excellent communication and interpersonal skills to engage diverse populations.
  • Proficiency with electronic health records (EHR) and care management systems.
  • Knowledge of and skills in complex care management using CCM, CMSA, and/or ACM models.
  • Collaborate with team to meet Key Performance Indicators (KPI's).
  • Proficiency using Epic systems and remote monitoring programs.
  • Cultural competence and sensitivity to work with individuals from varied backgrounds.
  • Case Management (CCM) certification preferred or willingness to obtain within one year.

Quartz offers an excellent benefit and compensation package, opportunity for career advancement and a professional culture built upon the foundations of Respect, Responsibility, Relationships & Resourcefulness. Quartz is a federal contractor and supports a safe, drug-free workplace. All employment offers are contingent upon successful completion of a pre-employment criminal background check.

Quartz values and embraces diversity and is proud to be an Equal Employment Opportunity. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, gender identity or expression, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability.

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