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Remote Utilization Review Rn Jobs in Anaheim, CA

Molina Healthcare

Care Manager, LTSS (RN)

Long Beach, CA · On-site +1

$26.41 - $51.49/hr

***Remote and will travel throughout the Southwest and Western regions of Wisconsin for member ... RNs may conduct medication reconciliation as needed. • 25-40% estimated local travel may be ...

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All JobsUtilization Review Rn JobsRemote Utilization Review Rn JobsRemote Utilization Review Rn Jobs in Anaheim, CA

Remote Utilization Review Rn information

See Anaheim, CA salary details

$22

$44

$72

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

As of Aug 8, 2026, the average hourly pay for remote utilization review rn in Anaheim, CA is $44.27, according to ZipRecruiter salary data. Most workers in this role earn between $35.00 and $50.82 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.
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What cities near Anaheim, CA are hiring for Remote Utilization Review Rn jobs? Cities near Anaheim, CA 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 Anaheim, CA as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 16% Part Time, and 2% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $92,072 per year, or $44.3 per hour.

Medical Director Utilization Management Oncology

The Oncology Institute (TOI)

Cerritos, CA • Remote

Other

Re-posted 8 days ago

Job description

Utilization Management Medical Director Oncology

Work Location: REMOTE (work from home)
The Medical Director role provides clinical expertise in assessing the medical necessity, appropriateness, and efficiency of oncology care with a focus on direct utilization management for case review and clinical decision making.  

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