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Remote Utilization Review Rn Jobs in Augusta, ME

Entyre Care

Registered Nurse

Lewiston, ME · On-site +1

... a Registered Nurse on our Maine team, supporting family caregivers and ensuring high-quality in ... Review and implement the Authorized Plan of Care provided by the state's Assessing Services Agency

Option Care

Chronic Practice Liaison

Augusta, ME · Remote

$64K - $86K/yr

Participate in provider business reviews and performance discussions * Recommend process ... Clinical experience or exposure (RN, LPN, Pharmacy Technician, etc.) * Experience managing complex ...

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All JobsUtilization Review Rn JobsRemote Utilization Review Rn JobsRemote Utilization Review Rn Jobs in Augusta, ME

Remote Utilization Review Rn information

See Augusta, ME salary details

$21

$41

$68

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 Augusta, ME is $41.86, according to ZipRecruiter salary data. Most workers in this role earn between $33.08 and $48.08 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 popular job titles related to Remote Utilization Review Rn jobs in Augusta, ME? For Remote Utilization Review Rn jobs in Augusta, ME, the most frequently searched job titles are:
What cities near Augusta, ME are hiring for Remote Utilization Review Rn jobs? Cities near Augusta, ME with the most Remote Utilization Review Rn job openings:
Remote Utilization Review Rn jobs near you

Registered Nurse

Entyre Care

Lewiston, ME • On-site, Remote

Full-time

Re-posted 26 days ago

Job description

About Us
At Entyre Care, our mission is to support caregivers by offering families both emotional and financial support throughout their caregiving journey. We ensure our caregivers have access to the right resources and guidance in all areas of outpatient care, so they feel confident and prepared to care for their loved ones at home. Entyre Care recognizes the essential role caregivers play and are committed to helping them receive fair compensation, allowing them to focus on delivering compassionate, high-quality care.
Why Join Us
  • Meaningful Work: Leverage your expertise to teach caregivers how to best take care of their loved ones while spending quality time with patients
  • Relationship-Driven Care: Maintain strong, trust-based relationships with families and ensure consistent "insanely great" support
  • Start-up Impact: Join a growing team where your contributions directly shape our expansion and care model

Role Overview
You will serve as a Registered Nurse on our Maine team, supporting family caregivers and ensuring high-quality in-home care delivery. This role will begin as per diem during our launch phase, with the opportunity to transition to part-time or full-time as the program grows.
Phase 1: Launch (Per Diem)
  • Conduct initial in-home visits prior to the start of caregiving services
  • Review and implement the Authorized Plan of Care provided by the state's Assessing Services Agency
  • Provide on-site supervision to caregivers at least monthly for the first three months of each families' enrollment in the program, with supervisory visits every 3-6 months thereafter
  • Maintain accurate clinical documentation and ensure EVV (Electronic Visit Verification) compliance

Phase 2: Growth (Part-Time/Full-Time) .
  • Continue initial and supervisory home visits for new and existing patients
  • Train and evaluate caregiver competency and conduct annual performance reviews
  • Monitor patient health status and coordinate with the service coordination agencies / physicians regarding significant changes
  • Ensure ongoing compliance with documentation standards and EVV requirements

Qualifications
  • Active Registered Nurse (RN) license in the state of Maine
  • Experience in home health, community health, or caregiver support preferred
  • Strong communication and interpersonal skills
  • Ability to work independently in a field-based environment
  • Reliable transportation for home visits

Apply