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Remote Utilization Review Rn Jobs in Baton Rouge, LA

Varsity Tutors

NCLEX-RN Tutor

Baton Rouge, LA · 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 ...

Urrly

Telehealth Nurse Practitioner

Baton Rouge, LA · Remote

$600 - $720/day

Location/Type: Louisiana Remote (No travel) * Pay: $600-$720/day (1099 contractor, based on ... Review medications, history, and preventive care needs * Deliver clear care plans and follow-up ...

Varsity Tutors

NCLEX-PN Tutor

Baton Rouge, LA · Remote

$18 - $40/hr

... RN scope questions, pharmacology calculations, and managing anxiety with the adaptive testing format. Adapts instruction using NCLEX-PN specific practice question banks, content review focused on ...

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All JobsUtilization Review Rn JobsRemote Utilization Review Rn JobsRemote Utilization Review Rn Jobs in Baton Rouge, LA

Remote Utilization Review Rn information

See Baton Rouge, LA salary details

$18

$36

$60

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

As of Jul 15, 2026, the average hourly pay for remote utilization review rn in Baton Rouge, LA is $37.00, according to ZipRecruiter salary data. Most workers in this role earn between $29.23 and $42.50 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 Baton Rouge, LA? For Remote Utilization Review Rn jobs in Baton Rouge, LA, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review Rn jobs in Baton Rouge, LA look for? The top searched job categories for Remote Utilization Review Rn jobs in Baton Rouge, LA are:
What cities near Baton Rouge, LA are hiring for Remote Utilization Review Rn jobs? Cities near Baton Rouge, LA 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 Baton Rouge, LA as of July 2026, with employment types broken down into 85% Full Time, 13% Part Time, and 2% Contract. Highlights an 40% Physical, 2% Hybrid, and 58% Remote job distribution, with an average salary of $76,951 per year, or $37 per hour.
Care Coordinator RN remote work: Baton Rouge or New Orleans

Care Coordinator RN remote work: Baton Rouge or New Orleans

eQHealth Solutions

Baton Rouge, LA • Remote

Full-time

Re-posted 5 days ago

Job description

  • Performs care coordination services for assigned recipients who are eligible for home health services (Home Health Visits, PPEC, Personal Care Services and/or Private Duty Nursing Services etc. based on contract requirements).
  • Uses discretion to approve/validate UR or forward to 2nd level reviewer. Provides first level utilization review for all inpatient and outpatient services requiring authorization: Prospective Review Urgent/ Non-urgent, Concurrent Review and Retrospective Review.
  • Completes prior authorizations as appropriate in a timely manner.
  • Conducts an initial survey to recommend appropriate (home health assessment) for the recipient, unless this has already been done during the current fiscal year
  • Conducts a home and/or PPEC visit as needed or if contract requirement
  • Schedules and convenes initial face-to-face meeting in the recipient’s home and/or PPEC comprised of the recipient (if able) and the parent or legal guardian.
  • Assesses, plans, implements, monitors and evaluates the options and services required to meet the recipient’s health care needs.
  • Documents recipient’s assessment findings, actions, and outcomes.
  • Documents all communication, interventions and follow up tasks in the Care Coordination System within one (1) business day of each intervention and/or encounter.
  • Identifies patient care issues and makes recommendations on patient care issues.
  • Collaborates with the parent or legal guardian and healthcare team to arrange for identified home care needs.
  • Responsible for maintaining regular monthly contact (telephonically or face-to-face) with the recipient and the recipient’s parent or legal guardian.for purpose of updating Plan of Care (POC), resolving issues and identifying additional issues
  • As part of the multidisciplinary team, regularly meets with the team and contributes to the development of a comprehensive plan of care based on the needs of the recipient and recipient’s parent or legal guardian.
  • Evaluates and modifies recipient’s the plan of care as needed.  Regularly communicates changes to the recipient’s parent or legal guardian, healthcare team, and other agencies involved in the recipient’s care.
  • Monitors assigned caseload eligibility status on a monthly basis, based on their status in MMIS.
  • Completes a Staffing Tool (Freedom of Choice) any time a parent or legal guardian expresses the desire to reconsider a recipient’s placement into a Skilled Nursing Facility
  • Follow guidelines for additional required calls and visits for Skilled Nursing Facility (SNF) transitions to community settings for six (6) months.
  • Functions as a resource to the community.
  • Manages daily workload associated with quality review process, including facilitation of case assignments and follows up to ensure that all cases requiring additional assistance or care coordination are completed within timelines required by contract.
  •  Prioritizes and addresses requests and assignments in a professional manner to develop cooperative relationships to ensure that customer confidentiality is assured.
  • Provides courteous and prompt service to all internal and external customers at all times.
  • Attends staff meetings and continuing education sessions and will assist with learning opportunities as needed.
  • Participates in special projects, as needed.
  • Assists with the implementation of quality improvement initiatives.
  • Performs other duties as assigned.

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