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Remote Utilization Review Rn Jobs in Brunswick, OH

Varsity Tutors

NCLEX-RN Tutor

Cleveland, OH · Remote

$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

Akron, OH · Remote

$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 ...

Little Acorn ABA

BCBA-remote

Cleveland, OH · Remote

$70K - $85K/yr

BCBA-remote Company: Little Acorn ABA Location: Ohio We're here to nurture the mighty oak that ... Registered Behavior Technicians implementing treatment programs. * Monitor client progress: Review ...

Varsity Tutors

NCLEX-PN Tutor

Akron, OH · Remote

$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 ...

Varsity Tutors

NCLEX-PN Tutor

Cleveland, OH · Remote

$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 Brunswick, OH

Remote Utilization Review Rn information

See Brunswick, OH salary details

$18

$37

$60

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

As of Sep 14, 2026, the average hourly pay for remote utilization review rn in Brunswick, OH is $37.36, according to ZipRecruiter salary data. Most workers in this role earn between $29.52 and $42.88 per hour, depending on experience, location, and employer.

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 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 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 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 popular job titles related to Remote Utilization Review Rn jobs in Brunswick, OH?

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

What job categories do people searching Remote Utilization Review Rn jobs in Brunswick, OH look for?

The top searched job categories for Remote Utilization Review Rn jobs in Brunswick, OH are:

What cities near Brunswick, OH are hiring for Remote Utilization Review Rn jobs?

Cities near Brunswick, OH 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 Brunswick, OH as of August 2026, with employment types broken down into 1% As Needed, 76% Full Time, 19% Part Time, 2% Contract, and 2% Nights. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution, with an average salary of $77,709 per year, or $37.4 per hour.

Director of Managed Care

Garfield Heights, OH • Remote

Nightingale
Recruiting and Staffing Services • 501 - 1,000 employees
Learn more about Nightingaleexternal

Full-time

Posted 19 days ago

Job description

Director of Managed Care

Remote Position

RN/LPN Preferred

Job Summary:

We are seeking an experienced, detail-driven Director of Managed Care to oversee prior authorizations, payer coordination, and utilization management across six skilled nursing facilities in Arkansas and Ohio. As a key member of our team, you will ensure timely authorizations, accurate documentation, and strong communication with payers to optimize reimbursement and resident care.

Responsibilities:

  • Manage and process all prior authorizations for admissions, continued stays, therapy services, and specialty care

  • Serve as the primary contact for managed care organizations, insurance plans, and payer representatives

  • Monitor authorization timelines, length of stay, and payer requirements to ensure compliance

  • Collaborate daily with MDS, nursing leadership, therapy, admissions, and regional leadership

  • Track, resolve, and appeal denials, ensuring complete and accurate documentation

  • Provide clear, consistent communication to facility teams regarding authorization status and next steps

  • Identify trends, barriers, and opportunities to strengthen managed care outcomes

  • Maintain organized workflows and reporting across all six facilities

Requirements:

  • Strong background in Managed Care, Utilization Review, Prior Authorization, or MDS within SNF/LTC

  • Deep understanding of Medicare Advantage, commercial plans, and authorization processes

  • Excellent communication, follow-through, and problem-solving skills

  • Ability to manage multiple facilities, deadlines, and payer relationships

  • Highly organized, tech-savvy, and comfortable working fully remote

  • Proactive, positive, team-focused professional who thrives in a collaborative environment

Your expertise ensures residents receive timely approvals, facilities maintain accurate reimbursement, and teams across Arkansas and Ohio stay aligned and supported. You'll be the central hub that keeps managed care operations running smoothly.

Why Join Us:

  • Fully remote role

  • Supportive, mission-driven leadership

  • Opportunity to impact outcomes across multiple communities

  • Competitive compensation

  • A role where your work directly strengthens resident care and operational success

If you're passionate about managed care excellence and excited to support six dedicated healthcare teams across Arkansas and Ohio, we want to meet you. Apply today and help us continue building strong, high-performing communities.