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Remote Utilization Review Rn Jobs in Camden, SC (NOW HIRING)

Varsity Tutors

NCLEX-RN Tutor

Columbia, SC · 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 ...

CEI

RN/Managed Care Coordinator (Remote

Columbia, SC · Remote

Must have an active, unrestricted RN license in the state of South Carolina Monday-Friday 830-5 Pay ... Reviews and evaluates medical or behavioral eligibility regarding benefits and clinical criteria by ...

Bcbsa

Director, Trade Client Relations

Columbia, SC · Remote

$155K - $175K/yr

Analytics Team - Collaborate on drug trends and utilization data to inform clinical policy ... Clinical Team - Liaise with Clinical team to review clinical data and policy requirements as needed

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All JobsUtilization Review Rn JobsRemote Utilization Review Rn JobsRemote Utilization Review Rn Jobs in Camden, SC

Remote Utilization Review Rn information

See Camden, SC salary details

$17

$34

$56

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

As of Aug 5, 2026, the average hourly pay for remote utilization review rn in Camden, SC is $34.57, according to ZipRecruiter salary data. Most workers in this role earn between $27.31 and $39.71 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 cities near Camden, SC are hiring for Remote Utilization Review Rn jobs? Cities near Camden, SC with the most Remote Utilization Review Rn job openings:
Remote Utilization Review Rn jobs near you

Managed Care Coordinator

TRC Talent Solutions

Columbia, SC • Remote

$30/hr

Full-time

Posted 9 days ago

Job description

Managed Care Coordinator (RN / Licensed Clinician)
Pay: Up to $30/hr
Schedule: MondayFriday, 8:30 AM5:00 PM
Training: 1 week onsite
After Training: Remote (must live within 2 hours of Columbia, SC)
Equipment Provided
Position Summary
Responsible for reviewing and authorizing medical and/or behavioral health service requests to ensure services meet benefit coverage and medical necessity guidelines. Applies clinical expertise, contract knowledge, and utilization management principles to support quality, cost-effective member outcomes.
Ideal Candidate: A licensed clinician who is detail-oriented, tech-savvy, and comfortable working independently in a remote environment. Strong clinical judgment, time management, and communication skills are essential, along with the ability to prioritize workload and collaborate within a team-centered culture.
Key Responsibilities
  • Perform medical/behavioral utilization reviews and authorizations
  • Prioritize and review cases based on due dates and clinical documentation
  • Compare requests against policy and member contracts
  • Refer complex cases to Medical Director when needed
  • Communicate approvals/denials to providers
  • Ensure accurate documentation and regulatory compliance
Required Qualifications
  • Associate Degree in Nursing OR Masters in Social Work, Counseling, or Psychology
  • Active, unrestricted RN, LMSW, Counselor, or Psychologist license
  • Minimum 2 years of clinical experience
TRC Talent Solutions is proud to be an Equal Opportunity Employer (EOE). All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.