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Remote Utilization Review Rn Jobs in Carson, CA (NOW HIRING)

KTI Health

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Registered Nurse Utilization Review - Remote

Torrance, CA · Remote

$2.1K - $2.2K/wk

Travel Registered Nurse - Utilization Review Location: Torrance, CA Position: Registered Nurse (RN) - Utilization Review Job Type: Remote Travel/Contract Contract: 13 weeks Start Date: September 21 ...

Imh

RN Care Manager

Billings, MT · Remote

$41.20 - $62.17/hr

Demonstrated experience in case management, utilization review, value-based care, and/or discharge ... If applying for a remote or hybrid role, this includes remote work expectations related to ...

Zócalo Health

RN Case Manager

Los Angeles, CA · Remote

$85K/yr

RN Case Manager Remote (Full Time) *Must reside in California* Compensation: $85,000 About Us ... Support quality, utilization, and member outcome goals established by the organization and health ...

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Remote Utilization Review Rn information

See Carson, CA salary details

$22

$44

$72

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

As of Sep 3, 2026, the average hourly pay for remote utilization review rn in Carson, CA is $44.22, according to ZipRecruiter salary data. Most workers in this role earn between $34.95 and $50.77 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 Carson, CA?

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

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

The top searched job categories for Remote Utilization Review Rn jobs in Carson, CA are:

What cities near Carson, CA are hiring for Remote Utilization Review Rn jobs?

Cities near Carson, 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 Carson, CA as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 14% Part Time, 2% Contract, and 1% Nights. Highlights an 86% Physical, 4% Hybrid, and 10% Remote job distribution, with an average salary of $91,977 per year, or $44.2 per hour.

Remote: Utilization Review Specialist

Treatment Center Management LLC

Los Angeles, CA • Remote

$80K - $90K/yr

Full-time

Medical, Dental, Vision, Life, PTO

Posted 3 days ago

New

Job description

Be part of a soul-hearted approach to healing

Alsana is a national leader in eating disorder treatment, offering a holistic, soul-hearted approach to recovery for adults and adolescents of all genders.

We exist to be a source of hope and healing, creating safe, nurturing spaces where individuals can cultivate the roots of their own recovery story.

As a Utilization Review Specialist at Alsana, you will support utilization management activities including medical necessity reviews, clinical documentation, and patient status determination. You will work closely with clinical teams and leadership to help ensure appropriate levels of care, accurate documentation, and compliance with payer and regulatory requirements.

Key Responsibilities
  • Perform utilization review, including preauthorization, concurrent, and retrospective reviews for inpatient and/or outpatient services.
  • Maintain current knowledge of payer requirements, LOCUS criteria, regulatory standards, accreditation expectations, and evidencebased documentation practices.
  • Use clinical expertise and payer knowledge to act as a liaison to treatment team members through ongoing communication.
  • Attend weekly Treatment Team Meetings, providing updates on new authorizations and atrisk cases.
  • Maintain timely, accurate records of review determinations, information requests, and recommendations within the electronic medical record (EMR).
  • Inspect documentation to confirm compliance with payer requirements, regulatory standards, accreditation expectations, and evidencebased documentation practices.
  • Assist with appeals, denials management, and corrective actions related to utilization review findings.
  • Participate in case conferences and provide training and education related to documentation standards and utilization review.
    • Qualifications
  • One or more of the following credentials: LPC, LCSW, LMFT, RD, RN, LVN, LPN, or PsyD
  • Experience in utilization review or case management preferred
  • Experience in a business/corporate setting or similar environment preferred
  • Experience in eating disorders preferred
    • Benefits That Support You

    At Alsana, we believe in caring for the people who make our mission possible. Eligible team members enjoy a supportive benefits package designed to support your health, well-being, and growth, including:

  • Medical, Dental, and Vision insurance with multiple plan options

    • (Cigna nationwide; Kaiser available in CA)

  • HSA plans with employer contributions
  • FSA Healthcare and Dependent Care plan options
  • Generous PTO, sick time, Covid Time, and 6 paid holidays
  • Companypaid Basic Life and AD&D insurance
  • Shortterm disability (companypaid for nonCA; CA uses state plan)
  • Continuing education stipend for eligible roles
  • Voluntary benefits including Supplemental Life, LongTerm Disability, Accident, and Hospital Indemnity
  • LifeMart employee discount program

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