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Remote Utilization Review Rn Jobs in Cedar Rapids, IA

Varsity Tutors

NCLEX-RN Tutor

Iowa City, IA · 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 ...

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Remote Utilization Review Rn information

See Cedar Rapids, IA salary details

$21

$41

$68

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

As of Jul 31, 2026, the average hourly pay for remote utilization review rn in Cedar Rapids, IA is $42.00, according to ZipRecruiter salary data. Most workers in this role earn between $33.17 and $48.22 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 Cedar Rapids, IA? For Remote Utilization Review Rn jobs in Cedar Rapids, IA, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review Rn jobs in Cedar Rapids, IA look for? The top searched job categories for Remote Utilization Review Rn jobs in Cedar Rapids, IA are:
What cities near Cedar Rapids, IA are hiring for Remote Utilization Review Rn jobs? Cities near Cedar Rapids, IA 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 Cedar Rapids, IA as of July 2026, with employment types broken down into 67% Full Time, 17% Part Time, and 16% Contract. Highlights an 42% Physical, 4% Hybrid, and 54% Remote job distribution, with an average salary of $86,407 per year, or $41.5 per hour.

MDS Solutions - Clinical Reimbursement Specialist

MDS Solutions

Cedar Rapids, IA • On-site, Remote

Other

Medical, Dental, Life, Retirement, PTO

Posted 22 days ago

Job description

Overview
MDS Solutions, a division of Key Rehabilitation, is looking for fun, energetic, and self-driven team members to join our remote MDS division as a Clinical Reimbursement Specialist.
Clinical Reimbursement Specialist (CRS)
The Clinical Reimbursement Specialist (CRS) plays a critical role in supporting clients through specialized project work, including conducting RAI assessments, developing comprehensive care plans, and delivering targeted education and training to MDS Coordinators on the Resident Assessment Instrument (RAI) process. This work is performed in strict alignment with applicable laws, regulations, and company standards. The CRS also reviews reimbursement systems for PDPM and Case Mix to ensure accurate and optimized reimbursement. Additionally, the CRS provides support with interim long-term and short-term contract coordination, ensuring the smooth completion of these efforts
About Us:
At Key Rehab, we're shaking up rehab services with a fresh, standout approach. We offer a wide range of services, stick to top-notch systems, and work in strategic locations to get the best results for our patients and support our clients' goals. We're all about clear communication, using our deep experience to deliver therapy that's both effective and affordable. Our reputation is built on great patient care, happy clients and staff, and solid management. We are proud to exceed expectations for patients, families, healthcare providers, and businesses.
We prioritize both exceptional patient care and the well-being of our employees. We are committed to delivering compassionate, results-driven therapy while offering the flexibility and comprehensive benefits needed to thrive in today's healthcare environment. Our team is large enough to offer competitive pay and benefits but small enough to ensure personalized attention and support for your career aspirations.
Whether you're looking for a role that accommodates family commitments, travel plans, home projects, or future savings, we provide tailored solutions to fit your lifestyle. Join us and experience a workplace that values your individual needs and career goals. Come experience a rewarding career where you're valued and supported every step of the way.
We offer a creative, engaging, and flexible work environment, alongside a comprehensive benefits package designed to support your success and well-being:
  • Competitive salaries with bonus opportunities
  • Ample opportunities for promotion, transfer, and advancement
  • Work that is meaningful, fulfilling, and provides high job satisfaction
  • Reasonable working hours promoting work-life balance
  • Continuing education (CE) opportunities for ongoing professional development
  • Generous paid time off
  • Comprehensive health, dental, and life insurance packages
  • 401K with discretionary matching
  • Mileage and licensure reimbursements
  • Flexible Spending Account (FSA) and Health Savings Account (HSA) options

Responsibilities
  • Serve as a trusted advisor to healthcare agencies and facilities, offering expert guidance and insights to optimize their operations.
  • Assist clients in assessing, planning, developing, and implementing systems and processes related to reimbursement, tailored to the specific needs and contracts established with each client.
  • Provide consulting services and technical expertise, including interim MDS management, ensuring providers receive the support they need to achieve optimal outcomes.
  • Stay up-to-date on professional standards of clinical care, federal and state regulations, QM measures, and the RAI process to ensure the delivery of accurate, compliant, and effective solutions.
  • Deliver high-quality, professional services that encompass reimbursement optimization, staff education, in-depth research, system analysis, creative problem-solving, and the presentation of actionable recommendations to clients.
  • Identify and address training needs, developing and conducting training sessions or in-service programs as requested by clients to enhance staff competency and performance.
  • Operate within the defined scope of work, maintaining strict adherence to client agreements and expectations.
  • Uphold client confidentiality and ensure full compliance with HIPAA regulations, safeguarding sensitive information throughout the engagement.

Qualifications
Minimum Qualifications:
  • Bachelor's degree in nursing from an accredited college or university, with at least five (5) years of clinical experience, including 3+ years specializing in the RAI process.
  • Current and unrestricted RN ,along with active RAC-CT certification, ensuring adherence to industry standards and best practices.
  • Possesses exceptional critical thinking skills, with the proven ability to make informed decisions, demonstrate sound clinical judgment, and apply expert knowledge in quality improvement concepts and processes.
  • Demonstrates strong leadership abilities and excels in interpersonal communication, fostering collaboration, and guiding teams to achieve optimal clinical outcomes.

Key Rehab is an equal opportunity employer/service provider.

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