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Remote Utilization Review Rn Jobs in Cloquet, MN

Essentia Health

RN Pre-Service Authorization

Duluth, MN · On-site +1

$70K - $105K/yr

Working remote * Epic * Insurance knowledge/Prior authorization Licensure/Certification Qualifications: Current nursing licensure in state(s) of employment FTE: 1 Possible Remote/Hybrid Option:

Essentia Health

RN Pre-Service Authorization

Duluth, MN · On-site +1

$70K - $105K/yr

Working remote * Epic * Insurance knowledge/Prior authorization Licensure/CertificationQualifications: Current nursing licensure in state(s) of employment FTE: 1 Possible Remote/Hybrid Option: Remote ...

Essentia Health

Coding Quality Associate Analyst

Duluth, MN · On-site +1

$25.22 - $37.83/hr

This includes but is not limited to record reviews for APC, ICD-9-CM, ICD-10-CM, HCPCS, and CPT ... RHIA (Registered Health Information Administrator), RHIT (Registered Health Information technician ...

All JobsUtilization Review Rn JobsRemote Utilization Review Rn JobsRemote Utilization Review Rn Jobs in Cloquet, MN

Remote Utilization Review Rn information

See Cloquet, MN salary details

$20

$40

$65

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

As of Aug 11, 2026, the average hourly pay for remote utilization review rn in Cloquet, MN is $40.33, according to ZipRecruiter salary data. Most workers in this role earn between $31.88 and $46.30 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 are popular job titles related to Remote Utilization Review Rn jobs in Cloquet, MN? For Remote Utilization Review Rn jobs in Cloquet, MN, the most frequently searched job titles are:
What cities near Cloquet, MN are hiring for Remote Utilization Review Rn jobs? Cities near Cloquet, MN 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 Cloquet, MN as of August 2026, with employment types broken down into 1% As Needed, 79% Full Time, 17% Part Time, and 3% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $83,877 per year, or $40.3 per hour.

RN Pre-Service Authorization

Essentia Health

Duluth, MN • On-site, Remote

$70K - $105K/yr

Full-time

Medical, Dental, Vision, Life, Retirement

Posted 7 days ago

Essentia Health rating

7.0

Company rating: 7.0 out of 10

Based on 210 frontline employees who took The Breakroom Quiz

416th of 887 rated healthcare providers

Job description

Building Location:
Support Services Building
Department:
1007190 PRE-SERVICE AUTHORIZATION - EH SS
Job Description:
Conducts Managed Care Programs in conjunction with third party administrators' health care agreements. Works collaboratively with and provides clinical expertise and leadership to Access Coordinators to perform all aspects of managed care, including the referral, prior authorization/precertification processes, using and revising Essentia Health's established policies and procedures for managed care activities. Performs complex care coordination and referral management. Works collaboratively with the Essentia Health customer service personnel to provide efficient service for insurance issue resolution and smooth operations. Works collaboratively with clinical areas and business services both internally and externally. Supports efforts and participates with the Supervisor of Contracting & Payor Relations and the Health Plans Medical Directors regarding health care initiatives and compliance issues for health plans.
Education Qualifications:
BSN or ADN degree from an accredited school or college of nursing
Be a part of a Healthcare organization that invests in you and your career.
Apply now and help us continue to raise the bar in patient care!
We are looking for candidates with experience in:
  • Working remote
  • Epic
  • Insurance knowledge/Prior authorization

Licensure/Certification Qualifications:
Current nursing licensure in state(s) of employment
FTE:
1
Possible Remote/Hybrid Option:
Remote
Shift Rotation:
Day Rotation (United States of America)
Shift Start Time:
0800
Shift End Time:
1630
Weekends:
Holidays:
No
Call Obligation:
No
Union:
Union Posting Deadline:
Compensation Range:
$70,595.20 - $105,892.80
Employee Benefits at Essentia Health:At Essentia Health, we're committed to supporting your well-being, growth, and work-life balance. Our comprehensive benefits include medical, dental, vision, life, and disability insurance, along with supplemental options to fit your needs. We offer a 401(k) plan with employer contributions to help you plan for the future, and we invest in your professional development through training, tuition reimbursement, and educational programs. To help you thrive both at work and at home, we provide flexible scheduling, generous time off, and wellness resources focused on your physical, mental, and emotional health. Please note that benefit eligibility may vary. For full details, refer to your benefit summary or contact our HR Service Center at (218) 576-0000.

What Essentia Health employees say

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About Essentia Health

Sourced by ZipRecruiter

Headquartered in Duluth, Minnesota, Essentia Health combines the strengths and talents of 13,500 employees, including 3,500 registered nurses & licensed practical nurses, who serve our patients and communities through the mission of being called to make a healthy difference in people's lives. Essentia Health, which includes many Catholic facilities, is guided by the values of Quality, Hospitality, Respect, Joy, Justice, Stewardship and Teamwork. The organization lives out its mission by having a patient-centered focus at 14 hospitals, 70 clinics, six long-term care facilities, three assisted living facilities, three independent living facilities, five ambulance services and one research institute.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Duluth, MN, US

Year founded

2004

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