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Remote Utilization Review Rn Jobs in Dearborn, MI

Lancesoft

RN Case Manager - Remote Role

Detroit, MI · On-site +1

$30 - $35/hr

The Care Manager RN leads the coordination of a multidisciplinary team to deliver a holistic, person centric care management program to a diverse health plan population with a variety of health and ...

Humana

RN Field Care Manager Nurse

Sterling Heights, MI · On-site +1

Reviews, assesses, and completes medical complexity attestations and clinical oversight activities ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...

Humana

RN Field Care Manager Nurse

Dearborn, MI · On-site +1

Reviews, assesses, and completes medical complexity attestations and clinical oversight activities ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...

Humana

RN Field Care Manager Nurse

Southgate, MI · On-site +1

Reviews, assesses, and completes medical complexity attestations and clinical oversight activities ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...

Humana

RN Field Care Manager Nurse

Southgate, MI · On-site +1

Reviews, assesses, and completes medical complexity attestations and clinical oversight activities ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...

Humana

RN Field Care Manager Nurse

Canton, MI · On-site +1

Reviews, assesses, and completes medical complexity attestations and clinical oversight activities ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...

Humana

RN Field Care Manager Nurse

Warren, MI · On-site +1

Reviews, assesses, and completes medical complexity attestations and clinical oversight activities ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...

Humana

RN Field Care Manager Nurse

Dearborn, MI · On-site +1

Reviews, assesses, and completes medical complexity attestations and clinical oversight activities ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...

Humana

RN Field Care Manager Nurse

Detroit, MI · On-site +1

Reviews, assesses, and completes medical complexity attestations and clinical oversight activities ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...

Humana

RN Field Care Manager Nurse

Flat Rock, MI · On-site +1

Reviews, assesses, and completes medical complexity attestations and clinical oversight activities ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...

Humana

RN Field Care Manager Nurse

Canton, MI · On-site +1

Reviews, assesses, and completes medical complexity attestations and clinical oversight activities ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...

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All JobsUtilization Review Rn JobsRemote Utilization Review Rn JobsRemote Utilization Review Rn Jobs in Dearborn, MI

Remote Utilization Review Rn information

See Dearborn, MI salary details

$19

$38

$63

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

As of Jul 14, 2026, the average hourly pay for remote utilization review rn in Dearborn, MI is $38.84, according to ZipRecruiter salary data. Most workers in this role earn between $30.67 and $44.62 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 Dearborn, MI? For Remote Utilization Review Rn jobs in Dearborn, MI, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review Rn jobs in Dearborn, MI look for? The top searched job categories for Remote Utilization Review Rn jobs in Dearborn, MI are:
What cities near Dearborn, MI are hiring for Remote Utilization Review Rn jobs? Cities near Dearborn, MI 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 Dearborn, MI as of July 2026, with employment types broken down into 88% Full Time, 9% Part Time, and 3% Contract. Highlights an 50% Physical, 3% Hybrid, and 47% Remote job distribution, with an average salary of $80,797 per year, or $38.8 per hour.
Clinical Documentation Specialist - Full Time - CDI HIM (Remote)

Clinical Documentation Specialist - Full Time - CDI HIM (Remote)

Trinity Health

Pontiac, MI • On-site, Remote

$34.50 - $46.50/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

This job post has expired today. Applications are no longer accepted.

Trinity Health rating

6.5

Company rating: 6.5 out of 10

Based on 353 frontline employees who took The Breakroom Quiz

599th of 884 rated healthcare providers

Job description

Employment Type:
Full timeShift:
Day Shift
Description:
POSITION PURPOSE
  • Trinity Health Oakland is seeking an experienced Clinical Documentation Specialist (CDS) with a strong clinical background improving documentation integrity across inpatient care settings.
  • The Clinical Documentation Specialist utilizes advanced clinical and coding expertise to direct efforts toward the integrity of clinical documentation through the roles of reviewer, educator and consultant. Facilitates the overall quality, completeness, accuracy and integrity of medical record documentation through extensive record review.
  • Fully remote position with flexible scheduling options.
  • Full-Time benefited position. Scheduled 40 hours per week (1.0 FTE).

MINIUMUM QUALIFICATIONS
  • Must possess an Associate/Diploma Degree in Nursing, or Health Information Technology (HIT) OR Advanced degree in nursing or medical field such as NP/APN or PA.
  • Must possess one of the following:
    • Current Registered Nurse License in the State of practice,
    • Registered Health Information Administrator (RHIA),
    • Registered Health Information Technician (RHIT),
    • Certified Coding Specialist (CCS) required,
    • Licensure as a physician assistant (PA) or Nurse Practitioner/Advanced Practice Nurse (NP/APN) or completion of medical school.

  • Preferred:
    • Certified Clinical Documentation Specialist (CCDS) or Certified Documentation Improvement Professional (CDIP) preferred.
    • Two (2) years' experience in Critical Care, Medical or Surgical Inpatient Care Nursing, as an RN, physician assistant (PA), nurse practitioner/advanced practice nurse (NP/APN), medical school graduate or as an inpatient coder preferred.

WHAT YOU WILL DO
  • Through extensive interaction with physicians, nursing staff, and other patient caregivers, it achieves appropriate clinical documentation to support the medical necessity and level of services rendered to all patients.
  • Demonstrates understanding of appropriate clinical documentation, to ensure that the severity of illness, risk of mortality and level of services provided are accurately reflected in the health record. Assists in overall quality, timeliness and completeness of the health record to ensure appropriate data, provider communication and quality outcomes. Serves as a resource for appropriate clinical documentation.
  • Communicates with and educates physicians and all other members of the healthcare team regarding clinical documentation and monitors provider engagement. Identifies learning opportunities for healthcare providers.
  • Conducts concurrent reviews of selected patient health records to address legibility, clarity, completeness, consistency and precision of clinical documentation.
  • Formulates compliant clarifications/queries following Trinity Health's documentation integrity procedures.
  • Interacts with physicians, nurses and ancillary staff regarding compliant documentation requirements, clarification/query requests and educational opportunities.
  • Accurately codes all relevant, appropriate and compliant working diagnoses codes, establishing a working principal diagnosis and working DRG (MS or APR).
  • Collaborates with coding staff to ensure documentation of discharge diagnoses and co-morbidities are a complete reflection of the patient's clinical status and care. Resolves all discrepancies in a courteous manner.

POSITION BENEFITS AND HIGHLIGHTS
  • Competitive compensation.
  • Full benefits package including Medical, Dental, Vision, PTO, Life Insurance, Short and Long-term Disability.
  • Benefits effective Day One! No waiting periods.
  • Retirement savings plan with employer match.
  • Opportunity for growth and advancement throughout Trinity Health
  • Tuition Reimbursement

Our Commitment
Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.

What Trinity Health employees say

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About Trinity Health

Sourced by ZipRecruiter

Trinity Health Ann Arbor is a 537 -bed teaching hospital located on 340 acre campus. Recognized by IBM Watson as a Top 100 Hospital and #1 Teaching Hospital, Trinity Health Ann Arbor has been a leading health care provider for more than 100 years. Trinity Health has received numerous local and national awards in recognition of our leadership, quality outcomes, and clinical excellence.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Livonia, MI, US

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