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Remote Utilization Review Rn Jobs in Dearborn, MI

Pharmacy Careers

Appeals Pharmacist (Remote)

Ypsilanti, MI · On-site +1

$51.75 - $63/hr

Collaborate with physicians, nurses, and medical directors during case reviews. * Track, document ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...

Pharmacy Careers

Appeals Pharmacist (Remote)

Detroit, MI · On-site +1

$52.50 - $63.75/hr

Collaborate with physicians, nurses, and medical directors during case reviews. * Track, document ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...

DataAnnotation

Registered Nurse

Sterling Heights, MI · Remote

$40 - $60/hr

Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...

DataAnnotation

Registered Nurse

Ann Arbor, MI · Remote

$40 - $60/hr

Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...

DataAnnotation

RN

Detroit, MI · Remote

$40 - $60/hr

Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...

DataAnnotation

RN

Sterling Heights, MI · Remote

$40 - $60/hr

Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...

DataAnnotation

RN

Warren, MI · Remote

$40 - $60/hr

Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...

DataAnnotation

Registered Nurse

Dearborn, MI · Remote

$40 - $60/hr

Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...

DataAnnotation

RN

Dearborn, MI · Remote

$40 - $60/hr

Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...

DataAnnotation

Registered Nurse

Warren, MI · Remote

$40 - $60/hr

Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...

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

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

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

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

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 ...

DataAnnotation

Registered Nurse

Detroit, MI · Remote

$40 - $60/hr

Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...

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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 Jun 11, 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 is the meaning of the word remote?

In the context of a Remote Utilization Review RN job, 'remote' refers to working outside of a traditional office setting, often from home or another location of the employee's choice. This setup typically involves using digital tools and communication platforms to perform job duties without being physically present in an office environment.

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 meaning of remote in one word?

In the context of a Remote Utilization Review RN role, 'remote' means working from a location outside of a traditional office, typically from home, using digital communication tools. It emphasizes flexibility and virtual access to work systems without physical presence at a healthcare facility.

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.

How to make 2000 a week working from home?

A Remote Utilization Review RN can potentially earn $2,000 weekly by working full-time hours, often 40 hours per week, and gaining experience or certifications that allow for higher billing rates. Increasing income may involve taking on additional cases, specializing in high-demand areas, or working for agencies that offer competitive pay for remote utilization review roles.

What is remote job?

A remote Utilization Review RN job is a healthcare position where the nurse reviews patient cases and insurance claims from a location outside of a traditional office, often working from home. It requires strong communication skills, knowledge of medical documentation, and familiarity with electronic health record systems, with flexible schedules common in remote roles.

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
Remote Revenue Integrity Nurse Auditor

Remote Revenue Integrity Nurse Auditor

Trinity Health

Livonia, MI • On-site, Remote

$31.88 - $47.82/hr

Full-time

Posted 7 days ago

Trinity Health rating

6.5

Company rating: 6.5 out of 10

Based on 349 frontline employees who took The Breakroom Quiz

591st of 870 rated healthcare providers

Job description

Employment Type:
Full timeShift:
Description:
ESSENTIAL FUNCTIONS
Our Trinity Health Culture: Knows, understands, incorporates & demonstrates our Trinity Health Mission, Values, Vision, Actions & Promise in behaviors, practices & decisions.
Work Focus: Performs clinical care activities (direct or indirect) for patients within the "scope of practice" laws & training received; Cares for patients safely by assisting in clinical care services or engaging in administrative activities (e.g., maintaining records or supplies) that enhance or improve coordination, preparation & flow of the care experience.
Process Focus: Knows, understands & incorporates basic or essential area of practice (document, coordinate, communicate) & training standards.
Communication: Uses clear, effective, respectful language & communication methods / means.
Environment: Performs work in a safe, engaging, & supportive manner; Influences the responsible use of resources; Accountable for continuous self-development & supporting the growth of others. Maintains a working knowledge of applicable federal, state & local laws/regulations, Trinity Health Integrity & Compliance Program & Code of Conduct, as well as other policies, procedures & guidelines in order to ensure adherence in a manner that reflects honest, ethical & professional behavior & safe work practices.
FUNCTIONAL ROLE
Core Function: Responsible for coordinating revenue integrity/ charge-related denials with Patient Business Service (PBS) center & ensures compliant & complete clinical documentation, assists with denials & related audits & identifies opportunities for revenue optimization.
Performs thorough and routine chart reviews, providing education to clinical colleagues & tracking of identified trends.
Leverages clinical knowledge & standard procedures to ensure timely attention to charge-related trends and provides necessary education to responsible party.
Responsible for retrospective charge reviews & assistance with third party charge audits. May require travelling between locations within the region.
Ensures tracking of all Revenue Integrity- related audits, identifying trends & collaborating with other Revenue Integrity, PBS & /or departmental colleagues on education & reporting to key stakeholders. Serves as a resource contact, providing clinical information as requested by intra & inter-departmental colleagues & payers.
Collaborates with Revenue Integrity team on opportunities to improve & implement front-end process to support denial prevention.
NS IV - licensed: Licensed role (direct or indirect healthcare); Provides nursing interventions or clinical knowledge application in decision-making; Participates in the planning, implementation & / or evaluation of & solutions for care; Performs delegated focused / holistic care autonomously according to care plan; May administer medication & carry out the therapeutic treatment within scope of license (state & TH policy); Performs direct & essential care or supportive activities as part of an interdisciplinary team with a deeper understanding, including theoretical knowledge; Demonstrates a level of independence to perform activities with general oversight, through personal contributions, teamwork & initiatives to safely improve outcomes; Advocates for patients & informs/counsels patients & families about illness & care details; May serve as a knowledge resource, role model & mentor or lead/coordinate/supervise direct & essential care activities or role-based service responsibilities of unlicensed/licensed/certified healthcare professionals within licensed scope of practice.
COMPENSATION RANGE: $31.8795 - $47.8193
MINIMUM QUALIFICATIONS
  • High school diploma or GED; Completion of an accredited program associated with license. License in the applicable state(s) of engagement. Valid driver's license where required by assignment.
  • Four plus (4+) years of nursing experience
  • Must possess a demonstrated knowledge of revenue cycle & denial management functions
  • Knowledge of and experience in case management and utilization management.
  • Customer service background is required.

Preferred:
  • Registered Nurse
  • Bachelor's degree
  • Two plus (2+) years of charge audit, managed care or comparable patient payment processing experience preferred.
  • AAPC,AHIMA, CHRI certification/membership.
  • Outpatient CDI experience.
  • Working knowledge of Electronic Health Records (EHR).

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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Hours and flexibility

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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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