In this position you will be reviewing patient charts to determine if pre-elective surgical cases ... Previous utilization management or case management experience preferred. CERTIFICATIONS/LICENSURES ...
In this position you will be reviewing patient charts to determine if pre-elective surgical cases ... Previous utilization management or case management experience preferred. CERTIFICATIONS/LICENSURES ...
In this position you will be reviewing patient charts to determine if pre-elective surgical cases ... Previous utilization management or case management experience preferred. CERTIFICATIONS/LICENSURES ...
In this position you will be reviewing patient charts to determine if pre-elective surgical cases ... Previous utilization management or case management experience preferred. CERTIFICATIONS/LICENSURES ...
Director of Utilization Management
Troy, MI · On-site +1
$160K - $160K/yr
Prepare and maintain Utilization Review Plan policies and procedures * Obtain or maintain ... Career development opportunities Remote Opportunities We are actively seeking new colleagues in:
Director of Utilization Management
Troy, MI · On-site +1
$160K - $160K/yr
Prepare and maintain Utilization Review Plan policies and procedures * Obtain or maintain ... Career development opportunities Remote Opportunities We are actively seeking new colleagues in:
Director of Utilization Management
Troy, MI · Remote
$160K - $160K/yr
Prepare and maintain Utilization Review Plan policies and procedures * Obtain or maintain ... Career development opportunities Remote Opportunities We are actively seeking new colleagues in:
Quick apply
Director of Utilization Management
Troy, MI · Remote
$160K - $160K/yr
Prepare and maintain Utilization Review Plan policies and procedures * Obtain or maintain ... Career development opportunities Remote Opportunities We are actively seeking new colleagues in:
... Nurse (RN) to serve our patient population in the navigation, prevention and management of their ... Welcome patients into continuous care program(s) and review benefits and services included
Quick apply
... Nurse (RN) to serve our patient population in the navigation, prevention and management of their ... Welcome patients into continuous care program(s) and review benefits and services included
... Nurse (RN) to serve our patient population in the navigation, prevention and management of their ... Welcome patients into continuous care program(s) and review benefits and services included
... Nurse (RN) to serve our patient population in the navigation, prevention and management of their ... Welcome patients into continuous care program(s) and review benefits and services included
Assess whether a review is needed for a member's return to their own occupation, and identify the ... Work Environment You will be working in an approved remote environment within the states of:
Assess whether a review is needed for a member's return to their own occupation, and identify the ... Work Environment You will be working in an approved remote environment within the states of:
Assess whether a review is needed for a member's return to their own occupation, and identify the ... Work Environment You will be working in an approved remote environment within the states of:
Quick apply
Assess whether a review is needed for a member's return to their own occupation, and identify the ... Work Environment You will be working in an approved remote environment within the states of:
Assess whether a review is needed for a member's return to their own occupation, and identify the ... Work Environment You will be working in an approved remote environment within the states of:
Quick apply
Assess whether a review is needed for a member's return to their own occupation, and identify the ... Work Environment You will be working in an approved remote environment within the states of:
Be Seen First
Remote RN Case Manager [MI RNs only]
Detroit, MI · Remote
$35 - $39/hr
Job Title: RN Case Manager Location: 100% Remote Duration: 12+ months License Required: Active & unrestricted Michigan RN license The RN Case Manager serves as the primary point of contact for ...
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Remote RN Case Manager [MI RNs only]
Detroit, MI · Remote
$35 - $39/hr
Job Title: RN Case Manager Location: 100% Remote Duration: 12+ months License Required: Active & unrestricted Michigan RN license The RN Case Manager serves as the primary point of contact for ...
Registered Nurse - Interventional Radiology
Ann Arbor, MI · On-site +1
$81K - $139K/yr
... outcomes utilization consultation. Demonstrates leadership in delivering and improving holistic ... The IR RN is responsible for direct patient care, assessing, planning, implementing, and evaluating ...
Registered Nurse - Interventional Radiology
Ann Arbor, MI · On-site +1
$81K - $139K/yr
... outcomes utilization consultation. Demonstrates leadership in delivering and improving holistic ... The IR RN is responsible for direct patient care, assessing, planning, implementing, and evaluating ...
Auditor, Healthcare Services (Remote in MI)
Detroit, MI · On-site +1
$26.41 - $51.49/hr
Opportunity for an RN who has a US license in good standing to join our Medicaid Team as a Clinical ... Essential Job Duties • Performs audits in utilization management, care management, member ...
Auditor, Healthcare Services (Remote in MI)
Detroit, MI · On-site +1
$26.41 - $51.49/hr
Opportunity for an RN who has a US license in good standing to join our Medicaid Team as a Clinical ... Essential Job Duties • Performs audits in utilization management, care management, member ...
Auditor, Healthcare Services (Remote in MI)
Detroit, MI · Remote
$26.41 - $51.49/hr
Opportunity for an RN who has a US license in good standing to join our Medicaid Team as a Clinical ... Essential Job Duties • Performs audits in utilization management, care management, member ...
Auditor, Healthcare Services (Remote in MI)
Detroit, MI · Remote
$26.41 - $51.49/hr
Opportunity for an RN who has a US license in good standing to join our Medicaid Team as a Clinical ... Essential Job Duties • Performs audits in utilization management, care management, member ...
Opportunity for an RN who has a US license in good standing to join our Medicaid Team as a Clinical ... Essential Job Duties Performs audits in utilization management, care management, member assessment ...
Opportunity for an RN who has a US license in good standing to join our Medicaid Team as a Clinical ... Essential Job Duties Performs audits in utilization management, care management, member assessment ...
RN (Registered Nurse)
Detroit, MI · Remote
$20 - $25/hr
Remote Duration: 12 months Description: * The Case Manager RN leads the coordination of a multidisciplinary team to deliver a holistic, person centric care management program to a diverse health plan ...
Quick apply
RN (Registered Nurse)
Detroit, MI · Remote
$20 - $25/hr
Remote Duration: 12 months Description: * The Case Manager RN leads the coordination of a multidisciplinary team to deliver a holistic, person centric care management program to a diverse health plan ...
Case Manager Registered Nurse (LTSS) - Field MI (Wayne and Macomb County)
Sterling Heights, MI · Remote
Review claims data, clinical records, and assessment tools to evaluate member needs and benefit ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Case Manager Registered Nurse (LTSS) - Field MI (Wayne and Macomb County)
Sterling Heights, MI · Remote
Review claims data, clinical records, and assessment tools to evaluate member needs and benefit ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Review claims data, clinical records, and assessment tools to evaluate member needs and benefit ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Review claims data, clinical records, and assessment tools to evaluate member needs and benefit ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Review claims data, clinical records, and assessment tools to evaluate member needs and benefit ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Review claims data, clinical records, and assessment tools to evaluate member needs and benefit ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Review claims data, clinical records, and assessment tools to evaluate member needs and benefit ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Review claims data, clinical records, and assessment tools to evaluate member needs and benefit ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Review claims data, clinical records, and assessment tools to evaluate member needs and benefit ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Review claims data, clinical records, and assessment tools to evaluate member needs and benefit ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Remote Utilization Review Rn information
See Detroit, MI salary details
$21.18 - $25.46
2% of jobs
$25.46 - $29.75
9% of jobs
$32.68 is the 25th percentile. Wages below this are outliers.
$29.75 - $34.03
21% of jobs
The median wage is $37.50 / hr.
$34.03 - $38.31
23% of jobs
$38.31 - $42.60
13% of jobs
$45.93 is the 75th percentile. Wages above this are outliers.
$42.60 - $46.88
10% of jobs
$46.88 - $51.16
8% of jobs
$51.16 - $55.45
5% of jobs
$55.45 - $59.73
5% of jobs
$59.73 - $64.01
2% of jobs
$64.01 - $68.30
2% of jobs
$21
$41
$68
How much do remote utilization review rn jobs pay per hour?
As of Aug 3, 2026, the average hourly pay for remote utilization review rn in Detroit, MI is $41.86, according to ZipRecruiter salary data. Most workers in this role earn between $33.08 and $48.08 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?
| Aspect | Remote Utilization Review Rn | Remote Case Manager Rn |
|---|---|---|
| Certifications | RN license, Utilization Review certification (e.g., URAC) | RN license, Case Management certification (e.g., CCM) |
| Work Environment | Reviewing medical records, insurance policies, telehealth platforms | Coordinating patient care, discharge planning, telehealth |
| Employer & Industry | Insurance companies, healthcare organizations | Hospitals, 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 Detroit, MI? For Remote Utilization Review Rn jobs in Detroit, MI, the most frequently searched job titles are:
- Utilization Review Nurse
- Remote Utilization Management
- Remote Chart Review Nurse
- Remote Utilization Review Nurse
- Part Time Utilization Review Nurse
- Evening Utilization Review Nurse
- Per Diem Utilization Review Nurse
- Full Time Physician Advisor Utilization Review
- Weekend Physician Advisor Utilization Review
- Weekend Prior Authorization Nurse
What job categories do people searching Remote Utilization Review Rn jobs in Detroit, MI look for? The top searched job categories for Remote Utilization Review Rn jobs in Detroit, MI are:
- Remote Lpn Utilization Review
- Remote Occupational Therapy Utilization Review
- Remote Cigna Utilization Review Nurse
- Cigna Utilization Review Nurse
- Retrospective Review Nurse
- Utilization Review
- From Home Anthem Utilization Review Nurse
- Volunteer Rn Utilization Review Nurse
- Full Time Remote Lpn Utilization Review
- Volunteer Navihealth Utilization Review
What cities near Detroit, MI are hiring for Remote Utilization Review Rn jobs? Cities near Detroit, MI with the most Remote Utilization Review Rn job openings:
Other
Re-posted 7 days ago
Job description
In this position you will be reviewing patient charts to determine if pre-elective surgical cases should be boarded as inpatient instead of outpatient. You will also review the CPTs that were boarded for meeting inpatient on the CMS inpatient list and the InterQual inpatient list based on payer criteria used.
Hours are Monday - Friday from 830am until 5pm with no weekends
EDUCATION AND EXPERIENCE:
- RHIT, RHIA, or related coding certification required.
- Minimum 3-5 years of clinical experience preferred.
- Previous utilization management or case management experience preferred.
CERTIFICATIONS/LICENSURES REQUIRED:
- RHIT, RHIA, or related coding certification required.
Additional Information
- Organization: Corporate Services
- Department: Central Utilization Mgt
- Shift: Day Job
- Union Code: Not Applicable