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Remote Utilization Review Rn Jobs in Dubuque, IA

SISCO

TPA Sales Executive (Fully Remote)

Dubuque, IA · Remote

Professional Staff - Imagine working with a team that includes ERISA attorneys, MDs, PharmDs, RNs and Health Coaches; where member service is delivered by licensed agents and the average tenure of ...

Origin Design

Senior Architect

Dubuque, IA · On-site +1

Coordinate and review work of civil, structural, MEP and other consultants. * Keep current on ... Iowa Registered Architect. * 20 years of experience preferred. * Experience in one or more of ...

Access Dubuque

Account Manager

Dubuque, IA · On-site +1

Plan for and lead client and partner plan performance review meetings; promote programs and ... Benefits Sales Manager Cottingham & Butler/ SISCO Nurse Care Manager Hillcrest Family Services ...

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Remote Utilization Review Rn information

See Dubuque, IA salary details

$20

$39

$65

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

As of May 29, 2026, the average hourly pay for remote utilization review rn in Dubuque, IA is $39.87, according to ZipRecruiter salary data. Most workers in this role earn between $31.49 and $45.77 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 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 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 popular job titles related to Remote Utilization Review Rn jobs in Dubuque, IA? For Remote Utilization Review Rn jobs in Dubuque, IA, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review Rn jobs in Dubuque, IA look for? The top searched job categories for Remote Utilization Review Rn jobs in Dubuque, IA are:
What cities near Dubuque, IA are hiring for Remote Utilization Review Rn jobs? Cities near Dubuque, IA with the most Remote Utilization Review Rn job openings:
Remote Utilization Review Rn jobs near you
TPA Sales Executive (Fully Remote)

TPA Sales Executive (Fully Remote)

SISCO

Dubuque, IA • Remote

Full-time

Medical, Life

Posted 9 days ago

Job description

SISCO is looking for an experienced sales professional to launch their suite of services into new markets. Through SISCO, your broker-partners can leverage the strength of national carriers coupled with the oversight of an independent TPA.

Why SISCO?

  1. "Privately Owned" does not mean private equity - Our family of companies has a history in insurance services that spans over 130 years and is characterized by organic growth with zero debt.
  2. Professional Staff – Imagine working with a team that includes ERISA attorneys, MDs, PharmDs, RNs and Health Coaches; where member service is delivered by licensed agents and the average tenure of the Account Management team is 8+ years.
  3. True Integration – SISCO's "One Roof" service model includes expert claim adjudication for both self-funded medical and insured ancillary benefits. Optional services include a suite of advocacy and population health services along with dependent audits, ben admin and enrollment/billing services. We also offer a flexible BPO service model for carriers, MEWAs, affinity groups and cost control firms.

Primary Responsibilities:

  • Leverage and expand your network with focus on channel partners whose expertise and distribution align with our strategy and value proposition.
    • Targeted partners include carriers, affinity programs, MGUs, captives, point solutions and brokers.
  • Continuously develop expertise, identify opportunities to solve problems through innovation.
  • Develop and deliver effective employee benefit solutions, build strong relationships with client decision-makers.
  • Meet and exceed sales and retention targets on your book of business.

Requirements:

  • 1-5 years of prior sales experience with a TPA, cost control vendor, MGU and/or carrier
  • Knowledge of ERISA, Affordable Care Act, Insured Ancillary/Voluntary coverages, Affinity Programs, Captives, or TPA operations and related cost control point solutions
  • Prefer CEBS, Self-Funded Specialist Designation and/or Licensed in Life and Health
  • Possess excellent communication, negotiation, and sales skills
  • Ability to travel nationwide

SISCO – experience the benefits
Our Mission: Simplify Benefits, Control Costs, Maximize Value

The SISCO division was established by Cottingham & Butler in 1980 to serve the employee benefit needs of self-funded employer groups. Today, SISCO is a cornerstone of the C&B family of insurance services companies, headquartered in Dubuque, IA employing 1300 professional teammates across the nation. Organic growth has fueled SISCO's ability to diversify and develop complementary services relied on by over 500,000 employees. Our strategic partnerships include national carrier networks as well as various alternatives, including RBP, regional networks, innovative cost control companies, leading technology firms and proprietary network contracts with healthcare providers. Learn more at www.siscobenefits.com