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Remote Utilization Review Rn Jobs in Edmond, OK (NOW HIRING)

Corvel

Telephonic Case Manager I

Oklahoma City, OK · Remote

$63K - $95K/yr

Current RN Licensure in state of operation * 3 or more years of recent clinical experience ... Strong cost containment background, such as utilization review or managed care helpful

Varsity Tutors

NCLEX-RN Tutor

Oklahoma City, OK · Remote

$40/hr

Adapts instruction using UWorld, Kaplan, or ATI practice question banks, content review materials, and test-taking strategy workshops to support BSN and ADN graduates preparing for registered nurse ...

Humana

Compliance Audit Nurse

Oklahoma City, OK · On-site +1

Active Registered Nurse, RN, license in the state of Oklahoma with no discrepancies * 3+ years ... Previous experience in utilization management, case management, discharge planning and/or home ...

Humana

Compliance Audit Nurse

Oklahoma City, OK · On-site +1

Active Registered Nurse, RN, license in the state of Oklahoma with no discrepancies * 3+ years ... Previous experience in utilization management, case management, discharge planning and/or home ...

Corvel

Care Advocate Nurse

Oklahoma City, OK · Remote

$61K - $98K/yr

... ies), reviews medical data in CareMC, validates and secures medical information, assesses and ... This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Initiates and receives telephonic ...

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Remote Utilization Review Rn information

See Edmond, OK salary details

$18

$35

$58

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

As of Sep 11, 2026, the average hourly pay for remote utilization review rn in Edmond, OK is $35.78, according to ZipRecruiter salary data. Most workers in this role earn between $28.27 and $41.11 per hour, depending on experience, location, and employer.

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 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 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 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 Edmond, OK?

For Remote Utilization Review Rn jobs in Edmond, OK, the most frequently searched job titles are:

What job categories do people searching Remote Utilization Review Rn jobs in Edmond, OK look for?

The top searched job categories for Remote Utilization Review Rn jobs in Edmond, OK are:

What cities near Edmond, OK are hiring for Remote Utilization Review Rn jobs?

Cities near Edmond, OK 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 Edmond, OK as of September 2026, with employment types broken down into 1% As Needed, 79% Full Time, 16% Part Time, 1% Temporary, and 3% Contract. Highlights an 87% Physical, 2% Hybrid, and 11% Remote job distribution, with an average salary of $74,421 per year, or $35.8 per hour.

Orthopedic Spine Reviewer (Remote)

Oklahoma City, OK • Remote

Managed Medical Review Organization
Public Administration • 51 - 200 employees
Learn more about Managed Medical Review Organizationexternal

Contractor

Posted 17 days ago

Job description

About MMRO
Managed Medical Review Organization (MMRO) is a nationally recognized, URAC-accredited Independent Review Organization (IRO) specializing in objective, evidence-based medical peer reviews and disability evaluations. For more than 30 years, MMRO has partnered with government agencies, health plans, employers, and disability systems across the United States to deliver high-quality, clinically sound, and impartial medical reviews.
Our mission is to support fair and accurate healthcare and disability-related decisions by leveraging the expertise of experienced practicing physicians. MMRO is committed to integrity, clinical excellence, quality assurance, and timely service, providing an environment where physician expertise directly impacts important healthcare determinations.
We are currently seeking Board-Certified Orthopedic Surgeons, with a preference for physicians who have completed an Orthopedic Spine Fellowship, to join our nationwide network of independent Physician Reviewers.
Position Overview
As an Independent Physician Reviewer, you will perform objective medical record reviews and provide evidence-based opinions regarding diagnosis, treatment, disability, impairment, and medical necessity questions. Reviews are conducted remotely and do not require direct patient interaction.
This role is ideal for physicians seeking flexible consulting opportunities that allow them to apply their clinical expertise while maintaining control over their schedule and workload.
Responsibilities
  • Conduct thorough, unbiased medical chart reviews in accordance with accepted clinical standards and evidence-based guidelines.
  • Analyze medical records and supporting documentation to formulate clear, well-reasoned clinical opinions.
  • Prepare concise, accurate, and defensible written reports that clearly support review determinations.
  • Complete reviews in accordance with MMRO's quality standards and established turnaround times.
  • Utilize MMRO review templates and ensure all required elements are addressed completely and accurately.
  • Maintain professionalism, objectivity, and confidentiality throughout the review process.
  • Respond promptly to communications from MMRO clinical and operations staff.
  • Participate in required reviewer orientation and ongoing training activities.
  • Incorporate quality feedback provided by MMRO's Medical Director, Associate Medical Director, and clinical team.
  • Support continuous quality improvement initiatives through constructive suggestions and collaboration.
Qualifications
Required
  • Current, unrestricted M.D. or D.O. license to practice medicine in the United States.
  • Active Oklahoma state medical license.
  • Board Certification through an American Board of Medical Specialties (ABMS) or American Osteopathic Association (AOA) recognized specialty board.
  • Minimum of five (5) years of full-time equivalent clinical practice providing direct patient care.
  • Active clinical experience within the past three (3) years.
  • Strong written communication skills and attention to detail.
  • Ability to meet established review deadlines consistently.
Preferred
  • Fellowship training in Orthopedic Spine Surgery.
  • Prior experience performing peer reviews, independent medical reviews, disability evaluations, utilization review, or expert medical opinions.
Why Partner with MMRO?
  • 100% remote independent contractor opportunity
  • Flexible scheduling with the ability to accept cases based on your availability
  • No patient appointments, call coverage, or administrative practice responsibilities
  • Competitive per-case compensation
  • Opportunities to review cases aligned with your specialty expertise
  • Dedicated clinical and operational support team
  • Work with a respected, URAC-accredited organization committed to quality and clinical integrity
  • Make a meaningful impact on healthcare and disability-related decision-making nationwide

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