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Remote Utilization Review Rn Jobs in Fishers, IN

Astyra Corporation

Clinical Reviewer

Indianapolis, IN · Remote

$38 - $40/hr

Remote (U.S.-based) Licensure Requirement: Must hold an active clinical license in the State of ... nursing program * 2+ years of Utilization Review/Management (UR/UM) and/or Prior Authorization ...

RADcube

Be Seen First

Registered Nurse Clinical Auditor

Indianapolis, IN · Remote

$60K - $75K/yr

Remote with Occasional travel - Downtown Indianapolis, IN We are seeking a detail-oriented Registered Nurse to support medical record reviews, billing compliance audits for the Indiana Health ...

Briljent

Clinical Auditor - RN

Indianapolis, IN · Remote

... remote position with occasional travel required within Indiana. Key Responsibilities * Review ... Requirements * RN license preferred; Indiana license or compact license accepted. * Coding ...

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Remote Utilization Review Rn information

See Fishers, IN salary details

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$39

$64

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

As of Jul 11, 2026, the average hourly pay for remote utilization review rn in Fishers, IN is $39.58, according to ZipRecruiter salary data. Most workers in this role earn between $31.30 and $45.43 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 Fishers, IN? For Remote Utilization Review Rn jobs in Fishers, IN, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review Rn jobs in Fishers, IN look for? The top searched job categories for Remote Utilization Review Rn jobs in Fishers, IN are:
What cities near Fishers, IN are hiring for Remote Utilization Review Rn jobs? Cities near Fishers, IN 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 Fishers, IN as of July 2026, with employment types broken down into 89% Full Time, 8% Part Time, and 3% Contract. Highlights an 40% Physical, 3% Hybrid, and 57% Remote job distribution, with an average salary of $82,318 per year, or $39.6 per hour.
Clinical Reviewer

Clinical Reviewer

Astyra Corporation

Indianapolis, IN • Remote

$38 - $40/hr

Full-time

Medical, Dental, Vision, Life, Retirement

Posted 10 days ago

Job description

Job Summary

The purpose of this position is to utilize clinical expertise to review medical records against established criteria in accordance with contract requirements.

Location: Remote (U.S.-based)
Licensure Requirement: Must hold an active clinical license in the State of Indiana or a Compact State license

Work Schedule:

  • 40 hours per week - Friday, Saturday, Sunday, and two weekdays
  • Weekend and/or holiday availability required 

Training Requirement:

  • Must be fully available to attend 100% of training. 
  • Schedule: Monday to Friday 9:00 AM – 6:00 PM EST
  • Duration: Minimum of 3 weeks
Key Responsibilities
  • Ensure accuracy and timeliness of all review cases in accordance with contract requirements
  • Manage daily workload and queues; adjust workflow as needed to meet departmental demands
  • Collaborate with Supervisor on quality monitoring and improvement activities
  • Maintain current knowledge of clinical practices and review processes
  • Serve as a liaison for providers regarding customer service issues and resolution
  • Perform various review types as assigned based on workload
  • Build and maintain professional relationships with internal and external stakeholders
  • Attend required trainings and team meetings
  • Cross-train to support business and client needs
  • Comply with all corporate policies, including HIPAA Privacy and Security regulations

Note: Responsibilities may evolve based on client needs.
 

Required Qualifications
  • Active, unrestricted LPN/LVN or RN license in Indiana or Compact State
  • Associate’s degree (Bachelor’s preferred) or diploma from an accredited nursing program
  • 2+ years of Utilization Review/Management (UR/UM) and/or Prior Authorization experience
  • 2+ years of medical necessity review experience
  • 1+ year of InterQual and/or Milliman Care Guidelines (MCG) experience
  • Strong knowledge of medical records, terminology, and disease processes
  • Excellent clinical assessment and critical thinking skills
  • Strong written and verbal communication skills
  • Ability to navigate multiple systems efficiently
  • Strong organizational skills and flexibility
Preferred Qualifications
  • 3+ years of clinical experience (acute care, behavioral health, and/or med-surgical)
  • Knowledge of NCQA and URAC standards
  • Experience working in a team-based environment
  • Proficiency in Microsoft Office
  • Strong time management and prioritization skills
  • Demonstrated ability to maintain confidentiality and ensure HIPAA compliance
Weekend and holiday flexibility is required
Proper email communication will only be done to and from @astyra.com email addresses. Please ensure you are communicating with approved Astyra recruiters by checking this point when receiving offers and messages from us. Please ensure you are communicating within these guidelines and proper channels for the quickest possible interview consideration!
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