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Remote Utilization Review Rn Jobs in Independence, MO

Corvel

Telephonic Case Manager I

Overland Park, KS · 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

Corvel

Telephonic Case Manager I

Overland Park, KS · Remote

$62K - $93K/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

Corvel

Telephonic Case Manager I

Overland Park, KS · Remote

$62K - $93K/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

Kansas City, MO · Remote

$18 - $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 ...

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Remote Utilization Review Rn information

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

As of Jun 29, 2026, the average hourly pay for remote utilization review rn in Independence, MO is $38.55, according to ZipRecruiter salary data. Most workers in this role earn between $30.48 and $44.28 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 Independence, MO? For Remote Utilization Review Rn jobs in Independence, MO, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review Rn jobs in Independence, MO look for? The top searched job categories for Remote Utilization Review Rn jobs in Independence, MO are:
What cities near Independence, MO are hiring for Remote Utilization Review Rn jobs? Cities near Independence, MO with the most Remote Utilization Review Rn job openings:
Remote Utilization Review Rn jobs near you
Utilization Review Clinician (RN, OT, or PT) - Remote

Utilization Review Clinician (RN, OT, or PT) - Remote

WellSky

Overland Park, KS • Remote

$2.5K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

This job post has expired today. Applications are no longer accepted.

Key responsibilities

  • Conduct prior authorization reviews and continued stay reviews for post-acute care services by applying clinical guidelines and escalating cases to medical directors as needed.

  • Collaborate with case managers, physicians, and medical directors to ensure appropriate levels of care and seamless care transitions.

  • Approve services in compliance with health plan guidelines, contractual agreements, and medical necessity criteria.

WellSky rating

7.5

Company rating: 7.5 out of 10

Based on 9 frontline employees who took The Breakroom Quiz

124th of 192 rated software companies

Job description

The Utilization Review Clinician is responsible for reviewing medical records to determine medical necessity. This includes conducting patient evaluations, managing admissions and informational visits, and ensuring timely post-discharge follow-ups with completed assessments to help prevent acute care readmissions.

In this role, you will also review requests for post-acute services promptly, using established clinical guidelines and coverage criteria to assess appropriateness. You'll collaborate with physicians, healthcare providers, and both internal and external stakeholders to support improved health outcomes. By applying clinical expertise, you'll coordinate care with facilities and providers, follow standard operating procedures and organizational policies, and consult with peer reviewers, Medical Directors, or delegated clinical reviewers to ensure care is medically appropriate, high-quality, and cost-effective throughout the medical management process.

The ideal candidate will have working knowledge of Microsoft Office applications (e.g., Word, Excel) and be comfortable using clinical decision support tools and operational software.

Join us in shaping the future of healthcare - apply today!

Key Responsibilities:

  • Conduct prior authorization reviews and/or continued stay reviews for post-acute care services by applying clinical guidelines and escalating cases to medical directors as needed

  • Approve services in compliance with health plan guidelines, contractual agreements, and medical necessity criteria

  • Collaborate with case managers, physicians, and medical directors to ensure appropriate levels of care and seamless care transitions

  • Participate in team meetings, educational activities, and interrater reliability testing to maintain review consistency and professional growth

  • Ensure compliance with federal, state, and accreditation standards, and identify opportunities to enhance communication or processes

  • Support all payer programs and initiatives related to the post-acute space

  • Make benefit determinations about appropriate levels of care using clinical guidelines

  • Coordinate benefits and transitions between various areas of care

  • Utilize knowledge of resources available in the healthcare system to assist physicians and patients effectively

  • Perform other job duties as assigned

Required Qualifications:

  • Bachelor's degree or equivalent work experience

  • 4-6 years of clinical nursing or therapy experience

  • Active RN, OT, or PT license

Preferred Qualifications:

  • 1-2 years' experience in utilization review, case management and/or managed care regulations

  • Experience with MCG Guidelines, InterQual or other clinical decision support tools, especially inutilization managementandprior authorizationprocesses

Job Expectations:

  • Willing to travel up to 30% based on business needs

  • Willing to work additional or irregular hours as needed

  • Must work in accordance with applicable security policies and procedures to safeguard company and client information

  • Must be able to sit and view a computer screen for extended periods of time

WellSky is where independent thinking and collaboration come together to create an authentic culture. We thrive on innovation, inclusiveness, and cohesive perspectives. At WellSky you can make a difference.

WellSky provides equal employment opportunities to all people without regard to race, color, national origin, ancestry, citizenship, age, religion, gender, sex, sexual orientation, gender identity, gender expression, marital status, pregnancy, physical or mental disability, protected medical condition, genetic information, military service, veteran status, or any other status or characteristic protected by law. WellSky is proud to be a drug-free workplace.

Applicants for U.S.-based positions with WellSky must be legally authorized to work in the United States. Verification of employment eligibility will be required at the time of hire. Certain client-facing positions may be required to comply with applicable requirements, such as immunizations and occupational health mandates.

Here are some of the exciting benefits full-time teammates are eligible to receive at WellSky:

  • Excellent medical with Rx, dental, and vision benefits

  • Mental Health support through EAP

  • Generous paid time off, plus 13 paid holidays

  • 100% vested 401(K) retirement plans

  • Educational assistance up to $2500 per year

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