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Remote Utilization Review Rn Jobs in Jacksonville, NC

Coastal Horizons Center

TASC Care Manager

Jacksonville, NC · Remote

$42K - $45K/yr

... registered with the North Carolina Addiction Specialist Professional Practice Board (NCASPPB ... Proficiency in using electronic health record systems and remote collaboration tools (i.e., Teams ...

Coastal Horizons Center

TASC Care Manager

Jacksonville, NC · Remote

$42K - $45K/yr

... registered with the North Carolina Addiction Specialist Professional Practice Board (NCASPPB ... Proficiency in using electronic health record systems and remote collaboration tools (i.e., Teams ...

All JobsUtilization Review Rn JobsRemote Utilization Review Rn JobsRemote Utilization Review Rn Jobs in Jacksonville, NC

Remote Utilization Review Rn information

See Jacksonville, NC salary details

$19

$38

$62

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

As of Aug 6, 2026, the average hourly pay for remote utilization review rn in Jacksonville, NC is $38.14, according to ZipRecruiter salary data. Most workers in this role earn between $30.14 and $43.80 per hour, depending on experience, location, and employer.

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 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 Jacksonville, NC? For Remote Utilization Review Rn jobs in Jacksonville, NC, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review Rn jobs in Jacksonville, NC look for? The top searched job categories for Remote Utilization Review Rn jobs in Jacksonville, NC are:
What cities near Jacksonville, NC are hiring for Remote Utilization Review Rn jobs? Cities near Jacksonville, NC 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 Jacksonville, NC as of August 2026, with employment types broken down into 1% As Needed, 83% Full Time, 14% Part Time, and 2% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $79,331 per year, or $38.1 per hour.

Post Transition Care Coordinator (South-Central)

TRILLIUM HEALTH RESOURCES

Beulaville, NC • Remote

$56K - $69K/yr

Full-time

Medical, Retirement, PTO

Posted 7 days ago

Job description

Pay Plan Title: Coordinator

Working Title: Post Transition Care Coordinator

FLSA Status: Exempt

Posting Salary Range: $56,270 - $69,898

Office Location: Remote within Trillium’s South-Central Region (See requirements section for included counties)


POSTING DETAILS:


Make an Impact


Trillium Health Resources is a Tailored Plan and Managed Care Organization (MCO) serving 46 counties across North Carolina. We manage services for individuals with serious mental health needs, substance use disorders, traumatic brain injuries, and intellectual/development (IDD) disabilities. Our mission is to help individuals and families build strong foundations for healthy, fulfilling lives.


Why Work for Us?


Trillium believes that empowering others begins with supporting our team. We offer our employees:


  • A collaborative, mission-driven work environment
  • Competitive benefits and work-from-home options for most positions
  • Opportunities for professional growth in a diverse inclusive culture


Every day, our work changes lives – from children thriving through early intervention and school-based therapies, to adults with severe mental illness living independently and contributing to their communities.


If you are looking for a unique opportunity to make a tangible impact on the lives of others, apply today!


What We’re Looking For


Trillium Health Resources has a career opening for a Post Transition Care Coordinator to join our team! The Post Transition Care Coordinator is responsible for providing care coordination (treatment planning, assessment, monitoring, educating, and referral/linking) to individuals identified in the Transitions to Community Living Initiative Special Needs Populations (TCLI) by targeting those with chronic, unresolved, or complex physical, behavioral health, and social determinant needs. The Post Transition Care Coordinator will provide care planning as well as discharge and transition planning from Adult Care Homes, inpatient units, and detention centers with foundations in national evidence based and informed standards providing whole person care.


On a typical day, you might:


  • Work collaboratively with licensed Clinicians, Registered Nurses, and Peer Support Specialists to ensure successful discharge/transition planning/post transition monitoring.
  • Provide care coordination/care management to assigned TCL individuals who may have identified needs with behavioral health, physical health, co-occurring, co-morbid or multi-morbid conditions.
  • Assess member’s needs who have transitioned into supportive housing to determine if additional support and services are needed for continued independent living.
  • Complete assessments as needed.
  • Ensure timely and accurate documentation of all planning and coordination efforts in multiple software platforms and State database systems.


Employee Benefits:


Trillium knows that work/life balance is essential. That’s why we offer:


  • Typical working hours: 8:30 am – 5:00 pm; flexible work schedules available for some positions with management approval.
  • Work-from-home options available for most positions
  • Health Insurance with no premium for employee coverage
  • Flexible Spending Accounts
  • 24 days of Paid Time Off (PTO) plus 12 paid holidays in your first year
  • NC Local Government Retirement Pension (defined-benefit plan) https://www.myncretirement.gov/systems-funds/local-governmental-employees-retirement-system-lgers/lgers-handbook
  • 401k with 5% employer match and immediate vesting
  • Public Service Loan Forgiveness (PSLF) qualifying employer
  • Quarterly stipend for remote work supplies


Qualifications


Required:

  • Must meet Qualified Professional (QP) status.
  1. Fully licensed by the NC governing board regulating Human Services professions; OR Fully licensed RN who is licensed to practice in the state of NC by the NC Board of Nursing who also has four (4) years of full-time experience with the MH/DD/SA population served. OR
  2. A graduate of a college or university with a master’s degree in a human service field and has one year of full-time, pre or post-graduate degree accumulated MH/DD/SA experience with the MH/DD/SA population, or a substance abuse professional who has one year of full-time, pre or postgraduate degree accumulated supervised experience in alcoholism and drug abuse counseling; OR
  3. A graduate of a college or university with a bachelor's degree in a human service field and has two years of full-time, pre or post-bachelor's degree accumulated MH/DD/SA experience with the MH/DD/SA population, or a substance abuse professional who has two years of full-time, pre or post bachelor's degree accumulated supervised experience in alcoholism and drug abuse counseling; OR
  4. A graduate of a college or university with a bachelor's degree in a field other than human services and has four years of full-time, pre or post-bachelor's degree accumulated MH/DD/SA experience with the MH/DD/SA population, or a substance abuse professional who has four years of full-time, pre or post-bachelor's degree accumulated supervised experience in alcoholism and drug abuse counseling.
  • Must have a valid driver’s license.
  • Must reside within Trillium’s South Central Region, which includes the following counties: Carteret, Craven, Duplin, Jones, Lenoir, Onslow, Pender, Sampson and Wayne.
  • Must be able to travel within catchment as required.


Preferred:

  • License and/or certification may be accepted as noted above.
  • Experience and knowledge of peer support and experience working with individuals who are certified peer support specialists.


Deadline for Application: Friday August 7,2026 at 11:59PM


How to Apply


To be considered, submit your application and resume through our ADP Career Center. Your resume must include:


  • Employer name, dates of service (month/year), average hours worked per week, and essential job duties
  • Education details (degree type, date awarded, institution, field of study)
  • Licensure/certification information, if applicable


After submission, your resume will be reviewed to ensure it meets the essential criteria for the position. You’ll be notified by HR regarding your application status as appropriate. All applicants will receive a final update once the recruitment cycle closes.


Join our Talent Community through ADP to stay informed about future opportunities. Be sure to keep your resume updated in your profile.


Trillium Health Resources is an Equal Employment Opportunity (EEO) employer and a drug-free workplace. All candidates must pass a drug test as a condition of employment.


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