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Remote Utilization Review Rn Jobs in Lexington, SC

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Remote Utilization Review Rn information

See Lexington, SC salary details

$18

$36

$59

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

As of Jul 16, 2026, the average hourly pay for remote utilization review rn in Lexington, SC is $36.19, according to ZipRecruiter salary data. Most workers in this role earn between $28.61 and $41.59 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 Lexington, SC? For Remote Utilization Review Rn jobs in Lexington, SC, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review Rn jobs in Lexington, SC look for? The top searched job categories for Remote Utilization Review Rn jobs in Lexington, SC are:
What cities near Lexington, SC are hiring for Remote Utilization Review Rn jobs? Cities near Lexington, SC with the most Remote Utilization Review Rn job openings:
Infographic showing various Remote Utilization Review Rn job openings in Lexington, SC as of July 2026, with employment types broken down into 82% Full Time, 16% Part Time, and 2% Contract. Highlights an 40% Physical, 3% Hybrid, and 57% Remote job distribution, with an average salary of $75,278 per year, or $36.2 per hour.
Healthcare Quality Architect - 61009022

Healthcare Quality Architect - 61009022

State of South Carolina

Cayce, SC • On-site, Remote

$80K - $90K/yr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 2 days ago


State Of South Carolina rating

7.7

Company rating: 7.7 out of 10

Based on 42 frontline employees who took The Breakroom Quiz

25th of 50 rated states


Job description

Job Responsibilities Careers at DPH: Work that makes a difference. Embracing Service, Inspiring Innovation, Promoting Teamwork, Pursuing Excellence, and Advancing Equity This position supports the Low Country counties: Jasper, Beaufort, Hampton, Barnwell, Allendale, Bamberg, Colleton, Orangeburg, Calhoun, Sumter, Clarendon, Williamsburg, and Berkeley. These counties are subject to change based on agency needs.

Under limited supervision, reviews architectural/engineering drawings and specifications for health facilities; inspects construction projects for compliance with licensing regulations and applicable building codes and standards to include the International Building Codes, National Fire Prevention Code and ANSI A 117.1 Code. Reports to the Lead Architect. Reviews submitted Architectural/Engineering drawings and monitors the construction/renovation of any licensed or proposed health care facility

Maintains professional demeanor and state-of-the-art knowledge of health care facility construction issues. Maintains documentation in accordance with Standard Operating Procedures including but not limited to construction inspections and testing. Assists with staff training.

Consults with owners, administrators, architects, and engineers in planning, design, and construction of licensed or proposed health care facilities. Provides assistance and coordination to personnel within the Department concerning Architectural, Engineering, and Fire/Life Safety issues pertaining to health care facilities. When requested, participates as a member of Healthcare Quality's Emergency Response Team, serving in the Emergency Operations Center or other designated assignment.

Participates in disaster preparedness and response and is designated as an essential employee, subject to duty and/or call on a 24-hour basis during an emergency. Performs other duties as requested. Minimum and Additional Requirements State Minimum Requirements: A bachelor's degree in architecture and experience as a registered architect.

Agency Additional Requirements: Travel overnight and occasionally out of state may be required. Applicants indicating college credit or degree(s) on the application may upload an unofficial copy of the transcript as an attachment to the application. Please note that the agency will require an official, certified copy of the transcript or diploma prior to hiring.

Institutions of Higher Learning must be recognized by the Council for Higher Education Accreditation. Preferred Qualifications Registration with the South Carolina Board of Architectural Examiners. Experience in construction design of Group B, I-1, I-2, I-4, R-3, or R-4 occupancies.

A master's degree in architecture and five (5) or more years of relative experience as a registered architect. Additional Comments EEO: The Department of Public Health is committed to providing equal employment opportunities to all applicants and does not discriminate on the basis of race, color, religion, sex (including pregnancy, childbirth, or related medical conditions including, but not limited, to lactation), national origin, age (40 or older), disability, or genetic information. REASONABLE ACCOMMODATION: Applicants needing accommodation for medical reasons or a sincerely held religious belief may submit a request for accommodation.

A reasonable accommodation may be granted if it doesn't impose an undue hardship or pose a direct threat to the health and safety of others. STATE DISASTER PLAN: In accordance with the State's Disaster Plan, which includes hazardous weather, Department of Public Health employees may be required to work in times of an emergency or disaster. DRIVING RECORD: If this position requires the applicant to possess a valid driver's license to operate a state vehicle or personal vehicle, any applicant being considered in the final stages of selection for the position will be required to provide a certified copy of a 10-year driving record.

The South Carolina Department of Public Health offers an exceptional benefits package for FTE positions that includes: 15 days Annual (Vacation) Leave per year 15 days Sick Leave per year 13 Paid Holidays Paid Parental Leave Health, dental, vision, long-term disability, and life insurance for employees, spouse, and children. Click here for additional information. S.C

Deferred Compensation Program available (S.C. Deferred Compensation) Retirement benefit choices * State Retirement Plan (SCRS) State Optional Retirement Program (State ORP) *Enrollment in one of the listed plans is required for all FTE employees; please refer to the contribution section of hyperlinked retirement sites for the current contribution rate of gross pay. HYBRID WORK: The option to work partially remote or adjusted work hours may be available after 12 months of employment for approved positions.


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About State of South Carolina

Sourced by ZipRecruiter

State of South Carolina is not a typical corporation, but the governing body of the US state of South Carolina, located in the capital city of Columbia. Its industry focuses on public administration, providing key essential services to ensure the efficient functioning of the state. These services range from public safety and environment protection to education, healthcare, and economic development. The state was founded in 1788, grounded in democratic principles meant to support the overall well-being of its citizenry. Its core values revolve around service, integrity, accountability, and transparency. The mission of the State of South Carolina is to improve the quality of life for all its people, with a focus on education advancement, economic growth, and improved healthcare.

Industry

Public administration

Company size

10,000+ Employees

Headquarters location

Columbia, SC, US

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