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Remote Utilization Review Rn Jobs in Lombard, IL

Guidehealth

Remote RN Case Manager

Chicago, IL · On-site +1

As a registered nurse with an Illinois nursing license, you will work remotely to enhance the ... Knowledge of utilization review, quality improvement, managed care, and/or community health.

Rising Medical Solutions

Legal Nurse

Chicago, IL · Remote

Hold an active RN license in one or more states * Experience reviewing drafting and/or reviewing ... Minimum 5 years of clinical, legal, utilization review, or case management experience

Rising Medical Solutions

Legal Nurse

Chicago, IL · On-site +1

Hold an active RN license in one or more states * Experience reviewing drafting and/or reviewing ... Minimum 5 years of clinical, legal, utilization review, or case management experience

Rising Medical Solutions

Lead Legal Nurse

Chicago, IL · Remote

$34.75 - $47/hr

Hold an active RN license in one or more states * Experience reviewing drafting and/or reviewing ... Minimum 5 years of clinical, legal, utilization review, or case management experience

Rising Medical Solutions

Lead Legal Nurse

Chicago, IL · On-site +1

$35 - $47.50/hr

Hold an active RN license in one or more states * Experience reviewing drafting and/or reviewing ... Minimum 5 years of clinical, legal, utilization review, or case management experience

Phamily

Clinical Care RN

Villa Park, IL · Remote

$75K - $95K/yr

This position is remote and offers health benefits as well as a retirement plan and paid days off ... review meetings * Serve as a liaison for payer utilization management, interpreting policy, and ...

Phamily

Clinical Care RN

Oakbrook Terrace, IL · Remote

$75K - $95K/yr

This position is remote and offers health benefits as well as a retirement plan and paid days off ... review meetings * Serve as a liaison for payer utilization management, interpreting policy, and ...

Med-Metrix

Physician Advisor - Fully Remote

Chicago, IL · On-site +1

Provides consultation to attendings, nurses, and case management staff regarding complex clinical ... Board Certification by the American Board of Quality Assurance and Utilization Review Physicians ...

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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 16, 2026, the average hourly pay for remote utilization review rn in Lombard, IL is $41.61, according to ZipRecruiter salary data. Most workers in this role earn between $32.88 and $47.79 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 Lombard, IL? For Remote Utilization Review Rn jobs in Lombard, IL, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review Rn jobs in Lombard, IL look for? The top searched job categories for Remote Utilization Review Rn jobs in Lombard, IL are:
What cities near Lombard, IL are hiring for Remote Utilization Review Rn jobs? Cities near Lombard, IL with the most Remote Utilization Review Rn job openings:
Remote Utilization Review Rn jobs near you
Utilization Review Nurse

Utilization Review Nurse

Rising Medical Solutions

Chicago, IL • On-site, Remote

Full-time

Medical, Dental, Vision, Retirement

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

Job description

Rising Medical Solutions has an opening for a Utilization Review Nurse, and we want to hear from you! We're a bill review and cost containment company - so what does that mean? Basically we are trying to fix a very broken healthcare system by reducing the cost of healthcare claims through bill review, case management, and utilization review. Our mission is "To make lives better" and everyone here at Rising works hard to achieve this goal. So take a look at the job, let us know what you think, and let's start working towards a better future!
**This is a full-time position - 40 hours per week (Must work M-F each day).
Responsibilities
  • Perform all aspects of the Utilization Review Process
  • Review records and requests for UR, which may arrive via mail, e-mail, fax, or phone
  • Utilize evidence-based guidelines to determine if authorization can be given versus having to send the file or for Peer or Physician Review
  • Write nurse summaries on all UR files
  • Document properly in Rising's database (and client data bases when appropriate), and send determination letters on each completed UR
  • Establish collaborative relationships with clients, patients, employers, providers and attorneys
  • Track ongoing status of all UR activity so that appropriate turn-around times are met
  • Maintain organized files containing clinical documentation of interactions with all parties of every claim
  • Utilize good clinical judgment, careful listening, and critical thinking and assessment skills
  • Respond to various written and telephonic inquiries regarding status of case
  • Must be proficient in the use of a computer, including the use of various software programs simultaneously

Requirements
  • An Associate's or Bachelor's degree in Nursing
  • Hold an active and unencumbered RN license in one or more states
  • 3 to 5 years of clinical practice experience or 2 years of case management and/or UR experience
  • More than one state license (a plus)
  • Experience with Workers' Compensation, short-term or long-term disability, or liability claims
  • The ability to set priorities and work both autonomously and as a team member
  • Well-developed time-management, organization, and prioritization skills
  • Excellent analytical skills
  • Superb oral and written communication
  • The ability to gather data, compile information, and prepare summary reports
  • Strong interpersonal and conflict resolution skills
  • Experience in a fast-paced, multi-faceted environment
  • Demonstrated persistence and attention to detail
  • General understanding of CPT and ICD-9/ICD-10 codes and Medicare guidelines
  • Working knowledge of: Microsoft Word, Excel, and Outlook
  • Ability to remain calm during stressful situations
  • A customer-service mindset

Benefits
    • Generous Flexible Time Off (take it when you need it!)
    • Comprehensive benefit package including health/dental/vision insurance, profit sharing, and 401k matching
    • Career Growth Opportunities - We often promote from within
    • Professional Development Reimbursement Program (PDRP)
    • You will be part of our new Elevate program designed to recognize and reward employees for their hard work
    • Rising was named a Top Workplace in the healthcare industry for 2023! Check out our profile here: Working at Rising Medical Solutions Top Workplaces
    • We're on YouTube! Check out our culture at: http://www.youtube.com/user/RisingMedical
    • Want to see more? Check out our:
      • Facebook: https://www.facebook.com/RisingMedicalSolutions
      • LinkedIn: http://www.linkedin.com/company/rising-medical-sol..

If you are ready to join a team of professionals dedicated to making a difference and making lives better, please apply today!

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