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Remote Utilization Review Rn Jobs in Lombard, IL

Corvel

Telephonic Case Manager II

Downers Grove, IL · Remote

$65K - $98K/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

Case Management Supervisor RN

Downers Grove, IL · Remote

$76K - $117K/yr

This is a remote position. ESSENTIAL FUNCTIONS &RESPONSIBILITIES: * Responsible for directing a ... May perform daily, weekly, monthly reviews of various reports, invoices, logs and expenses * May be ...

Corvel

Case Management Supervisor RN

Downers Grove, IL · Remote

$77K - $120K/yr

This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Responsible for directing a ... May perform daily, weekly, monthly reviews of various reports, invoices, logs and expenses * May be ...

Corvel

Bilingual Medical Case Manager II

Downers Grove, IL · On-site +1

$65K - $98K/yr

CorVel Corporation is hiring a caring, self-motivated, energetic and independent registered nurse ... A cost containment background, such as utilization review or managed care is helpful. * Strong ...

Varsity Tutors

NCLEX-RN Tutor

Naperville, IL · Remote

$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 ...

Varsity Tutors

NCLEX-RN Tutor

Highland Park, IL · Remote

$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 ...

Varsity Tutors

NCLEX-RN Tutor

Wheaton, IL · Remote

$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 ...

Varsity Tutors

NCLEX-RN Tutor

Oak Lawn, IL · Remote

$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 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
Registered Nurse (RN) Specialty - Remote

Registered Nurse (RN) Specialty - Remote

Walgreens

Deerfield, IL • On-site, Remote

$33.75 - $44.75/hr

Full-time

Posted 7 days ago

Walgreens rating

5.5

Company rating: 5.5 out of 10

Based on 2,107 frontline employees who took The Breakroom Quiz

87th of 99 rated pharmacies

Job description

Job Description
Job Summary:
Responsible for patient focused programs which may include but is not limited to: collaborating with health care team in providing direction for maintaining high quality patient care, outcomes, and goals for patients; provides enhanced services support and assistance with contractually required Biopharma programs. Follows specific care modules or standard operation procedures approved by the Clinical and Professional Services Team including scripting, assessments, screenings, and education.
Provides enhanced nursing services support, evaluating diagnoses and other clinical criteria to complete requests for prior authorization, specialty care specific to the department and patient needs in an effort to provide exceptional care and support. Administers clinical training and orientation programs and validates and educations subcontracted nursing providers knowledge base.
Job Responsibilities:
  • Completes initial screening for patients which may include:
    • Assists with infusion pump programming and troubleshooting based on Plan of Treatment (POT);
    • Completes system driven assessments such as Depression Screenings for select disease states;
    • Conducts follow-up assessments and outreach to determine medication history and to improve medication adherence;
    • Provides disease state education including medication administration, resources on side effect management, outreached to MDO, etc.
  • Responsible for the daily nursing care activities, including completion of nursing coordination/plan of treatment forms, building supply lists, nursing assessments, initial screenings, and surveys for patients, programming and troubleshooting infusion pumps based on the Plan of Treatment (POT) established by a pharmacist, injection site/infusion site education training/techniques, obtaining nursing orders, assay management and patient clinical nursing management, and follow up calls to patients as appropriate per specialty.
  • Audits and reports daily on team and individual performance metrics and quality statistics and assist with extrapolation of system applications to develop reports of data from regarding productivity trends.
  • Assists in developing, updating, and implementing departmental Standard Operating Procedures related to system applications, programs, processes and merchandise.
  • Provides support within the scope of practice for a nurse and escalating to pharmacist for patient specific medication questions, including side effect management and quality of life screening.
  • May work with specific nursing specialties such as but not limited to: Infusion Care, Fertility Order, Nursing Network, Care Management.
  • May have other responsibilities delegated as specific to nurse specialty and as designated by the specific department, other responsibilities as judgment or necessity dictate.
  • Reviews prior authorization criteria for specified payers related to defined medications. Evaluates all requests for prior authorizations, appeals and accompanying tasks.
  • Provides nursing network subject matter expert support; administers tracking pharma and payer related nursing documentation request; advises on complex cases and assists in quality care resolution.
  • Acts as a liaison between physicians/practitioners, medical consultants and facility clinical staff.
  • Participates in professional organizations and workshops to gain additional job related knowledge, in service programs and continuing education as required.
  • Serves as Point of Contact for disease-specific operations teams.
About Walgreens
Founded in 1901, Walgreens (www.walgreens.com) has a storied heritage of caring for communities for generations and proudly serves nearly 9 million customers and patients each day across its approximately 8,500 stores throughout the U.S. and Puerto Rico, and leading omni channel platforms. Walgreens has approximately 220,000 team members, including nearly 90,000 healthcare service providers, and is committed to being the first choice for retail pharmacy and health services, building trusted relationships that create healthier futures for customers, patients, team members and communities.
External Basic Qualifications
  • Associate's degree in Nursing
  • Current license/registration as an RN (Registered Nurse) with the State Board of Nursing in the state in which the position resides
  • Must obtain and maintain Nurse Licensing Compact multi-state license and necessary non-Nursing Licensing Compact state license within 6 months of employment start date (company sponsored); any and all exception to this timeline requires leadership approval
  • 2 years' work experience in nursing
  • Related work experience in a specialty pharmacy, PBM, and/or healthcare call center setting
  • Good verbal and written communication and interpersonal skills with the ability to communicate in a diplomatic and confidential manner
  • Willing to travel up to/at least 10% of the time for business purposes (within state and out of state).

Preferred Qualifications
  • Bachelor's degree in Nursing
  • Active Nursing Licensing Compact multistate license and nursing license(s) in states not participating in Nursing Licensure Compact
  • Experience working with contracting and contract requirements if necessary for the appropriate specialty
  • Proven ability to work in a team environment
  • Organized and detail oriented with proven problem solving skills
  • Excellent written/verbal communication skills and interpersonal skills with the ability to lead, motivate, and communicate with internal and external customers
  • Knowledge of customer service principles and processing including customer needs assessment, meeting quality standards for services, and evaluation of customer satisfaction
  • Basic skills in MS Office Suite
We will consider employment of qualified applicants with arrest and conviction records.
The Salary below is being provided to promote pay transparency and equal employment opportunities at Walgreens. The actual hourly salary within this range that you will be offered will depend on a variety of factors including geography, skills and abilities, education, experience and other relevant factors. This role will remain open until filled. To review benefits, please click here jobs.walgreens.com/benefits. If you are applying on a job board or unable to click on the link, please copy and paste this URL into your browser jobs.walgreens.com/benefits

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