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Remote Utilization Review Rn Jobs in Los Angeles, CA

Astrana Health, Inc.

UM Review Nurse

Monterey Park, CA · Remote

$34 - $47/hr

Description Astrana Health is looking for a CA-licensed Utilization Review Nurse to assist our ... This is a remote position for CA-licensed nurses. Candidates must live in California. We are ...

Astrana Health, Inc.

UM Review Nurse

Monterey Park, CA · On-site +1

$34 - $47/hr

... Utilization Review Nurse to assist our Health Services Department. In this position, you will ... This is a remote position for CA-licensed nurses. Candidates must live in California. We are ...

Astrana Health

UM Review Nurse

Monterey Park, CA · Remote

$34 - $47/hr

Astrana Health is looking for a CA-licensed Utilization Review Nurse to assist our Health Services ... This is a remote position for CA-licensed nurses. Candidates must live in California. We are ...

Molina Healthcare

Medical Review Nurse (RN)

Long Beach, CA · Remote

$29.05 - $56.64/hr

Resolves escalated complaints regarding utilization management and long-term services and supports ... Reviews medically appropriate clinical guidelines and other appropriate criteria with medical ...

New

Imh

RN Care Manager

West Covina, CA · Remote

$41.20 - $62.17/hr

Demonstrated experience in case management, utilization review, value-based care, and/or discharge ... If applying for a remote or hybrid role, this includes remote work expectations related to ...

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All JobsUtilization Review Rn JobsRemote Utilization Review Rn JobsRemote Utilization Review Rn Jobs in Los Angeles, CA

Remote Utilization Review Rn information

See Los Angeles, CA salary details

$23

$45

$74

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

As of Aug 10, 2026, the average hourly pay for remote utilization review rn in Los Angeles, CA is $45.56, according to ZipRecruiter salary data. Most workers in this role earn between $36.01 and $52.31 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 the most commonly searched types of Utilization Review Rn jobs in Los Angeles, CA? The most popular types of Utilization Review Rn jobs in Los Angeles, CA are:
What are popular job titles related to Remote Utilization Review Rn jobs in Los Angeles, CA? For Remote Utilization Review Rn jobs in Los Angeles, CA, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review Rn jobs in Los Angeles, CA look for? The top searched job categories for Remote Utilization Review Rn jobs in Los Angeles, CA are:
What cities near Los Angeles, CA are hiring for Remote Utilization Review Rn jobs? Cities near Los Angeles, CA 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 Los Angeles, CA as of July 2026, with employment types broken down into 78% Full Time, 12% Part Time, and 10% Contract. Highlights an 100% Remote job distribution, with an average salary of $94,763 per year, or $45.6 per hour.

Oncology Utilization Review - Remote - 1099 (contract)

MRIoA

Los Angeles, CA • On-site, Remote

Contractor

Re-posted 22 days ago

Job description

Description
Oncology Utilization Review State Medical Licenses required: Arizona, Florida, Minnesota, North Dakota, Oregon or Tennessee
Flexible Independent Contractor (1099) Opportunity
ABOUT MRIoA
Founded in 1983, Medical Review Institute of America (MRIoA) is a nationally recognized Independent Review Organization (IRO) specializing in technology-driven utilization management and clinical medical review solutions. We're a leader in Peer and Utilization Reviews, known for excellence and continuous improvement.
THE OPPORTUNITY:
We are currently seeking Board-Certified physicians in Oncology to conduct independent Utilization Reviews. This is a flexible, fully remote opportunity requiring just 1-2 hours per week-with no minimum commitment.
ADDITIONAL INFORMATION:
  • Work remotely from anywhere in the US (Per HIPAA Regulations, patient records cannot leave the US).
  • Covered under MRIoA's Errors and Omissions policy.
  • Independent Contractor (1099) opportunity.
  • Workers are required to adhere to all applicable HIPAA regulations and company policies and procedures regarding the confidentiality, privacy, and security of sensitive health information

Requirements
  • Must have a Medical Degree MD or DO
  • Must have a current State Medical License in one of the above listed states.
  • Current Board Certification in Medical Oncology
  • Must have 5 years of clinical experience, residency can be included
  • Daytime availability is required for peer-to-peer conversations

California Consumer Privacy Act (CCPA) Information (California Residents Only):
  • Sensitive Personal Info: MRIoA may collect sensitive personal info such as real name, nickname or alias, postal address, telephone number, email address, Social Security number, signature, online identifier, Internet Protocol address, driver's license number, or state identification card number, and passport number.
  • Data Access and Correction: Applicants can access their data and request corrections. For questions and/or requests to edit, delete, or correct data, please email the Medical Review Institute at HR@mrioa.com.

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