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Remote Utilization Review Rn Jobs in Louisville, KY

Nurseline triage, Call Center Utilization Management, Call Center Case Management, a plus. * Case ... Remote work eligibility is subject to all work from home criteria met and based on business need.

NCLEX-RN Tutor

Louisville, KY ยท Remote

$18 - $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 ...

Telehealth Nurse - Remote

Louisville, KY ยท Remote

$32 - $34/hr

Maintain active nursing licensure (LPN or RN) Minimum Qualifications Education & Licensure Vocational/technical nursing training required Active RN or LPN license (must be maintained throughout ...

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Remote Utilization Review Rn information

See Louisville, KY salary details

$20

$40

$66

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

As of Aug 21, 2026, the average hourly pay for remote utilization review rn in Louisville, KY is $40.61, according to ZipRecruiter salary data. Most workers in this role earn between $32.12 and $46.63 per hour, depending on experience, location, and employer.

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 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 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 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 the most commonly searched types of Utilization Review Rn jobs in Louisville, KY?

The most popular types of Utilization Review Rn jobs in Louisville, KY are:

What cities near Louisville, KY are hiring for Remote Utilization Review Rn jobs?

Cities near Louisville, KY with the most Remote Utilization Review Rn job openings:

Infographic showing various Remote Utilization Review Rn job openings in Louisville, KY as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 14% Part Time, 3% Contract, and 1% Nights. Highlights an 90% Physical, 3% Hybrid, and 7% Remote job distribution, with an average salary of $84,470 per year, or $40.6 per hour.

Tele-Triage Registered Nurse - RN

Starting Point Nursing Services

Louisville, KY โ€ข On-site, Remote

$33 - $35/hr

Full-time

Posted 16 days ago


Job description

Our Company

Starting Point Nursing Services

Overview

Full Time Tele-Triage (Fully Remote) Registered Nurse Position:

*Must have compact state RN licensure from the state in which you currently reside

*Remote Triage & Home Health RN experience highly preferred

*Potential Start Date:ย  9/14/26

New Available FULL TIME Schedule:

* Tuesday, Wednesday, Thursday 2p-10p CST (3p-11p EST) & Friday 11a-7p CST (12p-8p EST) & Saturday 8a-4p CST (9a-5p EST)

This Registered Nurse provides On-Call and Triage for the assigned population in accordance with triage protocols. This position remotely develops/implements care plans for persons served in the area of responsibility. The Tele-Triage RN assesses health status, identifies problems and needs of person(s) served in their assigned caseload, develops nursing care plans in collaboration with operations RN's. You will complete chart reviews and monthly host home reviews and perform On-Bound calling to assigned populations/locations. This RN performs data analysis in multiple systems.

Responsibilities
  • Monitor assigned phone lines during service hours to ensure timely response for caller needs
  • Triage all symptom-based calls and give recommendations according to the approved triage protocol
  • Triage patients by assessing severity of symptoms and referral to appropriate setting or level of care
  • Document in real time all care related recommendations and ensure local operations are notified of triage supports and outcomes
  • Initiate contact with acute care setting to coordinate services for clients receiving care in the ED/Hospital and coordinate the discharge planning; Notify operations of triage recommendations
  • Coordinate any medication orders with the assigned pharmacy and update MAR/QuickMar for appropriate administration
  • Work assigned prior authorizations to ensure timely documentation and submit to assigned pharmacy for billing
  • Complete/conduct assessment and reassessment of persons served as assigned
  • Develop/update care plans and determine persons served needs and secure physicians orders as needed
  • Communicate with beneficiaries primarily phone, text, online (web) chat, or email
  • Ensure compliance with state/local/payer requirements through review of documentation
  • Provide coaching and education related to the health and well-being of persons served
  • Participate in performance improvement activities and maintain ongoing clinical knowledge through internal/external training programs
  • Document above actions in Nurse's Notes or Service Delivery Log
  • Maintain time sheet log for weekly submission for productivity management to assigned supervisor
  • Notify each practice, physician, and/or managed care client of all encounters with patients, parents, or managed care clients regardless of follow-up needs before office opening
  • Notify designated leadership of operational concerns
  • Actively participate in applicable meetings and committees as requested (e.g., IDT, HRC, Safety/Quality committee, and annual person served directed/active treatment plan meetings)
Qualifications
  • Degree/certification from an accredited school of nursing
  • Current licensure as a Registered Nurse (RN) in the state of practice, which is current and remains in good standing. Must have a compact state RN license.
  • Clinical experience in providing services and supports to individuals with intellectual and developmental disabilities, home health and Hospice patients or related disorders
  • Two year Home Health nursing experience
About our Line of BusinessStarting Point Nursing Services, an affiliate of BrightSpring Health Services, is staffed 100% by a team of remote registered nurses trained to support the post-acute continuum with clinical advice and interventions. Our 24/7 On-Call and Triage team responds to physician practices, home health agencies, intellectual disability providers, and assisted living providers. Our services are tailored to our partners, including remote physical/chart assessments, predictive care modeling, clinical programming interventions for high-risk populations, emergent care coordination, and case management. For more information, please visit www.startingpointnursing.com. Follow us on LinkedIn.Salary RangeUSD $33.00 - $35.00 / HourEmployment Type: FULL_TIME