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Remote Utilization Review Rn Jobs in Moore, OK (NOW HIRING)

Varsity Tutors

NCLEX-PN Tutor

Oklahoma City, OK · Remote

$18 - $40/hr

... RN scope questions, pharmacology calculations, and managing anxiety with the adaptive testing format. Adapts instruction using NCLEX-PN specific practice question banks, content review focused on ...

Chloeta

Management Analyst

Oklahoma City, OK · On-site +1

$35 - $40/hr

... utilization, and program performance. Supervisory Responsibilities : No Job Classification ... Remote / Virtual Travel: Travel up to 50% Compensation: This pay band reflects Chloeta's good faith ...

micro1 AI

Pharmacovigilance Expert

Edmond, OK · Remote

$70 - $80/hr

Remote micro1 is engaging Pharmacovigilance Experts to contribute their advanced drug safety ... Author and review evaluation tasks based on DSURs, PSURs/PBRERs, and associated safety data and ...

micro1 AI

Pharmacovigilance Expert

Oklahoma City, OK · Remote

$70 - $80/hr

Remote micro1 is engaging Pharmacovigilance Experts to contribute their advanced drug safety ... Author and review evaluation tasks based on DSURs, PSURs/PBRERs, and associated safety data and ...

micro1 AI

Clinical Pharmacy Technicians

Edmond, OK · Remote

$70 - $80/hr

Remote micro1 is engaging Pharmacovigilance Experts to contribute their advanced drug safety ... Author and review evaluation tasks based on DSURs, PSURs/PBRERs, and associated safety data and ...

micro1 AI

Clinical Pharmacy Technicians

Norman, OK · Remote

$70 - $80/hr

Remote micro1 is engaging Pharmacovigilance Experts to contribute their advanced drug safety ... Author and review evaluation tasks based on DSURs, PSURs/PBRERs, and associated safety data and ...

micro1 AI

Pharmacovigilance Expert

Norman, OK · Remote

$70 - $80/hr

Remote micro1 is engaging Pharmacovigilance Experts to contribute their advanced drug safety ... Author and review evaluation tasks based on DSURs, PSURs/PBRERs, and associated safety data and ...

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All JobsUtilization Review Rn JobsRemote Utilization Review Rn JobsRemote Utilization Review Rn Jobs in Moore, OK

Remote Utilization Review Rn information

See Moore, OK salary details

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

As of Aug 22, 2026, the average hourly pay for remote utilization review rn in Moore, OK is $40.72, according to ZipRecruiter salary data. Most workers in this role earn between $32.16 and $46.78 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.

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For Remote Utilization Review Rn jobs in Moore, OK, the most frequently searched job titles are:

What job categories do people searching Remote Utilization Review Rn jobs in Moore, OK look for?

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What cities near Moore, OK are hiring for Remote Utilization Review Rn jobs?

Cities near Moore, OK 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 Moore, OK as of August 2026, with employment types broken down into 1% As Needed, 79% Full Time, 16% Part Time, 3% Contract, and 1% Nights. Highlights an 87% Physical, 4% Hybrid, and 9% Remote job distribution, with an average salary of $84,693 per year, or $40.7 per hour.

Manager, Appeals and Grievance (LPN) (51944)

GLOBALHEALTH HOLDINGS LLC

Oklahoma City, OK • On-site, Remote

$24 - $32.50/hr

Full-time

Medical

Re-posted 12 days ago

Job description

WHO WE ARE:
GlobalHealth is a fast-growing Medicare Advantage HMO health insurer. We aspire to be the employer of choice in our industry, attracting and retaining a highly talented workforce. Our passion is Genuine Care and Optimal Health for the members we serve. We are unique by providing high touch, high value and a partnership to our members. We go above and beyond to provide personalized, engaging, and responsive services to our members. We work hard to offer affordable health insurance coverage with the benefits people truly want and need. It is our hope to be more than just a health insurance company we want to be long-term partners with our members. We are looking for future employees who exude our core values of taking accountability through ownership, being driven, innovative and who have a passion for continuous learning.
WHO YOU ARE:
The successful candidate provides daily Clinical leadership and compliance of Appeals and Grievance. Identifying and executing opportunities to promote timeliness and resolution based on regulatory requirements.
ESSENTIAL JOB FUNCTIONS:
  • Schedule and balance available resources to match anticipated demand
  • Monitor and oversight of appeals and grievances process
  • Handle escalations for member issues
  • Manage employee time and attendance
  • Provide coaching and training of A&G team
  • Provide daily reporting for critical measures
  • Identify and execute on opportunities for improvement with workflow and structure
  • Manage daily workload for subordinates to ensure contractual and regulatory compliance
  • Perform hiring, coaching and disciplinary actions as required
  • Serve as primary Clinical representative and advocate for A&G issues and concerns in department leadership meetings
  • Must maintain confidentiality of business information, including Protected Health Information (PHI), as required by HIPAA and company policy.
  • Performs 1st round Quality of Care reviews
  • Performs other duties as assigned

EDUCATION:
  • Licensed Practical Nurse (LPN)
  • Associate degree or bachelor's

EXPERIENCE:
  • 3 years A&G Clinical operations experience required
  • 2 years appeals and grievances required
  • 1 year experience with one or more of the following: MS Office (+Power BI a plus), call center management and reporting applications (Mitel) or CRM applications (Epic) required
  • Familiarity with process analytics and continuous improvement methodologies (lean, six-sigma, EOS, TOC) preferred
  • Proven history of successful process design and implementation preferred
  • Medicare and/or NCQA experience preferred

KNOWLEDGE, SKILLS AND ABILITIES:
  • Exceptional prioritization and task management skills
  • Must be detail oriented and able to multitask, focusing on multiple cases at a time
  • Strong documentation skills are essential
  • Ability to perform essential job functions with high degree of independence, flexibility, and creative problem-solving techniques
  • Ability to thrive in a results-oriented environment
  • Naturally pushes to drive tasks to completion

WORK ENVIRONMENT:
Current work environment is remote; however, some state exclusions apply. Must have access to a reliable and secured internet connection source. Work environment must maintain confidentiality of business information, including Protected Health Information (PHI), as required by HIPAA and company policy. This position will also be required to use reasonable and necessary safeguards to protect GlobalHealth records from unauthorized access, disclosure or damage and will adhere to all GlobalHealth privacy and security policies.
TRAVEL:
Minimal travel expected (less than 5% in support of corporate initiatives)
MANAGER RESPONSIBILITY:
Supervises work of others, including planning, assigning, scheduling, and reviewing work, ensuring quality standards. Is responsible for hiring, terminating, training, and developing, reviewing performance and administering corrective action for staff. Plans organizational structure and job content.
OTHER DUTIES:
  • Must maintain confidentiality of business information, including Protected Health Information (PHI), as required by HIPAA and company policy.
  • Performs other duties as assigned.

This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

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