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Remote Utilization Review Rn Jobs in Oak Creek, WI

TEEMA Group

Registered Nurse - RN

West Allis, WI · Remote

$50 - $56/hr

We are seeking a dedicated Registered Nurse for a full-time position providing home health and ... Perform continuous record reviews to ensure regulatory compliance, quality service delivery, and ...

MDS Solutions

REMOTE MDS Coordinator

Milwaukee, WI · Remote

$33.75 - $43/hr

This role requires a RN license, LPN will not meet the minimum qualifications. What do we offer you ... Review and verify MDS documentation and charting requirements to support the clinical services ...

MDS Solutions

REMOTE MDS Coordinator

Milwaukee, WI · On-site +1

$33.75 - $43/hr

This role requires a RN license, LPN will not meet the minimum qualifications. What do we offer you ... Review and verify MDS documentation and charting requirements to support the clinical services ...

MDS Solutions

REMOTE MDS Coordinator

Milwaukee, WI · On-site +1

$33.75 - $43/hr

This role requires a RN license, LPN will not meet the minimum qualifications. What do we offer you ... Review and verify MDS documentation and charting requirements to support the clinical services ...

Varsity Tutors

NCLEX-RN Tutor

Milwaukee, WI · 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 ...

Ascension

Registered Nurse Transfer Center

Lannon, WI · On-site +1

$40.41 - $57.05/hr

Remote - Must be within 1 hour of Milwaukee, WI Department: Transfer Center Schedule: Mid shift ... Registered Nurse obtained prior to hire date or job transfer date required. * BLS Provider ...

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Remote Utilization Review Rn information

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$40

$65

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

As of Sep 1, 2026, the average hourly pay for remote utilization review rn in Oak Creek, WI is $40.34, according to ZipRecruiter salary data. Most workers in this role earn between $31.88 and $46.35 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 popular job titles related to Remote Utilization Review Rn jobs in Oak Creek, WI?

For Remote Utilization Review Rn jobs in Oak Creek, WI, the most frequently searched job titles are:

What job categories do people searching Remote Utilization Review Rn jobs in Oak Creek, WI look for?

The top searched job categories for Remote Utilization Review Rn jobs in Oak Creek, WI are:

What cities near Oak Creek, WI are hiring for Remote Utilization Review Rn jobs?

Cities near Oak Creek, WI 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 Oak Creek, WI as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 15% Part Time, 2% Contract, and 2% Nights. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution, with an average salary of $83,904 per year, or $40.3 per hour.

ProHealth Care - Remote Patient Monitoring 0.5 FTE ( Hybrid role )

ProHealth Care, Inc.

Waukesha, WI • On-site, Remote

Full-time, Part-time

Retirement, PTO

Posted 17 days ago

ProHealth Care rating

7.2

Company rating: 7.2 out of 10

Based on 66 frontline employees who took The Breakroom Quiz

347th of 898 rated healthcare providers

Job description

What You Will Do:
This is NOT a remote position and the candidate chosen for this role will need to be able to work on site in Waukesha, WI.
The Remote Patient Monitoring (RPM) RN will assess patient generated data provided via digital technology to manage the care of the acute and chronically ill patient. The RPM RN will provide individualized patient assessment, patient education, medication management, goal setting and clinical care planning. In collaboration with physicians and care team members, RPM nurses will educate and support self-management of medical conditions in the home environment using motivational communication techniques and positive reinforcement to changes. The RPM enrolled patient will submit vital signs and symptoms that the RN will rapidly interpret addressing patient needs, objectives and goals to improve clinical outcomes and patient experience. The RN will draw on clinical expertise for short and long-term health management goals for primary and specialty care. The RN will remotely monitor all data and respond to alerts efficiently and effectively, escalating care to patient's primary or specialty provider. Early detection and intervention for adverse health trends may decrease acute care utilization, emergency department visits and hospital admissions and readmissions. The nurse will build a long-term relationship with their panel of patients through regular communication, so they may become trusted members of the care team.
Additional Requirements:
  • Graduate from an Accredited School of Nursing. Bachelor's degree in Nursing preferred.
  • 1-2 years' experience working in hospital and or ambulatory care setting working with patients with chronic diseases.
  • Previous experience in remote patient monitoring highly desirable. Experience in working in an electronic medical record and care management system. Technological experience as primary healthcare delivery system. Epic experience.
  • Additional Requirements
  • Strong technological aptitude with the ability to quickly learn and adapt to new software and tools.

Why Join ProHealth Care:
We have nearly 5,000 dedicated clinical and non-clinical employees and physicians who work together every day to serve the health and well-being of our community. At ProHealth Care everyone contributes to the care our patients receive. And, everyone is treated with kindness and respect in our welcoming environment.
This Position Will Offer You:
  • Engaging and community focused culture
  • Competitive Salaries
  • Opportunity for professional career growth
  • Robust benefits for full-time and regular part-time roles, including Generous PTO; Choices in insurance; HSA; Tuition reimbursement; immediate 401K match; discounted tickets to various entertainment, social, and sporting events

ProHealth Care is an equal opportunity employer and is committed to an inclusive work environment and values the perspectives of our people. We maintain a drug-free workplace and perform pre-employment substance abuse testing. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability.

What ProHealth Care employees say

Pay

Benefits

Hours and flexibility

Workplace

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About ProHealth Care

Sourced by ZipRecruiter

ProHealth Care has been the health care leader in Waukesha County and surrounding areas providing outstanding care across a full spectrum of services. The people of ProHealth Care strive to continuously improve the health and well-being of the community by combining skill, compassion and innovation. ProHealth Care supports a Just Culture, one that encourages an open learning environment and maintaining safe systems. The ProHealth family includes Waukesha Memorial Hospital, Oconomowoc Memorial Hospital, the Rehabilitation Hospital of Wisconsin, ProHealth Medical Group clinics, AngelsGrace Hospice, ProHealth Home Care & Hospice, West Wood Health & Fitness Center and Regency Senior Communities.

Industry

Health care and social assistance

Company size

1,001 - 5,000 Employees

Headquarters location

Oconomowoc, WI, US

Year founded

1914

Social media

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