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Remote Utilization Review Rn Jobs in Oregon City, OR

Varsity Tutors

NCLEX-RN Tutor

Portland, OR · 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 ...

Adventist Health

Field RN (Hospice) Full Time

Portland, OR · On-site +1

$43.98 - $65.91/hr

Registered Nurse (RN) licensure in the state of practice: Required * Cardiopulmonary Resuscitation ... Participates in interdisciplinary team meetings to review and revise care plans. * Ensures timely ...

Children's Clinic PC

Advice RN

Tualatin, OR · Remote

JOB SUMMARY The Advice RN provides clinical & administrative support to clinicians & other health ... Implement and monitor quality assurance measures for advice services, conducting regular reviews of ...

Argenx

Nurse Case Manager, Oregon

Portland, OR · Remote

Review and educate the patients and/or caregivers on financial assistance programs that they may be ... Current RN License in good standing * Bachelor's degree required * 5+ years of clinical experience ...

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All JobsUtilization Review Rn JobsRemote Utilization Review Rn JobsRemote Utilization Review Rn Jobs in Oregon City, OR

Remote Utilization Review Rn information

See Oregon City, OR salary details

$22

$45

$73

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

As of Aug 9, 2026, the average hourly pay for remote utilization review rn in Oregon City, OR is $45.25, according to ZipRecruiter salary data. Most workers in this role earn between $35.77 and $51.97 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 popular job titles related to Remote Utilization Review Rn jobs in Oregon City, OR? For Remote Utilization Review Rn jobs in Oregon City, OR, the most frequently searched job titles are:
What cities near Oregon City, OR are hiring for Remote Utilization Review Rn jobs? Cities near Oregon City, OR 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 Oregon City, OR as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution, with an average salary of $94,110 per year, or $45.2 per hour.

Registered Nurse Quality Assurance - Temporary RN

CareOregon

Portland, OR • On-site, Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 4 days ago

CareOregon rating

8.3

Company rating: 8.3 out of 10

Based on 9 frontline employees who took The Breakroom Quiz

127th of 304 rated insurance

Job description

Registered Nurse Quality Assurance - Temporary RN
The Registered Nurse - Quality Assurance - Outreach's main function is to work with the HEDIS Manager to perform telephonic outreach in support of HEDIS and Stars work, with the possibility of cross training for HEDIS chart abstraction.
Estimated Hiring Range:
$102,330.00 - $125,070.00
Bonus Target:
Bonus - SIP Target, 5% Annual
Current CareOregon Employees: Please use the internal Workday site to submit an application for this job.
Essential Responsibilities
  • Outreach to members in support of Stars measure gap closure and re-engagement.
  • Use evidence-based approaches to patient education regarding engagement and recommended health screenings.
  • Utilize a trauma-informed approach to provide member-centric support.
  • Assist in helping members move through the continuum of care based on clinical/medical need.
  • Make referrals to community partners as appropriate.
  • Complete chart reviews for regulatory and quality improvement projects as assigned.
  • Use various EMR systems, or PDF files to complete chart abstractions and enter data into a HEDIS specialized or other software.
  • Maintain a 95% accuracy rate in abstractions and data entry, validated through peer over-reads.
  • Communicate in a collaborative and professional manner with the CareOregon clinics, team members, and other CareOregon staff.
  • Complete and successfully pass yearly and on-going HEDIS training and testing, as required, to maintain up-to-date knowledge of HEDIS and other quality improvement measurement requirements for performing chart abstractions.
  • Participate in other projects, as assigned.

Organizational Responsibilities
Perform work in alignment with the organization's mission, vision and values.
  • Support the organization's commitment to equity, diversity and inclusion by fostering a culture of open mindedness, cultural awareness, compassion and respect for all individuals.
  • Strive to meet annual business goals in support of the organization's strategic goals.
  • Adhere to the organization's policies, procedures and other relevant compliance needs.
  • Perform other duties as needed.

Experience and/or Education
Required
  • Current unrestricted license as a Registered Nurse in the State of Oregon
  • Minimum 3 years' experience as an RN in the healthcare industry

Preferred
  • Bachelor's degree in Nursing
  • Knowledge or understanding of HEDIS and previous chart abstraction experience
  • Prior primary care and/or specialty clinic practice experience
  • RN experience with quality improvement, population health and/or case management

Knowledge, Skills and Abilities Required
Knowledge
  • Knowledge of or desire to learn about current clinical practices specifically chronic diseases and guidelines for health screenings and health maintenance

Skills and Abilities
  • Ability to utilize a trauma-informed approach to provide member-centric support.
  • Ability to efficiently glean clinical information from a medical record, accurately document in the HEDIS or other specialized software, and save supporting documentation as instructed
  • Eagerness to sometimes search for the data equivalent of a needle in the haystack and also ability to move on if it is not found
  • Critical thinking skills
  • Strong attention to detail
  • Competency with computers and software programs, e.g. PDF, MS Outlook, Word, Excel, EMR systems
  • Ability to learn and adapt to new EMR systems, software programs, specification changes and deadlines
  • Ability to maintain strict confidentiality of protected health information
  • Awareness of the social determinants of health impacting CareOregon members and approaching interactions with clinics, members or CareOregon embedded staff with kindness and friendliness
  • Ability to work in an environment with diverse individuals and groups
  • Have a high degree of initiative and motivation along with ability to effectively collaborate and plan with co-workers and others
  • Ability to manage multiple tasks and flexibility to switch tasks as needed
  • Act professionally at all times when representing CareOregon
  • Ability to work under pressure and help the team meet deadlines for regulatory deliverables
  • Good written and verbal communication skills
  • Ability to prioritize work in a remote environment
  • Ability to work effectively with diverse individuals and groups
  • Ability to learn, focus, understand, and evaluate information and determine appropriate actions
  • Ability to accept direction and feedback, as well as tolerate and manage stress
  • Ability to see, read, and perform repetitive finger and wrist movement for at least 6 hours/day
  • Ability to stand and sit for at least 3-6 hours/day
  • Ability to speak clearly, bend, lift, carry, push, pull, and/or pinch small objects for at least 1-3 hours/day

Working Conditions
Work Environment(s): ☒ Indoor/Office ☐ Community ☐ Facilities/Security ☐ Outdoor Exposure
Member/Patient Facing: ☒ No ☐ Telephonic ☐ In Person
Hazards: May include, but not limited to, physical and ergonomic hazards.
Equipment: General office equipment and/or mobile technology
Travel: May include occasional required or optional travel outside of the workplace; the employee's personal vehicle, local transit or other means of transportation may be used.
Work Location: Work from home
We offer a strong Total Rewards Program. This includes competitive pay, bonus opportunity, and a comprehensive benefits package. Eligibility for bonuses and benefits is dependent on factors such as the position type and the number of scheduled weekly hours. Benefits-eligible employees qualify for benefits beginning on the first of the month on or after their start date. CareOregon offers medical, dental, vision, life, AD&D, and disability insurance, as well as health savings account, flexible spending account(s), lifestyle spending account, employee assistance program, wellness program, discounts, and multiple supplemental benefits (e.g., voluntary life, critical illness, accident, hospital indemnity, identity theft protection, pre-tax parking, pet insurance, 529 College Savings, etc.). We also offer a strong retirement plan with employer contributions. Benefits-eligible employees accrue PTO and Paid State Sick Time based on hours worked/scheduled hours and the primary work state. Employees may also receive paid holidays, volunteer time, jury duty, bereavement leave, and more, depending on eligibility. Non-benefits eligible employees can enjoy 401(k) contributions, Paid State Sick Time, wellness and employee assistance program benefits, and other perks. Please contact your recruiter for more information.
We are an equal opportunity employer
CareOregon is an equal opportunity employer. The organization selects the best individual for the job based upon job related qualifications, regardless of race, color, religion, sexual orientation, national origin, gender, gender identity, gender expression, genetic information, age, veteran status, ancestry, marital status or disability. The organization will make a reasonable accommodation to known physical or mental limitations of a qualified applicant or employee with a disability unless the accommodation will impose an undue hardship on the operation of our organization.

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