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Remote Utilization Review Rn Jobs in Plymouth, MN

Scribe-X

Remote Medical Scribe

Minneapolis, MN · Remote

$14 - $17/hr

Anyone looking to begin a career in medicine (MD, DO, PA, NP, or RN) should consider becoming a ... Review completed charts with the provider between patients or at the completion of shift * Update ...

Scribe-X

Remote Medical Scribe

Saint Paul, MN · Remote

$14 - $17/hr

Anyone looking to begin a career in medicine (MD, DO, PA, NP, or RN) should consider becoming a ... Review completed charts with the provider between patients or at the completion of shift * Update ...

Optomec Inc

Support Manager

Saint Paul, MN · Remote

... utilization, CSAT). * Lead post-incident reviews for P1/P2 incidents and implement corrective ... Excellent remote customer-facing communication skills; experience managing escalations virtually.

Allianz

Underwriter Senior - Actuary | Remote

Minneapolis, MN · On-site +1

$102K - $121K/yr

... • Review contract terms to ensure risks are appropriately controlled • Conduct transaction ... Utilization of artificial intelligence tools and resources (e.g. generative AI). What you bring ...

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Remote Utilization Review Rn information

See Plymouth, MN salary details

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$44

$72

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

As of Sep 6, 2026, the average hourly pay for remote utilization review rn in Plymouth, MN is $44.63, according to ZipRecruiter salary data. Most workers in this role earn between $35.29 and $51.25 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 Plymouth, MN?

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

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

The top searched job categories for Remote Utilization Review Rn jobs in Plymouth, MN are:

What cities near Plymouth, MN are hiring for Remote Utilization Review Rn jobs?

Cities near Plymouth, MN 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 Plymouth, MN as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 18% Part Time, 1% Temporary, and 2% Contract. Highlights an 88% Physical, 3% Hybrid, and 9% Remote job distribution, with an average salary of $92,822 per year, or $44.6 per hour.

Care Manager- LTC Claims RN or LSW

illumifin

Eden Prairie, MN • On-site, Remote

$60K/yr

Full-time

Posted 2 days ago

New

Illumifin rating

8.1

Company rating: 8.1 out of 10

Based on 21 frontline employees who took The Breakroom Quiz

113th of 247 rated software companies

Job description

The nation's leading administrator of long term care insurance services is looking for YOU. This is your opportunity to join a company with a culture that promotes respect for people, integrity, learning and initiative.
WE ARE THE KIND OF EMPLOYER YOU DESERVE.
LTCG is a leading provider of business process outsourcing for the insurance industry, managing over 1.3 million long-term care policies for the nation's largest insurers. We also provide clients with unique risk management insight built upon our proprietary long term care databases.
This position is responsible for gathering and reviewing requirements for the purpose of determining initial and ongoing claimant and provider eligibility.
RESPONSIBILITIES
1. Assess claimant eligibility by reviewing medical records from all current providers and conducting phone assessments with the claimant or legal representative. In the event of noted inconsistencies in the claimant eligibility, coordinate a benefit eligibility assessment in order to make a final determination.
2. In conjunction with plan language upon initial assessment and ongoing recertification, determine legitimacy and eligibility of service providers by requesting and reviewing provider licensing credentials, state-specific regulations, internet searches and phone assessments with the servicing provider.
3. Effectively communicate, verbal and written, all aspects of the claim benefit determination process.
4. Assist claimants with modifications to their current care plan, including changes in care needs as well as changes in provider.
5. Monitor daily, weekly and monthly reports to ensure claims are handled timely and appropriately.
6. Attend case conferences, internally and with the client, to present claims recommendations.
7. Meet quality and production metrics as established and communicated by the department.
8. Reviews Care Coordinator decision recommendations on tax qualified policies.
9. Other duties as assigned.
Minimum Qualifications
* RN Nursing or Social Work license.
* 3 years work experience with older adult population.
* Intermediate level experience with Microsoft Office products.
* Required to uphold the principles of compliance as outlined in the Code of Conduct, Employee Handbook and related policies and procedures. Supports and participates in the mandatory Corporate Compliance Program training initiative on an annual or more frequent basis, as required.
Preferred Qualifications
* Care planning experience preferred.
* Experience with insurance contract interpretation preferred.
* Excellent verbal and written communication skills.
* Lead Level: minimum of one year experience with Long Term Care Insurance Care Management
The annual compensation target is at $60,000 depending on experience and qualifications

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