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Remote Utilization Review Rn Jobs in Pomona, CA (NOW HIRING)

Astrana Health, Inc.

Care Manager I - RN

Monterey Park, CA · On-site +1

$78K - $91K/yr

At least two (2) years' experience in utilization management including experience applying ... This is a remote position. The home office is located at 1600 Corporate Center Dr., Monterey Park ...

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All JobsUtilization Review Rn JobsRemote Utilization Review Rn JobsRemote Utilization Review Rn Jobs in Pomona, CA

Remote Utilization Review Rn information

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$42

$69

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

As of Aug 12, 2026, the average hourly pay for remote utilization review rn in Pomona, CA is $42.46, according to ZipRecruiter salary data. Most workers in this role earn between $33.56 and $48.75 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 Pomona, CA? For Remote Utilization Review Rn jobs in Pomona, CA, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review Rn jobs in Pomona, CA look for? The top searched job categories for Remote Utilization Review Rn jobs in Pomona, CA are:
What cities near Pomona, CA are hiring for Remote Utilization Review Rn jobs? Cities near Pomona, CA 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 Pomona, CA as of August 2026, with employment types broken down into 1% As Needed, 79% Full Time, 17% Part Time, and 3% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $88,312 per year, or $42.5 per hour.

Chronic Care Management LVN - REMOTE (California License Required)

Orb Health, Inc.

Los Angeles, CA • On-site, Remote

$25/hr

Full-time

Re-posted 18 days ago

Job description

*FULL TIME REMOTE POSITION* $25hr
Who We Are:
Orb Health's Enterprise Virtual Care™ enables the high-performance delivery of Chronic Care, Patient Support, and Outbound Campaigns as a virtual extension of the health system or center without requiring additional staff, applications, or office space. Orb Health's mission is to empower a new healthcare paradigm where integrated virtual care creates the economies of scale necessary to drive effective and proactive patient engagement that maximizes outcomes and wellbeing over time while lowering the cost curve of healthcare.
About the Opportunity:
Orb Health in Richardson, Texas is currently seeking a licensed LVN, LPN, or RN to join their growing remote staff as a new Care Management Nurse. In this role the Care Management (LVN, LPN, or RN) will be responsible for providing telephonic care management services to identified chronic patients under direction of the patient's healthcare provider.
Responsibilities:
The Care Management Nurse (LVN, LPN, or RN) will:
• Cooperatively develop an integrate patient centered care plan and goals with the client/family and other providers.
• Work collaboratively with team members to provide outreach and engagement with the patient.
• Provide patient assistance through advocacy to client and family for entitlements and other community services.
• Work closely with in-office providers/staff members to manage day to day calls with enrolled patients involving symptom control, medication management, patient and family education, health maintenance reminders, medication refills, referral coordination, etc.
• Receive and respond to telephone calls from patients. Triaging and providing medical guidance as instructed by the patient's provider.
• Documents calls according to established guidelines.
• Connects patient's care team together with updated information as received.
• Participates in education & in-service programs.
• Performs on call for clinic that you are assigned to.
Required Qualifications:
• Minimum of 1-2 Years of experience in a clinical or telehealth setting.
• Ability to work full-time (40 hours minimum)
• Demonstrates progressive proficiency with the utilization of available computer technology, including typing skills.
• 60 + WPM typing • Demonstrated customer service, leadership, communication, interpersonal and problem-solving skills, required.
• Ability to plug computer directly into internet router.
• High speed internet Education and Certifications:
• Graduate from an accredited School of Nursing.
• Current license to practice as an LVN/LPN/RN with compact license. Physical Requirements:
• Ability to sit and work in front of a computer for long periods of time.
• Ability to speak on the phone for long periods. Nice to Have:
• Bilingual in Spanish • Experience working with the adult population.
• Experience working as telecommuter or call center setting.
• Experience in clinical telephone triage
• Experience working with Electronic Health Record (EHR) Diversity creates a healthier atmosphere:
Orb Health is an Equal Employment Opportunity/Affirmative Action employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. Orb Health is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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