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Remote Utilization Review Rn Jobs in Saint Albans, WV

Vida Health

Nurse Practitioner

Charleston, WV · Remote

$70 - $75/hr

Vida's team of Obesity Medicine-Certified Physicians, Registered Dietitians, Expert Coaches and ... Reach out to members identified by remote monitoring protocols and, if needed, prescribe rescue ...

Karius

Director, Health Systems

Charleston, WV · Remote

$178K - $267K/yr

Remote Primary Responsibilities Account Growth & Expansion ● Consistently exceed performance ... ● Lead Business and Utilization Reviews with system executives, demonstrating clinical ...

RELX

Senior Director Sales Enablement

Charleston, WV · Remote

Senior Director, Sales Enablement (Remote-US) About our Team Clinical Solutions is a technology ... Nursing, Patient Engagement and Precision Medicine. Our products aim to optimize care delivery ...

ABB

Utility Sales Support

Charleston, WV · Remote

$17.75 - $23.25/hr

While this is a remote position, candidates must be located in the United States. You will be ... Must have knowledge and skill in utilization of computer databases; empower experience preferred

OneOncology

Medical Coding Specialist

Charleston, WV · Remote

The Medical Coding Specialist may also be assigned to audit physician, nurse practitioner and ... Performs E&M and CPT coding review and other projects related to physician coding compliance in ...

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All JobsUtilization Review Rn JobsRemote Utilization Review Rn JobsRemote Utilization Review Rn Jobs in Saint Albans, WV

Remote Utilization Review Rn information

See Saint Albans, WV salary details

$19

$38

$62

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

As of Aug 18, 2026, the average hourly pay for remote utilization review rn in Saint Albans, WV is $38.44, according to ZipRecruiter salary data. Most workers in this role earn between $30.38 and $44.13 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 Saint Albans, WV?

For Remote Utilization Review Rn jobs in Saint Albans, WV, the most frequently searched job titles are:

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The top searched job categories for Remote Utilization Review Rn jobs in Saint Albans, WV are:

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Cities near Saint Albans, WV with the most Remote Utilization Review Rn job openings:

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Infographic showing various Remote Utilization Review Rn job openings in Saint Albans, WV as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 14% Part Time, 3% Contract, and 1% Nights. Highlights an 88% Physical, 2% Hybrid, and 10% Remote job distribution, with an average salary of $79,953 per year, or $38.4 per hour.

Telehealth MD with Multi-state Licensure (contract)

Everlywell

Charleston, WV • Remote

Full-time

Re-posted 3 days ago

Job description

Everlywell is a digital health company pioneering the next generation of biomarker intelligence—combining AI-powered technology with human insight to deliver personalized, actionable health answers. We transform complex biomarker data into life-changing insights—seamlessly integrating advanced diagnostics, virtual care, and patient engagement to reshape how and where health happens.
Over the past decade, Everlywell has delivered close to 1 billion personalized health insights, transforming care for 60 million people and powering hundreds of enterprise partners. In 2025, an estimated 1 in 94 U.S. adults received an Everlywell test, solidifying our spot as the #1 at-home testing company in the country. Fueled by AI and built for scale, we’re breaking down barriers, closing care gaps, and unlocking a more connected healthcare experience that is smarter, faster, and more personalized.

PWN Remote Care Services, P.A. (PWN) is a telehealth practice facilitating access to high-quality, diagnostic-driven patient care. PWN is part of a provider network affiliated with Everlywell, a leading remote-based healthcare company. At PWN our mission is to enable access to diagnostic testing, treatment, and professional guidance that empowers individuals to improve their health. Our suite of services enables a broad spectrum of health industry clients to provide seamless access to diagnostic testing and related care interventions. We are a 50-state physician, registered nurse, and genetic counselor network with a strong care coordination and patient support team and technology infrastructure.
 
We are looking for a board-certified physician licensed in multiple states, who is passionate about expanding access to care by providing focused telehealth consultations to our patients.
Specific Needs:
  • The physician will use their expertise and clinical judgment to provide telehealth sessions to patients via phone and/or video for prescriptive and/or informational sessions.
  • The physician will adhere to the required state telemedicine regulatory guidelines.
  • The physician will use their expertise and clinical judgment to conduct comprehensive health assessments on patients as they deem appropriate.
  • The physician will use their expertise and clinical judgment to develop and implement treatment plans as they deem appropriate.
  • The physician will use their expertise and clinical judgment to educate patients and their families on health promotion, disease prevention, and self-care techniques.
Position Credential Requirements:
  • Medical licensure is in good standing in all active states.
  • Board Certified in internal medicine or family medicine.
  • Must be a physician in good standing in their medical practice (if applicable).
  • Physician must be enrolled and in good standing with Medicaid in the states in which the physician is physically located, multiple medicaid state enrollments a plus.
  • Physician must be enrolled and in good standing with Medicare.
  • Must be in compliance with HIPAA regulations and our privacy policies.
  • Participating providers must be board certified by an ABMS-recognized board.
  • Exceptional webside manner and ability to deliver high-quality patient care.
  • Ability to provide result interpretation, in addition to education, information and guidance on appropriate next steps in their care.
  • 1+ year of telehealth experience.
  • Must be tech savvy.
  • Able and willing to learn/adjust to changes in protocols and/or workflows
Medical Specialities:
  • Internal Medicine
  • Family Medicine
Benefits:
  • Flexible schedule
  • Professional Liability Insurance
Work Setting:
  • Remote
  • Telehealth
Security Notice: Everlywell never requests fees, payment, or banking information at any stage of the recruitment process. Official communications and interview invitations will only come from verified email addresses ending in @everlywell.com or @everlyhealth.com. To ensure your application is secure, always apply directly through our official careers page at https://www.everlywell.com/careers/.

We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.