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Remote Utilization Review Rn Jobs in Saint Charles, MO

Workforce Connections

Denials Specialist

Saint Louis, MO · Remote

$23/hr

... reviews. This fully remote role supports utilization management by ensuring denial and approval letters are completed accurately, on time, and in compliance with regulatory requirements. The ideal ...

St. Louis County, MO

Public Health Nurse

Saint Louis, MO · On-site +1

$27.37 - $30/hr

North Central Community Health Center - St Louis County, MO, MO Job Type: Full-Time Remote ... Requires licensure as a Registered Nurse by the State of Missouri * Cardiopulmonary Resuscitation ...

Workforce Connections

Denial Specialist

Saint Louis, MO · Remote

$22/hr

Denials Specialist (Remote) Pay Rate: $22.47/hour Assignment Length: 6-12 months (with potential to ... Experience with denials, appeals, or utilization management * Background as a CNA, CMA, Radiology ...

ComForCare

Assistant & Research Intern

MO · On-site +1

Is an experienced clinician or student, a registered nurse, or holds an associates degree or the ... This is a remote position. Live your best life possible while helping others live theirs Our ...

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All JobsUtilization Review Rn JobsRemote Utilization Review Rn JobsRemote Utilization Review Rn Jobs in Saint Charles, MO

Remote Utilization Review Rn information

See Saint Charles, MO salary details

$20

$39

$64

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 Saint Charles, MO is $39.81, according to ZipRecruiter salary data. Most workers in this role earn between $31.44 and $45.72 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 Saint Charles, MO? For Remote Utilization Review Rn jobs in Saint Charles, MO, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review Rn jobs in Saint Charles, MO look for? The top searched job categories for Remote Utilization Review Rn jobs in Saint Charles, MO are:
What cities near Saint Charles, MO are hiring for Remote Utilization Review Rn jobs? Cities near Saint Charles, MO 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 Saint Charles, MO as of August 2026, with employment types broken down into 1% As Needed, 79% Full Time, 16% Part Time, 1% Temporary, and 3% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $82,812 per year, or $39.8 per hour.

Senior Product Manager

Krest Global Solutions

Saint Louis, MO • On-site, Remote

$50 - $60/hr

Contractor

Re-posted 12 days ago

Job description

Job Title: Senior Product Manager

Location : Hybrid

Compensation : 50-60$/Hr on C2C/1099

Work Authorization: GC, USC

Position Summary

We are seeking a seasoned Senior Product Manager to lead the strategic migration of our legacy contact center platforms (e.g., Avaya) to Amazon Connect, with a specific focus on healthcare payer operations. This role will be responsible for delivering scalable, cloud-native, and intelligent contact center solutions that enhance member and provider engagement, improve operational efficiency, and ensure compliance with healthcare industry standards.

The ideal candidate will have a strong background in healthcare payer environments, deep experience with contact center technologies, and a proven ability to drive digital transformation initiatives in regulated industries.

Key Responsibilities

· Lead the end-to-end migration of legacy contact center systems (e.g., Avaya, Cisco) to Amazon Connect, from discovery and planning through execution and rollout.

· Define and execute the product strategy and roadmap for contact center modernization, aligning with enterprise goals, user needs, and compliance requirements.

· Collaborate with IT, telephony/voice infrastructure teams, business operations, clinical teams, and customer service leadership to define functional and technical requirements.

· Serve as the primary voice of the customer (members, providers, internal users) in developing contact center features, IVR flows, routing logic, and integration with downstream systems (e.g., CRMs, case management tools, claims systems).

· Evaluate and optimize customer journeys across voice and digital channels (chat, SMS, email), ensuring seamless and empathetic support experiences.

· Leverage AWS ecosystem tools (e.g., Lex, Lambda, Connect Flows, Contact Lens) to enable smart routing, automation, sentiment analysis, and real-time analytics.

· Develop and track key KPIs and performance metrics (e.g., average handle time, NPS, first call resolution, abandonment rates) to ensure quality and efficiency.

· Own vendor relationships, contracting, and governance for telephony, transcription, workforce management, and analytics tools.

· Champion agile methodologies, backlog prioritization, and sprint execution across cross-functional teams.

· Drive change management, training, and adoption strategies across operational teams to ensure successful platform transition.

Required Qualifications

· 7+ years of product management experience, with at least 3 years leading initiatives in contact center platforms or voice automation within a healthcare payer setting.

· Strong understanding of healthcare call center operations, including member services, provider support, care management, and utilization review.

· Proven experience with Amazon Connect migration projects, including integration with AWS services, telephony architecture, and IVR design.

· Solid knowledge of HIPAA, PHI handling, and security best practices in cloud communications.

· Experience with voice UX, IVR design, and contact center reporting/analytics.

· Strong business and technical acumen with the ability to translate complex requirements into clear user stories and product features.

· Demonstrated success influencing cross-functional teams, executive stakeholders, and vendor partners.

· Expertise in agile frameworks, especially SAFe or Scrum, and tools like JIRA, Confluence, and Productboard. Education

· Bachelor’s degree in Computer Science, Information Systems, Healthcare Administration, or related field required.

· Master’s degree or certifications in Product Management, Cloud Technologies (especially AWS), or Healthcare IT preferred.

Preferred Experience

· Direct experience with Amazon Connect, Avaya, Genesys, or Cisco telephony platforms and their migration to cloud-based environments.

· Knowledge of CRM platforms (e.g., Salesforce, ServiceNow) and their integration into contact center ecosystems.

· Experience designing omnichannel strategies across voice, chat, and digital self-service.

· Familiarity with workforce management tools and quality assurance processes for contact centers.

· Experience managing cross-market rollouts in multi-state health plans or Blue Cross organizations.

Job Type: Full-Time Location: US (Remote/Hybrid – Preferred locations: Brillio Offices or St. Louis, MO) Industry: Healthcare / Health Insurance / Digital Transformation / Cloud Contact Centers