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Remote Utilization Review Rn Jobs in Springfield, OR

Varsity Tutors

NCLEX-RN Tutor

Eugene, OR · Remote

$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 ...

DataAnnotation

RN

Eugene, OR · Remote

$40 - $60/hr

Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...

DataAnnotation

Registered Nurse

Eugene, OR · Remote

$40 - $60/hr

Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...

Varsity Tutors

NCLEX-PN Tutor

Eugene, OR · Remote

$40/hr

... RN scope questions, pharmacology calculations, and managing anxiety with the adaptive testing format. Adapts instruction using NCLEX-PN specific practice question banks, content review focused on ...

Varsity Tutors

NCLEX Tutor

Eugene, OR · Remote

$40/hr

Adapts instruction using NCLEX review resources, practice question banks, and clinical scenario analysis to support nursing graduates preparing for first-time licensure as registered nurses or ...

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Remote Utilization Review Rn information

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

As of Jun 11, 2026, the average hourly pay for remote utilization review rn in Springfield, OR is $42.88, according to ZipRecruiter salary data. Most workers in this role earn between $33.89 and $49.23 per hour, depending on experience, location, and employer.

What is the meaning of the word remote?

In the context of a Remote Utilization Review RN job, 'remote' refers to working outside of a traditional office setting, often from home or another location of the employee's choice. This setup typically involves using digital tools and communication platforms to perform job duties without being physically present in an office environment.

What are the key skills and qualifications needed to thrive as a Remote Utilization Review RN, and why are they important?

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 meaning of remote in one word?

In the context of a Remote Utilization Review RN role, 'remote' means working from a location outside of a traditional office, typically from home, using digital communication tools. It emphasizes flexibility and virtual access to work systems without physical presence at a healthcare facility.

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.

How to make 2000 a week working from home?

A Remote Utilization Review RN can potentially earn $2,000 weekly by working full-time hours, often 40 hours per week, and gaining experience or certifications that allow for higher billing rates. Increasing income may involve taking on additional cases, specializing in high-demand areas, or working for agencies that offer competitive pay for remote utilization review roles.

What is remote job?

A remote Utilization Review RN job is a healthcare position where the nurse reviews patient cases and insurance claims from a location outside of a traditional office, often working from home. It requires strong communication skills, knowledge of medical documentation, and familiarity with electronic health record systems, with flexible schedules common in remote roles.

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 Springfield, OR? For Remote Utilization Review Rn jobs in Springfield, OR, the most frequently searched job titles are:
What cities near Springfield, OR are hiring for Remote Utilization Review Rn jobs? Cities near Springfield, OR with the most Remote Utilization Review Rn job openings:
Remote Utilization Review Rn jobs near you
Utilization Management Program Manager-RN

Utilization Management Program Manager-RN

Samaritan Health Services

Eugene, OR • Remote

Full-time

Posted 3 days ago

Samaritan Health Services rating

7.3

Company rating: 7.3 out of 10

Based on 62 frontline employees who took The Breakroom Quiz

292nd of 870 rated healthcare providers

Job description

Summary

  • Samaritan Health Plans (SHP) provides health insurance options to Samaritan employees, community employers, and Medicare and Medicaid members. SHP operates a portfolio of health plan products under several different legal structures: InterCommunityHealth Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage, Commercial Large Group, and Commercial Large Group PPO and EPO plans.

    As part of an Integrated Delivery System, Samaritan Health Plans is strategically and operationally aligned with Samaritan Health Services' mission of Building Healthier Communities Together.

    This is a remote position in which we are able to employ in the following states: Arizona, Arkansas, Connecticut, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, Oregon, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, or Wisconsin

    Our ideal candidate will have the following experience:

    • Health plan utilization management
    • Medicare and Medicaid rules and regulations and health plan benefit structure and policy.
    • Data analysis to include reporting results and developing improvement plans
    • Quality Management experience in a healthcare setting
  • JOB SUMMARY/PURPOSE
    • Executes program(s) that meet the needs of the organization, employees and/or customers. Plans, initiates, oversees execution of all elements for assigned program(s). Leads the development, implementation and management of assigned program(s) and associated projects. Oversees process from planning to completion. Works with multiple internal teams, vendors, clients. Responsible for explaining, training, and mentoring the entire organization on the program. Collaborates with SHS system experts to ensure focus, alignment, and best practices for the program.
  • EXPERIENCE/EDUCATION/QUALIFICATIONS
    • Current unencumbered Oregon RN License required within 90 days of hire. BSN preferred. Master's degree in a related field preferred.
    • One (1) year clinical nursing experience plus four (4) years health plan utilization management experience required.
    • Experience or training in the following required:
      • Health care delivery systems and/or managed care patients.
      • Computer applications including electronic documentation (e.g., MS Office, EPIC, Clinical Care Advanced).
    • Experience in the following preferred:
      • Team leadership.
      • Case management.
      • Medicare and Medicaid rules and regulations and health plan benefit structure and policy.
  • KNOWLEDGE/SKILLS/ABILITIES
    • Leadership - Inspires, motivates, and guides others toward accomplishing goals. Achieves desired results through effective people management.
    • Conflict resolution - Influences others to build consensus and gain cooperation. Proactively resolves conflicts in a positive and constructive manner.
    • Critical thinking– Identifies complex problems. Involves key parties, gathers pertinent data and considers various options in decision making process. Develops, evaluates and implements effective solutions.
    • Communication and team building– Lead effectively with excellent verbal and written communication. Delegates and initiates/manage cross-functional teams and multi-disciplinary projects.
  • PHYSICAL DEMANDS

    • Rarely
      (1 - 10% of the time)

      Occasionally
      (11 - 33% of the time)

      Frequently
      (34 - 66% of the time)

      Continually
      (67– 100% of the time)

      CLIMB - STAIRS

      LIFT (Floor to Waist: 0"-36") 0 - 20 Lbs

      LIFT (Knee to chest: 24"-54") 0– 20 Lbs

      LIFT (Waist to Eye: up to 54") 0 - 20 Lbs

      CARRY 1-handed, 0 - 20 pounds

      BEND FORWARD at waist

      KNEEL (on knees)

      STAND

      WALK– LEVEL SURFACE

      ROTATE TRUNK Standing

      REACH - Upward

      PUSH (0 - 20 pounds force)

      PULL (0 - 20 pounds force)

      SIT

      CARRY 2-handed, 0 - 20 pounds

      ROTATE TRUNK Sitting

      REACH - Forward

      MANUAL DEXTERITY Hands/wrists

      FINGER DEXTERITY

      PINCH Fingers

      GRASP Hand/Fist

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