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Remote Utilization Review Rn Jobs in St Cloud, MN

... utilization review of services to adequately reflect care provided and resources used ... Schedule: * Full-time | 80 hours every two weeks | Remote after training * Days | 8-hour shifts ...

REMOTE MDS Coordinator

Saint Cloud, MN · Remote

$34 - $43.25/hr

Review and verify MDS documentation and charting requirements to support the clinical services ... Nursing Experience in MDS Assessment: 3+ year * RN required * RAC-CT preferred * Thorough ...

REMOTE MDS Coordinator

Saint Cloud, MN · Remote

$34 - $43.25/hr

Review and verify MDS documentation and charting requirements to support the clinical services ... Nursing Experience in MDS Assessment: 3+ year * RN required * RAC-CT preferred * Thorough ...

REMOTE MDS Coordinator

Saint Cloud, MN · On-site +1

$34 - $43.25/hr

Review and verify MDS documentation and charting requirements to support the clinical services ... Nursing Experience in MDS Assessment: 3+ year * RN required * RAC-CT preferred * Thorough ...

Remote Utilization Review Rn information

See St Cloud, MN salary details

$21

$41

$68

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

As of Jul 6, 2026, the average hourly pay for remote utilization review rn in St. Cloud, MN is $41.88, according to ZipRecruiter salary data. Most workers in this role earn between $33.08 and $48.08 per hour, depending on experience, location, and employer.

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 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 job categories do people searching Remote Utilization Review Rn jobs in St. Cloud, MN look for? The top searched job categories for Remote Utilization Review Rn jobs in St. Cloud, MN are:
What cities near St. Cloud, MN are hiring for Remote Utilization Review Rn jobs? Cities near St. Cloud, MN with the most Remote Utilization Review Rn job openings:
Clinical Documentation Nurse

Clinical Documentation Nurse

CentraCare

Saint Cloud, MN • Remote

$87K - $130K/yr

Full-time

Medical, Dental, Retirement, PTO

This job post has expired today. Applications are no longer accepted.


CentraCare rating

6.9

Company rating: 6.9 out of 10

Based on 156 frontline employees who took The Breakroom Quiz

444th of 877 rated healthcare providers


Job description

CentraCare is looking for a qualified Clinical Documentation Nurse to join our team! This role is responsible for concurrent auditing of medical record documentation to evaluate the documentation and utilization review of services to adequately reflect care provided and resources used. Responsibilities include facilitation of appropriate physician documentation of care to accurately reflect patient severity of illness and risk of mortality. Proactively solicits clarification from physicians and clinical staff in areas where further specificity is needed in the documentation, and consults with attending physician when conflicting information appears in the medical record. Maintains documentation regarding results of audit activity and shares those with staff and management as necessary. Collects and analyzes data pertinent to documentation findings and outcomes for process improvement. This position supports the concepts and philosophies of nursing as well as sound business practices. Promotes and facilitates education to providers regarding disease processes. Communicates with appropriate healthcare team members to promote accurate and complete documentation of each patient encounter. 

Schedule:

  • Full-time | 80 hours every two weeks | Remote after training
  • Days | 8-hour shifts | Working hours between 6am- 5pm
  • Occasional travel to CentraCare site required

Pay and Benefits:

  • Starting pay begins at $87,193.60 per year; exact wage determined by years of related experience
  • Salary range: $87,193.60 - $130,873.60 per year
    • Salary and salary range are based on a 1.0 FTE, reduced FTE will result in a prorated offer rate
  • Full-time benefits: Medical, dental, PTO, retirement, employee discounts and more!
  • Tuition reimbursement and college grant programs available 

Qualifications:

  • Bachelor's degree in nursing required
  • Current Registered Nurse (RN) licensure in the State of Minnesota required
  • Minimum of 3 years acute care experience required
  • Performance improvement, quality assurance related experience is required
  • Certified Clinical Documentation Specialist National Certification as Clinical Documentation Specialist (CCDS) preferred
  • National Certification as a Clinical Documentation Specialist-Outpatient (CCDS-O) preferred
  • Candidates who have successfully completed the ACDIS bootcamp for Clinical documentation integrity (CDI) preferred
  • Candidates who have completed the ACDIS CDI Apprenticeship preferred 
  • Utilization review, coding, clinical informatics, case management or critical care experience preferred
  • Critical Thinking - must have the ability to process large amounts of information and to evaluate meaning with a rational open mind based on the evidence at hand.

CentraCare has made a commitment to diversity in its workforce. All individuals including, but not limited to, individuals with disabilities, are encouraged to apply. CentraCare is an EEO/AA employer. 


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About CentraCare

Sourced by ZipRecruiter

CentraCare has grown to meet the needs of the communities and is now one of the largest health systems in Minnesota. This means we are able to offer the latest advancements in care, technology and treatments close to home. But what makes CentraCare special is not our facilities or technology. It is our people. We live in the communities we serve. We are neighbors, friends and family. And when you need us, we are here for you.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

St. Cloud, MN, US

Year founded

1886