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Remote Utilization Review Rn Jobs in Stillwater, MN

Varsity Tutors

NCLEX-RN Tutor

Minneapolis, MN · Remote

$18 - $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 ...

Varsity Tutors

NCLEX-RN Tutor

Saint Paul, MN · Remote

$18 - $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 ...

MDS Solutions

REMOTE MDS Coordinator

Minneapolis, MN · On-site +1

$35.75 - $45.75/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 ...

MDS Solutions

REMOTE MDS Coordinator

Minneapolis, MN · Remote

$35.75 - $45.75/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 ...

MDS Solutions

REMOTE MDS Coordinator

Minneapolis, MN · Remote

$35.75 - $45.75/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 ...

Humana

RN Field Care Manager Nurse

Roseville, MN · On-site +1

Reviews, assesses, and completes medical complexity attestations and clinical oversight activities ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...

Humana

RN Field Care Manager Nurse

Roseville, MN · On-site +1

Reviews, assesses, and completes medical complexity attestations and clinical oversight activities ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...

Humana

RN Field Care Manager Nurse

Roseville, MN · On-site +1

Reviews, assesses, and completes medical complexity attestations and clinical oversight activities ... Travel: While this is a remote position, occasional travel to Humana's offices for training or ...

Pharmacy Careers

Appeals Pharmacist (Remote)

Saint Paul, MN · On-site +1

$58 - $70.50/hr

Collaborate with physicians, nurses, and medical directors during case reviews. * Track, document ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...

Pharmacy Careers

Appeals Pharmacist (Remote)

Minneapolis, MN · On-site +1

$57 - $69.25/hr

Collaborate with physicians, nurses, and medical directors during case reviews. * Track, document ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...

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Remote Utilization Review Rn information

See Stillwater, MN salary details

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$44

$71

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

As of Jul 7, 2026, the average hourly pay for remote utilization review rn in Stillwater, MN is $44.11, according to ZipRecruiter salary data. Most workers in this role earn between $34.86 and $50.67 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.
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Remote Utilization Review Rn jobs near you
Triage Nurse RN - Weekends AM - Remote

Triage Nurse RN - Weekends AM - Remote

Ecumen

Shoreview, MN • On-site, Remote

$36 - $41/hr

Part-time

PTO

Posted 5 days ago

Ecumen rating

7.5

Company rating: 7.5 out of 10

Based on 53 frontline employees who took The Breakroom Quiz

18th of 232 rated social care providers

Job description

Triage Nurse, RN - Remote - Part Time - 7am-3pm 16hrs bi-weekly - Every other Weekend rotation
Ecumen is hiring a Triage Nurse, RN.
The Triage Nurse position is responsible for providing telephone triage nurse for Assisted Living and Hospice support.
About Us:
Join Ecumen, a leading nonprofit senior living provider committed to advocating for older adults through exceptional housing, compassionate healthcare, and innovative services. With over 160 years of experience, we proudly rank as Minnesota's 8th largest senior living organization. Be part of a team that makes a meaningful impact, supporting our mission to serve older adults, while fostering inclusivity and belonging in everything we do.
Opportunity Details:
Schedule:
  • Part-Time 16hrs bi-weekly
  • Shift: 7am-3pm
  • Opportunity to pick up additional shifts - typically 7pm-11pm or 11pm-7am
  • Enjoy the flexibility of working remotely - must have an active RN License in the state of Minnesota

Pay:
  • The targeted pay range for this job is $36.00-41.00 per hour.
  • Ecumen considers a variety of factors when determining new hire pay including experience, qualifications, and, when applicable, certifications, licenses, and education.

Benefits:
  • Ecumen offers a benefits package based on the number of hours you are regularly scheduled to work including paid time off for Sick & Safe time, an Employee Assistance Program, other well-being resources. Learn more at https://www.ecumen.org/find-a-career/benefits/.

Essential Job Responsibilities:
  1. Independently provides professional nursing services over the telephone for Ecumen patient and resident care. Accurately documents symptoms/condition, assessment, advice provided, and patient/caller response. Follows policies, procedures, protocols to ensure consistency and improve outcomes and ensure satisfaction of clients and staff.
  2. Follows up on situations representing higher risk or need from the family or staff.
  3. Analyzes data, trends, and develops solutions to improve services and outcomes. Design workflows, develop plans and implement actions. Participates in quality improvement activities as assigned.
  4. Provides high level nursing support for patient care questions at assigned site, including incident follow-up.
  5. Efficiently and accurately documents in multiple electronic health records.
  6. Maintains high level of standards in clinical skills and professional ethics as established by the Nurse Practice Act and Ecumen.
  7. Performs other duties as assigned.

Minimum Required Qualifications:
  • Must be licensed as a Registered Nurse in MN and must maintain licensure or obtain within 60 days of hire.
  • 1 year of care management experience in home care or hospice
  • Strong clinical and relational skills
  • Ability to analyze situation and implement solutions
  • Ability to handle multiple priorities, ambiguity, frequent change and high stress situations.
  • Ability to communicate effectively in both verbal and written formats.
  • Proficient with Microsoft Office Suite
  • Ability to follow all safety rules, regulations, policies and procedures of the facility including but not limited to: Vulnerable Adult and Abuse Policy, HIPAA, Resident's Bill of Rights, Universal Precaution, AWAIR, OSHA, Right to know, SDS, ADA, HUD Policy and Procedures, Fair Housing laws and regulations

Preferred Qualifications:
  • Prior RN Triage Experience

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

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