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Remote Utilization Review Rn Jobs in Sunnyvale, CA

Telehealth Nurse Practitioner | Remote 1099 | Structured Intake & Care Navigation About Baba Baba ... Active Nurse Practitioner or APRN license, in good standing - licensed in multiple states ...

Professional experience in the healthcare industry (RN, EMT, Paramedic, PA, MD, DO, etc ... Remote work environment * SimX covers 99% of employee premiums and 50% of dependent premiums for ...

Professional experience in the healthcare industry (RN, EMT, Paramedic, PA, MD, DO, etc ... Remote work environment * SimX covers 99% of employee premiums and 50% of dependent premiums for ...

Showing results 41-60

Remote Utilization Review Rn information

See Sunnyvale, CA salary details

$25

$49

$80

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

As of Sep 12, 2026, the average hourly pay for remote utilization review rn in Sunnyvale, CA is $49.62, according to ZipRecruiter salary data. Most workers in this role earn between $39.23 and $56.97 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 Sunnyvale, CA?

For Remote Utilization Review Rn jobs in Sunnyvale, CA, the most frequently searched job titles are:

What job categories do people searching Remote Utilization Review Rn jobs in Sunnyvale, CA look for?

The top searched job categories for Remote Utilization Review Rn jobs in Sunnyvale, CA are:

What cities near Sunnyvale, CA are hiring for Remote Utilization Review Rn jobs?

Cities near Sunnyvale, CA with the most Remote Utilization Review Rn job openings:

Infographic showing various Remote Utilization Review Rn job openings in Sunnyvale, CA as of September 2026, with employment types broken down into 1% As Needed, 82% Full Time, 13% Part Time, 1% Temporary, and 3% Contract. Highlights an 88% Physical, 3% Hybrid, and 9% Remote job distribution, with an average salary of $103,219 per year, or $49.6 per hour.

Clinical Social Worker - Remote (LCSW) for Hospice Care

Hayward, CA • Remote

$120K - $130K/yr

Full-time

Medical, Retirement

Posted 10 days ago


Job description

Position Overview

Support Wellness Healthcare Services, LLC is seeking a dedicated and compassionate Licensed Clinical Social Worker (LCSW) to join our team in a full-time remote capacity. This role is pivotal in providing high-quality therapeutic support to patients within our hospice care facility, helping to navigate the multifaceted emotional and psychological challenges faced by patients and their families during often difficult end-of-life journeys.

About the Organization

Support Wellness Healthcare Services, LLC is a trusted provider of holistic wellness solutions, specializing in hospice care and advanced support systems for patients and their families. We pride ourselves on delivering compassionate care and ensuring optimal patient experiences. Our team strives to create an environment where every patient's dignity is preserved, and their individual needs are met with empathy and respect. We focus on improving the quality of life and promoting comfort at all stages of the care continuum.

Work Environment

This position offers a unique opportunity to work remotely while being part of a dedicated multidisciplinary team. You will collaborate closely with medical professionals, nurses, and other therapeutic staff to develop and implement comprehensive care plans tailored to each patient. The remote work setting allows for flexibility, enabling you to manage your time effectively while ensuring that you remain engaged in your responsibilities and the team dynamics.

Key Responsibilities
  • Lead individual therapy sessions and psychoeducational groups, utilizing evidence-based therapeutic techniques and interventions to promote mental well-being.
  • Conduct thorough clinical assessments to identify patient needs, risk factors, and suitability for discharge planning.
  • Facilitate engagement with patients and families during discharge sessions, ensuring they understand coping strategies, transition plans, and available resources for continued care.
  • Confirm discharge appointments with the patient and their loved ones, ensuring all aspects of their care plan are communicated effectively.
  • Collaborate with referral sources and outpatient providers to ensure continuity of care from admission through discharge.
  • Assist patients in transitioning to higher levels of care when necessary, ensuring a seamless shift in services.
  • Participate actively in clinical outreach initiatives to enhance community awareness of our hospice services.
  • Provide crisis intervention during therapy sessions and within the patient milieu to ensure safety and stability.
  • Support milieu staff in managing day-to-day interactions with patients, fostering a culture of cooperation and understanding.
  • Communicate with the Utilization Review Department and Business Department to ensure appropriate authorization and payment processes are followed.
  • Engage in comprehensive discharge planning starting on the day of admission, preparing patients for a smooth transition out of care.
  • Maintain meticulous documentation of assessments, treatment plans, and case notes in alignment with regulatory standards and organizational policies.
Patient Population / Client Focus

The LCSW will work primarily with patients receiving hospice care, a unique population requiring sensitivity to complex emotional needs surrounding end-of-life issues. Our client base is diverse, encompassing individuals from various backgrounds, cultures, and experiences. Professionals in this role must demonstrate cultural competence and adapt their approaches to meet each patient's unique situation, ensuring a supportive and inclusive therapeutic environment.

Qualifications
  • A Master's degree in Social Work, Counseling, Psychology, or a related field is required.
  • Must be independently licensed as a Licensed Clinical Social Worker (LCSW) in California.
  • Strong understanding of coping strategies and treatment modalities for individuals facing end-of-life challenges.
  • Stable and appropriate boundaries must be established and maintained with clients.
  • Demonstrated proficiency in Electronic Health Record (EHR) systems and Office 365 applications to manage documentation and communication effectively.
  • Exceptional verbal and written communication skills, essential for patient interactions and collaboration with interdisciplinary teams.
Preferred Experience
  • Previous experience working in hospice, palliative care, or a similar setting is highly desired.
  • A background in crisis management and therapeutic interventions tailored to end-of-life care will set candidates apart.
  • Familiarity with community resources and referral processes within California’s healthcare system is advantageous.
Compensation and Benefits
  • Competitive salary ranging from $120,000 to $130,000 annually for full-time employment.
  • Retirement plans to support long-term financial health.
  • Employee assistance program offering mental health support to all staff members.
  • A full caseload designed to provide a fulfilling and meaningful work experience.
Career Growth Opportunities

At Support Wellness Healthcare Services, we believe in the professional development and career advancement of our team members. As part of our commitment to growth, we offer ongoing training opportunities, professional development workshops, and pathways for specialization in various dimensions of mental health care. Employees are encouraged to attend conferences and participate in networking groups to enhance their expertise and expand their professional connections.

Why Join Our Team

Joining our team means becoming part of a supportive environment that values empathy, patient-centered care, and teamwork. You will have the opportunity to make a significant impact on the lives of patients and their families during some of their most challenging times. Our culture fosters collaboration, innovation, and a commitment to excellence, empowering you to deliver your best work.

Application Information

If you are a dedicated Licensed Clinical Social Worker with a passion for hospice care, we invite you to apply today. Please submit your resume and a cover letter detailing your experience and motivation for joining our team. We eagerly anticipate welcoming candidates who share our vision of compassionate, quality care!