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Remote Utilization Review Rn Jobs in Temecula, CA

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Registered Nurse

Murrieta, CA · 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 ...

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Registered Nurse

Carlsbad, CA · 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 ...

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Registered Nurse

Moreno Valley, CA · 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 ...

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Registered Nurse

Oceanside, CA · 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 ...

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Registered Nurse

Escondido, CA · 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 ...

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Registered Nurse

Vista, CA · 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 ...

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Registered Nurse

Temecula, CA · 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 ...

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Registered Nurse

Menifee, CA · 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 ...

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RN

Escondido, CA · 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 ...

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RN

Moreno Valley, CA · 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 ...

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RN

Temecula, CA · 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 ...

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RN

Oceanside, CA · 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 ...

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RN

Vista, CA · 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 ...

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RN

Murrieta, CA · 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 ...

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RN

Carlsbad, CA · 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 ...

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Remote Utilization Review Rn information

See Temecula, CA salary details

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$42

$68

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

As of Jun 14, 2026, the average hourly pay for remote utilization review rn in Temecula, CA is $42.01, according to ZipRecruiter salary data. Most workers in this role earn between $33.17 and $48.22 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 Temecula, CA? For Remote Utilization Review Rn jobs in Temecula, CA, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review Rn jobs in Temecula, CA look for? The top searched job categories for Remote Utilization Review Rn jobs in Temecula, CA are:
What cities near Temecula, CA are hiring for Remote Utilization Review Rn jobs? Cities near Temecula, CA with the most Remote Utilization Review Rn job openings:
Remote Utilization Review Rn jobs near you
RN Clinical Documentation Integrity Specialist - Remote

RN Clinical Documentation Integrity Specialist - Remote

UHS

Temecula, CA • On-site, Remote

$93K - $134K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 17 days ago

Universal Health Services rating

6.7

Company rating: 6.7 out of 10

Based on 248 frontline employees who took The Breakroom Quiz

527th of 872 rated healthcare providers

Job description

Responsibilities
Join the Southwest Healthcare Team!
About Us:
Creating Health and Harmony, Southwest Healthcare is a comprehensive network of care with convenient hospital and ambulatory care/outpatient locations here to serve the Southern California community. With over 7,000 passionate providers and healthcare employees, our shared goal is to provide convenient access to a wide range of healthcare services in a way that benefits you, your family, and the entire community.
Southwest Healthcare is comprised of five acute care hospitals and several non-hospital access points, including: Corona Regional Medical Center, Palmdale Regional Medical Center, Southwest Healthcare Rancho Springs Hospital, Southwest Healthcare Inland Valley Hospital and Temecula Valley Hospital, Temecula Valley Day Surgery, A+ Urgent Care Centers, Apex Heart Specialists, and Riverside Medical Clinics. We've won various awards throughout our region and focus on career development and promotion. The people are at the core of everything we do. If you are looking for a career and not just a job, you're in the right place! For more information on how to join our dynamic team, please visit our website at www.swhealthcaresystem.com .
Job Summary:
Southwest Healthcare is seeking a Full-Time Remote RN Clinical Documentation Integrity Specialist position. This position provides clinically based concurrent and retrospective review of inpatient medical records to evaluate the utilization and documentation of acute care services . Duties include but not limited to:
  • Responsible for improving the overall quality and completeness of clinical documentation.
  • Promotes a partnership between the concurrent clinical reviews, medical record coders, and physicians to improve documentation and reimbursement.
  • Facilitates clarification and specificity to clinical documentation through appropriate interaction with physicians, advocating for appropriate reimbursement.
  • Responsible for reviewing medical records to identify payer population as documented upon admission and throughout the hospitalization.
  • Analyzes status of patient, current treatment plan, past medical history and identified possible gaps in physician documentation.
  • Supports the accuracy and completeness of the clinical information used for measuring and reporting physician and hospital outcomes to reflect the patient's true severity of illness, intensity of care, and risk of mortality.
  • Responsible for improving the overall quality and completeness of clinical documentation.
  • Working knowledge of current ICD-10-CM coding guidelines, with working knowledge of Medicare reimbursement system required.
Qualifications
Experience/Training/Experience:
  • Associate's degree from an accredited College or University in the field of nursing required.
  • Bachelor's degree from an accredited College or University in the field of nursing preferred.
  • Minimum of five (5) years recent clinical experience in acute care setting (Critical care, Medical/Surgical or Emergency Medicine) required. Critical Care or Medical/Surgical preferred.
  • Minimum of three (3) years recent experience performing CDI reviews in an inpatient acute care setting required. Minimum of 5+ years strongly preferred.
Certifications/Licenses:
  • Current license as a Registered Nurse in the State of California required.
  • Current certification(s) for Certified Clinical Documentation Specialist (CCDS) or Certified Clinical Improvement Practitioner (CDIP) requried.
  • Additional licensure/certification of 1 or more of the following credentials preferred: CCDS-O, CCS, RHIT
Other Skills and Abilities:
  • Familiarity with basic medical laws and ethics, i.e. consents, confidentiality.
  • Knowledge of emergency procedures, medical terminology and medical abbreviations.
  • Proficiency in working with word processing, databases and spreadsheets.
  • Strong broad based clinical knowledge and understanding of anatomy and pathology/physiology of disease processes.
  • Ability to work independently in a time oriented environment is essential.
  • Working knowledge of current ICD-10-CM coding guidelines, with working knowledge of Medicare reimbursement system required.
  • Working knowledge of inpatient admission criteria.
  • Detailed oriented, ability to collect, trend and report data.
  • Excellent organizational skills required.
  • Ability to perform under pressure, meet frequent deadlines and tight schedules.
  • Demonstrates ability to maintain positive relationships and courteous interactions with co-workers, hospital staff, medical staff, etc. regardless of communication method (i.e. telephone, fax, written/verbal, instant message, email, etc.).
  • Ability to set priorities that may change and accomplish multiple tasks daily.
Benefit Highlights:
  • Challenging and rewarding work environment.
  • Competitive Compensation & Generous Paid Time Off.
  • Excellent Medical, Dental, Vision and Prescription Drug Plans.
  • 401(K) with company match and discounted stock plan.
  • SoFi Student Loan Refinancing Program.
  • Tuition, CEU, Certification, Licenses Reimbursement program.
  • Career development opportunities within UHS and its 300+ Subsidiaries!
  • More information is available on our Benefits Guest Website: UHS Guest Benefits
Southwest Healthcare is owned and operated by subsidiaries of Universal Health Services, Inc. (UHS) , a King of Prussia, PA-based company, one of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (NYSE: UHS) has built an impressive record of achievement and performance, growing since its inception into a Fortune 500 corporation. Headquartered in King of Prussia, PA, UHS has 99,000 employees. Through its subsidiaries, UHS operates 28 acute care hospitals, 331 behavioral health facilities, 60 outpatient and other facilities in 39 U.S. States, Washington, D.C., Puerto Rico and the United Kingdom.
EEO Statement:
All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. We believe that diversity and inclusion among our teammates is critical to our success.
Avoid and Report Recruitment Scams:
We are aware of a scam whereby imposters are posing as Recruiters from UHS, and our subsidiary hospitals and facilities. Beware of anyone requesting financial or personal information. At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.

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About Universal Health Services

Sourced by ZipRecruiter

Universal Health Services (UHS) is a major player in the healthcare industry, based in King of Prussia, Pennsylvania, U.S. Founded in 1978, UHS offers hospital and healthcare services. Their diverse services range from acute care hospitals, behavioral health facilities and ambulatory centers nationwide. The company's mission of enhancing the health and well-being of their patients is reflected in their commitment to 'Helping Individuals Live Longer, Healthier and Happier Lives'. Universal Health Services' consistent growth and success in their industry have been recognized on numerous occasions, including being ranked amongst the Fortune 500 list of largest companies.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

King of Prussia, PA, US

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