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Remote Utilization Review Rn Jobs in Waco, TX (NOW HIRING)

Current, unencumbered NP/PA/RN license in Texas * Aesthetic Training Certification (or willingness ... Review monthly updates and company communications * Treat a minimum of 4 patients per month Ideal ...

Remote Position Type: Full-Time Position Summary AxisCare is a dynamic and innovative home care ... Review customer feedback, trends, and feature requests, and collaborate with Product to help inform ...

Remote Position Type: Full-Time Position Summary AxisCare is a dynamic and innovative home care ... Review customer feedback, trends, and feature requests, and collaborate with Product to help inform ...

Remote Position Type: Full-Time Position Summary AxisCare is a dynamic and innovative home care ... Review customer feedback, trends, and feature requests, and collaborate with Product to help inform ...

Remote Utilization Review Rn information

See Waco, TX salary details

$18

$37

$61

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

As of Aug 6, 2026, the average hourly pay for remote utilization review rn in Waco, TX is $37.54, according to ZipRecruiter salary data. Most workers in this role earn between $29.66 and $43.12 per hour, depending on experience, location, and employer.

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 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 are popular job titles related to Remote Utilization Review Rn jobs in Waco, TX? For Remote Utilization Review Rn jobs in Waco, TX, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review Rn jobs in Waco, TX look for? The top searched job categories for Remote Utilization Review Rn jobs in Waco, TX are:
What cities near Waco, TX are hiring for Remote Utilization Review Rn jobs? Cities near Waco, TX with the most Remote Utilization Review Rn job openings:
Infographic showing various Remote Utilization Review Rn job openings in Waco, TX as of July 2026, with employment types broken down into 90% Full Time, 7% Part Time, and 3% Contract. Highlights an 51% Physical, 4% Hybrid, and 45% Remote job distribution, with an average salary of $78,075 per year, or $37.5 per hour.

REGISTERED NURSE - CLINICAL DOCUMENTATION INTEGRITY EDUCATOR

Veterans Health Administration

Temple, TX • On-site, Remote

$79K - $139K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 8 days ago


Veterans Health Administration rating

8.1

Company rating: 8.1 out of 10

Based on 1,004 frontline employees who took The Breakroom Quiz

69th of 887 rated healthcare providers


Job description

Summary
This position functions as a clinical expert and executes position responsibilities that demonstrate leadership, experience, and creative approaches to management of complex patient care. Executes position responsibilities that demonstrate leadership, experience, and creative approaches to management of complex client care. Assumes responsibility for the coordination of education focused on staff education, self-management, and customer satisfaction throughout the healthcare continuum.
Learn more about this agency
Duties
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The Nurse Ill Clinical Documentation Integrity Nurse (RN) demonstrates leadership, experience, and creative approaches to improvement in quality-of-care outcomes. The RN is responsible for providing competent, evidence-based practices within the position. The RN uses VHA Clinical Documentation Guidelines, Coding Guidelines, and other resources to perform complicated documentation reviews and provide education to a variety of healthcare professionals. The RN demonstrates performance and leadership that is broad enough to improve the care for a group of patients. The RN is responsible for the documented outcomes at the program or service level. Program or service level outcomes must be broad and complex and can be demonstrated at any organizational level within a facility. Program is defined as a substantial coordinated group of activities impacting patients and/or employees. The RN is assigned responsibility for their assigned area activities for the Medical Center.
Duties Include but are not limited to:
  • Collects data, monitors staff compliance with relevant policies, directives, and standards, provides reports detailing trends, and provides direct staff support to all services.
  • Participate in several facility councils, committees, and workgroups.
  • Executes the position responsibilities that demonstrate effective leadership, detailed planning, professional communication, creative and innovative approaches to the improvement of safety/healthcare program development and possess an ability to organize priorities.
  • Works in concert with leaders and others to sustain a culture of safety, modeling High Reliability Organization (HRO) practices.
  • Performs duties directly contributing to high quality and safe patient care within the Veterans Health Administration (VHA).
  • Duties require the ability to apply specialized principles and practices to ensure a systems approach to healthcare delivery.
  • Directly supports facility leadership in areas of planning, organization, development, direction, and evaluation within the facility.
  • Supports colleagues and other nurses through knowledge sharing to provide safe, quality nursing care.
  • Fosters a safe and supportive environment conducive to the professional development of health care professionals.
  • Evaluates outcomes of evidence-based decisions and practice changes for individuals, groups, and populations.

VA offers a comprehensive total rewards package: VA Nurse Total Rewards
Pay: Competitive salary, regular salary increases, potential for performance awards
Paid Time Off: 50 days of paid time off per year (26 days of annual leave, 13 days of sick leave, 11 paid Federal holidays per year)
Retirement: Traditional federal pension (5 years vesting) and federal 401K with up to 5% in contributions by VA
Insurance: Federal health/vision/dental/term life/long-term care (many federal insurance programs can be carried into retirement)
Licensure: 1 full and unrestricted license from any US State or territory
Work Schedule: Monday - Friday; 7:30am - 4:00pm or 8:00am - 4:30pm
Telework: Not Available
Virtual: This is not a virtual position.
Relocation/Recruitment Incentives: Not Authorized
Permanent Change of Station (PCS): Not Authorized
Requirements
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Conditions of employment
  • U.S. Citizenship; non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy.
  • All applicants tentatively selected for VA employment in a testing designated position are subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested will be denied employment with VA.
  • Selective Service Registration is required for males born after 12/31/1959.
  • Subject to background/security investigation.
  • Selected applicants will be required to complete an online onboarding process. Acceptable form(s) of identification will be required to complete pre-employment requirements (https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents). Effective May 7, 2025, driver's licenses or state-issued identification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment.
  • Must pass pre-employment physical evaluation.
  • Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP).
  • You may be required to serve a probationary period.
  • Complete all application requirements detailed in the "Required Documents" section of this announcement.

Qualifications
Basic Requirements:
  • English Language Proficiency. In accordance with 38 U.S.C. 7403(f), no person shall serve in direct patient care positions unless they are proficient in basic written and spoken English.
  • Graduate of a school of professional nursing approved by the appropriate accrediting agency and accredited by one of the following accrediting bodies at the time the program was completed by the applicant: The Accreditation Commission for Education in Nursing (ACEN) or The Commission on Collegiate Nursing Education (CCNE); OR Individuals attending a master's level bridge program in nursing who have completed coursework equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion of the bridge program. Upon achievement of a State license, the individual may be appointed on temporary basis and later converted to a permanent appointment upon successful completion and graduation from the bridge program. (Reference VA Handbook 5005, Appendix G6); OR In cases of graduates of foreign schools of professional nursing, possession of a current, full, active, and unrestricted registration will meet the requirement for graduation from an approved school of professional nursing to warrant an appointment as a Nurse who has completed an associated degree/entry level Nursing education program. Credit for foreign nursing education higher that associate degree/entry level requires a formal degree equivalency validation from a recognized equivalency evaluation accepted by VA such as International Consultants of Delaware (ICD).
  • Current, full, active, and unrestricted registration as a graduate professional nurse in a State, Territory or Commonwealth (i.e., Puerto Rico) of the United States, or the District of Columbia. Graduate Nurse Technician (GNT) Exception: Candidates who otherwise meet the basic education requirements, but do not possess the required licensure, may be appointed at the entry step of the grade and level applicable to the completed nursing education as a GNT on a 120-day temporary appointment while actively pursuing licensure (may be extended up to two years on a case-by-case-basis.)

NOTE: Grandfathering Provision - All persons currently employed in VHA in 0610 series and performing the duties as described in the qualification standard on the effective date of the standard (1/29/2024) are considered to have met all qualification requirements for the grade held including positive education and licensure/certification.
Grade Determinations: The following Scope, Education and Dimension criteria must be met in determining the grade assignment of candidates, and if appropriate, the level within a grade. The Dimension requirements (Practice, Veteran/Patient Driven Care, Leadership, Professional Development and Evidence-Based Practice/Research) are detailed for each grade and level within the online assessment: https://apply.usastaffing.gov/ViewQuestionnaire/13023202.
Grade/Level
Scope
Education
Nurse I, Level I
Delivers fundamental, knowledge-based care to assigned clients while developing technical competencies.
An Associate Degree (ADN) or Diploma in Nursing, with no additional professional nursing required.
Nurse I, Level II
Demonstrates integration of biopsychosocial concepts, cognitive skills and technically competent practice in providing care to clients with basic or complex.
An ADN or Diploma in Nursing AND 1 year of specialized nursing experience equivalent to Nurse I, Level 1 ;OR a Bachelor of Science in Nursing (BSN) with no additional professional nursing experience required.
Nurse I, Level III
Demonstrates proficiency in practice based on conscious and deliberate planning. Self-directed in goal setting for managing complex client situations.
An ADN or Diploma in Nursing AND 2 years of professional nursing experience in which one year is equivalent to Nurse I, Level 2; OR a BSN and 1 year of professional nursing experience equivalent to the Nurse I, Level 2; OR a Master's degree in nursing (MSN) and no additional professional nursing experience; OR a Master's degree in a *related field with a BSN and no additional professional nursing experience.
Nurse II
Demonstrates leadership in delivering and improving holistic care through collaborative strategies with others.
A BSN with 2 years of professional nursing equivalent to Nurse I, Level 3; OR an MSN with one year of specialized nursing experience equivalent to Nurse I, Level 3; OR a Master's degree in a *related field with a BSN and one year of specialized nursing experience equivalent to Nurse I, Level 3; OR a Doctoral degree in Nursing with no professional nursing experience; OR a Doctoral degree in a *related field with a BSN with no additional professional nursing experience.
Nurse III
Executes position responsibilities that demonstrate leadership, experience and creative approaches to management of complex client care beyond the immediate practice setting.
MSN and 2 years of specialized nursing experience, one of which is equivalent to Nurse II and meets all dimension requirements for Nurse III; OR a Master's degree in *related field with BSN and two years of specialized nursing experience, one of which is equivalent to Nurse II and meets all dimension requirements for Nurse III; OR a Doctoral degree in Nursing with and one year of specialized nursing experience equivalent to Nurse II and meets all dimension requirements for Nurse III; OR a Doctoral degree in a *related field with a BSN and one year of specialized nursing experience equivalent to Nurse II and meets all dimension requirements for Nurse III.
*Note: Foreign education programs/degrees are not creditable as related degrees.
Preferred Experience:
  • Evidence of Belt/Systems Redesign training/experience/certification;
  • Professional Governance participation;
  • Preceptor/charge nurse experience/training (combination of experience and training is acceptable);
  • Evidence-Based Practice experience/training (combination of experience and training is acceptable);
  • Evidence of clinical education experience

Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/.
Physical Requirements: The position requires potentially long periods of combined walking, standing, stooping, sitting, bending, pulling, and pushing. The incumbent must be a mature, flexible, sensible individual capable or working effectively in stressful situation, able to shift priorities based on needs of the organization.
Education
The Associate Degree Nursing (ADN), Bachelor of Science degree in Nursing (BSN), or Master of Science degree in Nursing (MSN) must be fully accredited by the Accreditation Commission for Education in Nursing (ACEN) or the Commission On Collegiate Nursing Education (CCNE). Verification of accreditation may be obtained from http://www.acenursing.us/accreditedprograms/programsearch.htm orhttps://directory.ccnecommunity.org/reports/accprog.asp
If your school has changed names, or is no longer in existence, you must provide this information in your application.
If your school was accredited by ACEN or CCNE at the time of graduation, but is no longer listed on the websites, you must provide documentation of accreditation with your application packet.

If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit: http://www.ed.gov/about/offices/list/ous/international/usnei/us/edlite-visitus-forrecog.html
Note: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.ed.gov/accreditation/. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit: http://www.ed.gov/about/offices/list/ous/international/usnei/us/edlite-visitus-forrecog.html.
Additional information
This job opportunity announcement may be used to fill additional vacancies.
This position is in the Excepted Service and does not confer competitive status.
VA encourages persons with disabilities to apply. The health-related positions in VA are covered by Title 38, and are not covered

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About Veterans Health Administration

Sourced by ZipRecruiter

The Veterans Health Administration (VHA) is the largest integrated health care system in the United States, serving millions of Veterans each year. Located in Phoenix, AZ, and many other parts of the US, the VHA operates under the Department of Veteran Affairs, as suggested by their official website va.gov. The VHA is dedicated to providing the highest level of comprehensive care to its veterans. The organization offers a broad spectrum of medical, surgical, and rehabilitative care, including mental health services, research, and pharmacy benefits.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Phoenix, AZ, US