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Remote Utilization Review Rn Jobs in Wheaton, IL

Elara Caring

Senior Compliance Auditor - RN

Chicago, IL · Remote

Senior Compliance Auditor - RN (Remote) At Elara Caring, we care where you are and believe the best ... Provide secondary review/oversight of PCS policy development, revisions and reviews for new and ...

Elara Caring

Senior Compliance Auditor - RN

Chicago, IL · Remote

Senior Compliance Auditor - RN (Remote) At Elara Caring, we care where you are and believe the best ... Provide secondary review/oversight of PCS policy development, revisions and reviews for new and ...

IQVIA

Flex Nurse Educator - Elgin, IL

Elgin, IL · Remote

Deliver remote patient education, including medication administration training and adherence ... Active RN license in good standing (compact multi-state preferred); may be required to obtain ...

IQVIA

Flex Nurse Educator - Chicago S, IL

Chicago, IL · Remote

Deliver remote patient education, including medication administration training and adherence ... Active RN license in good standing (compact multi-state preferred); may be required to obtain ...

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Remote Utilization Review Rn information

See Wheaton, IL salary details

$20

$40

$66

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

As of Sep 5, 2026, the average hourly pay for remote utilization review rn in Wheaton, IL is $40.87, according to ZipRecruiter salary data. Most workers in this role earn between $32.31 and $46.92 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 Wheaton, IL?

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

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

The top searched job categories for Remote Utilization Review Rn jobs in Wheaton, IL are:

What cities near Wheaton, IL are hiring for Remote Utilization Review Rn jobs?

Cities near Wheaton, IL with the most Remote Utilization Review Rn job openings:

Remote Utilization Review Rn jobs near you
Infographic showing various Remote Utilization Review Rn job openings in Wheaton, IL as of August 2026, with employment types broken down into 1% As Needed, 77% Full Time, 19% Part Time, 2% Contract, and 1% Nights. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution, with an average salary of $85,001 per year, or $40.9 per hour.

Psychiatrist Physician Reviewer - PRN - Remote (Within Illinois)

CNSI

Lombard, IL • On-site, Remote

$70.97 - $125/hr

Part-time

Medical, Retirement, PTO

Re-posted 17 days ago

Job description

Company Description
Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.
Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes - making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.
Job Description
Acentra seeks a Psychiatrist Physician Reviewer (PRN) to join our growing team.
Job Summary:
The Psychiatrist Physician Reviewer will provide principal leadership and clinical expertise to operations relating to the peer review process, utilization review activities, and other activities requiring clinical leadership and consultation. They will conduct phone consultations with various Illinois hospitals to establish medical necessity and continued stay criteria for IL Medicaid Fee-For-Service beneficiaries.
*Position is PRN and remote within the state of Illinois.
Job Responsibilities:
  • Conduct peer-to-peer physician consultations as requested/required and document consultations
  • Provide clinical expertise with respect to planning and establishing goals and policies to improve clinical operations
  • Represent the organization through state appeal processes
  • Review medical information trends, experiences, and approaches and assist in the development of strategic plans for clinical improvements
  • Provide program representation at stakeholder engagement meetings
  • Ensure compliance with regulatory and accreditation requirements
  • Analyze and remain current on national, state, and local regulations and legislation which impact the healthcare profession
  • Represent and promote Acentra Health at seminars, professional societies, medical staff meetings, and other professional settings as appropriate
  • Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules

Qualifications
Required Qualifications
  • Licensed Physician (MD/DO) to practice in all branches in Illinois
  • Board Certification in Psychiatry
  • Engaged in active practice
  • Have admitting or staff privileges in one or more Illinois hospitals or state facilities
  • Experience in Utilization Management, Case and Disease Management with knowledge of Medicaid and Medicare program
  • Knowledge of standards of practice related to the determination of level of care
  • Knowledge of Medicaid programs with relevant experience navigating similar complex projects
  • Computer proficiency in Microsoft Excel, Word, PowerPoint, Teams, and Outlook

Additional Information
Why us?
We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes.
We do this through our people.
You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career.
Thank You!
We know your time is valuable and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest. Best of luck in your search!
~ The Acentra Health Talent Acquisition Team
Visit us at Acentra.com/careers/
EEO AA M/F/Vet/Disability
Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law.
Benefits
Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.
Compensation
The pay range for this position is $70.97-125.00 per hour.
"Based on our compensation philosophy, an applicant's position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level."

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