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Remote Utilization Review Rn Jobs in Wright Patterson AFB, OH

Gentell

Certified Wound Care Clinician/Nurse

Dayton, OH · On-site +1

... utilization of wound care products - Understanding Medicare documentation and reimbursement ... (RN, LPN, PT, OTR-L, DPM or similar) preferred but could be certified in the first year of hire ...

CareSource

Pharmacist I

Dayton, OH · Remote

$94K - $164K/yr

Formulary Management guidelines, Utilization Management programs, CareSource Administrative and ... Current, unrestricted Registered Pharmacist (RPh) licensure is required Ability to acquire ...

Pacs

Interim Biller 6 Months

Spring Valley, OH · Remote

$35 - $36/hr

Interim Biller 6 months - Skilled Nursing Facility (SNF) Location: Fresno, CA (Open to Remote ... Review and reconcile billing reports and documentation Maintain compliance with federal, state, and ...

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Remote Utilization Review Rn information

See Wright Patterson AFB, OH salary details

$20

$39

$65

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

As of Aug 4, 2026, the average hourly pay for remote utilization review rn in Wright-Patterson AFB, OH is $39.94, according to ZipRecruiter salary data. Most workers in this role earn between $31.59 and $45.87 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 cities near Wright-Patterson AFB, OH are hiring for Remote Utilization Review Rn jobs? Cities near Wright-Patterson AFB, OH with the most Remote Utilization Review Rn job openings:
Remote Utilization Review Rn jobs near you

Virtual Nurse-RN/ Virtual Nursing

Premier Health

Dayton, OH • On-site, Remote

Full-time

Re-posted 17 days ago

Job description

Position: Virtual Nurse-RN
Department: Virtual Nursing
Facility: Premier System Support
Shift: Full-time 7:00am-7:30pm/ 72 Hours Per Pay
*This is not a remote work from home position*
The Virtual Clinical Nurse is a registered nurse (RN) who works remotely from a centralized location and partners with the bedside nurses and advocates for patients/families/significant others to provide physical, emotional, and spiritual support which impacts patient outcomes in a safe environment. The Virtual RN functions in a versatile role that demonstrates professionalism and promotes excellence and autonomy in the practice of Nursing. The Virtual RN utilizes the nursing process in conjunction with evidence-based principles to care for a diverse caseload of patients within the department scope of service. The Virtual RN collaborates with, and guides care delivered by the inter-professional team. The Virtual RN will perform task that may include admissions, discharges, patient education, rounding on patients, performance improvement, etc. The Virtual RN is accountable for compliance with the Ohio Nurse Practice Act, Nursing Code of Ethics, and applicable regulatory standards.
Education
Minimum Level of Education Required: Associate degree
Additional requirements:
  • Type of degree: Graduation from an accredited school of nursing.
  • Area of study or major: Nursing
  • Preferred educational qualifications: BSN Preferred; BSN Completion or Professional Certification may be required.
  • Position specific testing requirement: N/A

Licensure/Certification/Registration
  • Valid Ohio RN license

Experience
Minimum Level of Experience Required: 3 - 5 years of job related experience
Prior job title or occupational experience: N/A
Prior specific functional responsibilities: N/A
Preferred experience:
Other experience requirements: N/A
Knowledge/Skills
  • Must be able to multitask with constant interruptions while maintaining a pleasant demeanor.
  • Basic computer knowledge
  • Strong organization skills
  • Effective interpersonal and communication skills

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