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Remote Utilization Review Rn Jobs (NOW HIRING)

Umpqua Health

Utilization Review Nurse

$85K - $105K/yr

UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR ... Active, unrestricted RN license (BSN or MSN) in Oregon or a compact state * Graduation from an ...

Phoebe Putney Health System

... related to Utilization review duties in Care Management. Timely communication of clinical ... Nurse (RN) in the state of Georgia (Required) Certified Case Manager (Preferred) Certified ...

Umpqua Health

Utilization Review Nurse

Roseburg, OR · On-site +1

$85K - $105K/yr

UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR ... Active, unrestricted RN license (BSN or MSN) in Oregon or a compact state * Graduation from an ...

Umpqua Health

Utilization Review Nurse

Roseburg, OR · Remote

$85K - $105K/yr

UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR ... Active, unrestricted RN license (BSN or MSN) in Oregon or a compact state * Graduation from an ...

CorVel

CA Utilization Review Nurse I

$30.64 - $45.80/hr

This is a remote position. Essential Functions & Responsibilities: * Identifies the necessity of ... Current Nursing licensure in the state of operation required; RN is required unless local state ...

Corvel

CA Utilization Review Nurse I

Rancho Cucamonga, CA · Remote

$30.64 - $45.80/hr

This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Identifies the necessity of ... Current Nursing licensure in the state of operation required; RN is required unless local state ...

University of Utah

Utilization Review Nurse

Current license to practice as a Registered Nurse in the State of Utah, or obtain one within 90 ... Utilization Review Certification designation. * Knowledge of CMS Regulations. Working Conditions ...

Netsmart

Utilization Review Nurse (PRN)

Current and unrestricted RN license * At least 3 years clinical experience in acute care setting in ... Comfortable with remote work arrangements and virtual collaboration tools * Physical demands ...

McBee Associates

Utilization Review Nurse (PRN)

Current and unrestricted RN license * At least 3 years clinical experience in acute care setting in ... Comfortable with remote work arrangements and virtual collaboration tools * Physical demands ...

Personify Health

Utilization Review Nurse - RN

$30 - $40/hr

Current, unrestricted RN license in the United States or a U.S. territory (compact license accepted ... Utilization review/utilization management experience preferred Technical Skills: * Proficiency with ...

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Remote Utilization Review Rn information

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

As of Aug 20, 2026, the average hourly pay for remote utilization review rn in the United States is $42.28, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 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.

More about Remote Utilization Review Rn jobs

What cities are hiring for Remote Utilization Review Rn jobs?

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What states have the most Remote Utilization Review Rn jobs?

States with the most job openings for Remote Utilization Review Rn jobs include:

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Remote Utilization Review Rn jobs near you
Infographic showing various Remote Utilization Review Rn job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 13% Part Time, 3% Contract, and 1% Nights. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

Utilization Review RN - Remote in TX - Contract

HireOps Staffing, LLC

Dallas, TX • Remote

Full-time

Posted 15 days ago

Job description

This position is fully remote, however, you must reside in the State of Texas


The position is a contract for about 6 months.


RN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and appropriateness of the treatment plan.