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Remote Utilization Review Jobs in Ohio (NOW HIRING)

Imh

$41.20 - $62.17/hr

Demonstrated experience in case management, utilization review, value-based care, and/or discharge ... If applying for a remote or hybrid role, this includes remote work expectations related to ...

Imh

$41.20 - $62.17/hr

Demonstrated experience in case management, utilization review, value-based care, and/or discharge ... If applying for a remote or hybrid role, this includes remote work expectations related to ...

Imh

RN Care Manager PRN

Cleveland, OH · Remote

$41.20 - $62.17/hr

Demonstrated experience in case management, utilization review, value-based care, and/or discharge ... If applying for a remote or hybrid role, this includes remote work expectations related to ...

New

Medpace, Inc.

Clinical Data Coder

Cincinnati, OH · On-site +1

$18 - $22.75/hr

Produce coding reports for team review and utilization *Stable schedule with no weekends, no work on Medpace holidays, and flexible work schedule* Qualifications * BSN and RN with applicable ...

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All JobsUtilization Review JobsRemote Utilization Review JobsRemote Utilization Review Jobs in Ohio

Remote Utilization Review information

See Ohio salary details

$20

$40

$65

How much do remote utilization review jobs pay per hour?

As of Aug 4, 2026, the average hourly pay for remote utilization review in Ohio is $40.20, according to ZipRecruiter salary data. Most workers in this role earn between $31.78 and $46.15 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive in remote utilization review?

To thrive as a Remote Utilization Review professional, you need a solid foundation in clinical knowledge, critical thinking, and an active RN or LPN license, often supported by experience in case management or prior authorization. Familiarity with medical coding (ICD-10, CPT), electronic health records (EHRs), and utilization management software is typically required, along with URAC or related certifications. Excellent communication, attention to detail, and strong organizational skills help you efficiently manage cases and coordinate with providers and payers. These skills ensure accurate assessments of medical necessity, compliance with regulations, and effective remote collaboration with healthcare teams.

What does a remote utilization review do?

A typical day for a Remote Utilization Review professional involves reviewing patient medical records, evaluating the necessity of proposed treatments against established guidelines, and collaborating with healthcare providers to gather additional information when needed. You will spend much of your time analyzing documentation, submitting recommendations, and ensuring that care authorization decisions align with payer policies and clinical best practices. Communication with case managers, physicians, and insurance representatives is frequent and essential. The work is generally independent and deadline-driven but requires strong teamwork and responsiveness through virtual meetings, emails, and calls.

What is a remote utilization review?

A Remote Utilization Review job involves assessing medical records and treatment plans to ensure they meet insurance guidelines and medical necessity criteria. Professionals in this role, often nurses or healthcare specialists, work remotely to review patient care for cost-effectiveness and compliance with policies. They collaborate with healthcare providers, insurance companies, and case managers to approve or deny services based on established guidelines. This position requires strong analytical skills, knowledge of medical policies, and attention to detail.

What are the most commonly searched types of Utilization Review jobs in Ohio? The most popular types of Utilization Review jobs in Ohio are:
What are popular job titles related to Remote Utilization Review jobs in Ohio? For Remote Utilization Review jobs in Ohio, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review jobs in Ohio look for? The top searched job categories for Remote Utilization Review jobs in Ohio are:
What cities in Ohio are hiring for Remote Utilization Review jobs? Cities in Ohio with the most Remote Utilization Review job openings:
Remote Utilization Review jobs near you
Infographic showing various Remote Utilization Review job openings in Ohio as of July 2026, with employment types broken down into 100% Full Time. Highlights an 4% In-person, and 96% Remote job distribution, with an average salary of $83,610 per year, or $40.2 per hour.

REMOTE MDS NURSE (RN) - WISCONSIN

Concept Rehab & Engage Consulting

Toledo, OH • Remote

Other

Posted 10 days ago

Job description

Description

 REMOTE MDS NURSE (RN) - WISCONSIN
Full-Time | Work From Home

Engage Consulting is seeking an experienced Registered Nurse (RN) with strong MDS, Case Mix, PDPM, Medicare, Medicaid, and Quality Measure experience to join our growing team.

This is a full-time remote opportunity for an RN who enjoys working independently while partnering with skilled nursing facilities to improve reimbursement, maintain regulatory compliance, and support quality resident care.


WHAT YOU'LL DO

Complete, review, and audit MDS assessments for accuracy and compliance with CMS and state regulations

Ensure timely completion of MDS assessments and supporting documentation

Analyze Case Mix and PDPM opportunities to maximize reimbursement

Review and improve Quality Measures through accurate assessments and clinical documentation

Partner with interdisciplinary teams to strengthen documentation and reimbursement outcomes

Provide education and support related to MDS processes, reimbursement, and regulatory requirements

Maintain accurate records while meeting deadlines in a remote work environment

Assist with compliance initiatives and reimbursement optimization


WHAT WE'RE LOOKING FOR

Active Wisconsin Registered Nurse (RN) license or active Nurse Licensure Compact (NLC) license

Recent MDS experience in a Skilled Nursing Facility (SNF)

Strong knowledge of PDPM, Medicare, Medicaid, and Case Mix reimbursement

Experience managing Quality Measures

Excellent communication, organization, and critical thinking skills

Ability to work independently in a remote setting

Experience with electronic medical records and MDS software


PREFERRED

RAC-CT Certification

Multi-facility MDS experience


WHY JOIN ENGAGE CONSULTING?

100% Remote Position

Full-Time Opportunity

Competitive Compensation

Flexible Work Environment

Supportive and Collaborative Team

Opportunity to work with skilled nursing facilities throughout Wisconsin

Make a meaningful impact on reimbursement, compliance, and resident outcomes

If you're an experienced MDS RN looking for a rewarding remote opportunity where your expertise makes a difference every day, we'd love to hear from you.


Apply today and join the Engage Consulting team!

Apply