ZipRecruiter

Log In

2

Remote Utilization Review Jobs in Santa Rosa, CA

Madrona Hospice Care Inc.

Registered Nurse

Santa Rosa, CA · Remote

$140 - $150/hr

Review OASIS assessments for completeness, appropriateness, and compliance with federal and state ... Monitor visit utilization and flag potential financial risks or underutilization to clinical ...

next page

Showing results 1-20

All JobsUtilization Review JobsRemote Utilization Review JobsRemote Utilization Review Jobs in Santa Rosa, CA

Remote Utilization Review information

See Santa Rosa, CA salary details

$23

$46

$75

How much do remote utilization review jobs pay per hour?

As of Aug 13, 2026, the average hourly pay for remote utilization review in Santa Rosa, CA is $46.23, according to ZipRecruiter salary data. Most workers in this role earn between $36.54 and $53.08 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 Santa Rosa, CA? The most popular types of Utilization Review jobs in Santa Rosa, CA are:
What are popular job titles related to Remote Utilization Review jobs in Santa Rosa, CA? For Remote Utilization Review jobs in Santa Rosa, CA, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review jobs in Santa Rosa, CA look for? The top searched job categories for Remote Utilization Review jobs in Santa Rosa, CA are:
What cities near Santa Rosa, CA are hiring for Remote Utilization Review jobs? Cities near Santa Rosa, CA with the most Remote Utilization Review job openings:
Remote Utilization Review jobs near you
Infographic showing various Remote Utilization Review job openings in Santa Rosa, CA as of August 2026, with employment types broken down into 100% Part Time. Highlights an 100% Remote job distribution, with an average salary of $96,155 per year, or $46.2 per hour.

Registered Nurse

Madrona Hospice Care Inc.

Santa Rosa, CA • Remote

$140 - $150/hr

Full-time, Per diem

Re-posted 4 days ago

Job description

At Madrona Hospice Care Inc., we've designed a plan of care that will work for you and your family. We understand the importance in providing you the guidance to make those decisions easier and before a time of crisis. That’s why we have a diverse team of experienced professionals to offer a broad range of services.

As a Registered Nurse with Madrona Hospice Care, you will play a meaningful role in helping patients heal, stay safe, and thrive in the comfort of their own environment.

We value teamwork, empathy, and a commitment to high-quality service, all aimed at putting patients and their families at ease during their transition. If you are passionate about making a positive impact in patients' lives and working in a supportive and family-oriented atmosphere, we encourage you to join us in providing exceptional home hospice care.

Please note that this role is per diem with a rate of $140 - $150 per visit.

Responsibilities
  • Review OASIS assessments for completeness, appropriateness, and compliance with federal and state regulations.
  • Ensure accurate ICD-10 coding and sequencing based on each patient’s medical condition and co-morbidities.
  • Partner with clinical staff to resolve documentation and data integrity issues.
  • Monitor visit utilization and flag potential financial risks or underutilization to clinical management.
  • Identify and communicate trends that impact agency outcomes and process measures.
  • Conduct OASIS inter-rater reliability visits with clinical team members.
  • Participate in Quality Improvement and Corporate Compliance activities.
  • Stay current with best practices through ongoing education and professional development.
  • Perform other duties as required for patient services.

Requirements

  • Active Californian RN license in good standing.
  • 1–2 years of clinical home health experience.
  • Working knowledge of OASIS assessments and ICD-10 coding.
  • Knowledge of federal regulations and state licensure requirements.
  • Strong communication skills and a keen eye for detail.
  • Ability to work independently and manage priorities with minimal supervision.
  • Proficiency with computer systems and electronic health records.
  • Current CPR certification with AHA.
  • Valid driver’s license, reliable insured vehicle.

Nice to Have

  • OASIS certification (COS-C).
  • OASIS Home Health ICD-10 coding certification.

Benefits

  • Flexible Schedule
  • Ability to Convert to Full-Time Based On Performance If Interested
  • Paid Sick Days
  • Paid Bereavement Leave
  • Skills Training & Development
  • Company Social Events
  • Mileage Reimbursement for Patient to Patient Visits
  • Referral Bonus