Exploring Telehealth: A New Side Hustle for Nurses
Telehealth has moved from a pandemic workaround to a permanent fixture of how healthcare gets delivered. For nurses looking for flexible extra income, this shift has created a genuine opportunity: remote nursing roles that pay well, require no commute, and can be scheduled around existing shift work.
Here's a practical look at telehealth as a nursing side hustle — what it pays, where to find work, and what you need to get started.
What Telehealth Nursing Actually Looks Like
"Telehealth nursing" isn't one job — it's a category that covers several distinct types of work:
Telephone Triage
The most common telehealth nursing role. You take calls from patients or health plan members with clinical questions, assess symptoms using evidence-based protocols (typically Schmitt-Thompson or similar), and advise them on appropriate levels of care.
- Most triage nurses work from home, fully remote
- Shifts are often 8–12 hours and schedulable around your primary job
- Protocols and decision-support software guide every call — you're not improvising
- Typical pay: $30–52/hour depending on experience and employer
Who hires triage nurses: health insurance companies, large hospital systems, physician groups, and third-party nurse advice line services.
Utilization Management (UM) Review
UM nurses review medical records, treatment requests, and hospital cases to determine whether proposed care meets clinical criteria for insurance coverage. This is entirely remote and asynchronous — you review cases at your own pace within a deadline window.
- No direct patient contact (reviewing charts, not talking to patients)
- Requires strong clinical knowledge and good documentation skills
- Typical pay: $32–55/hour, often as an independent contractor
- Major employers: Cigna, Aetna/CVS, Humana, Optum/UnitedHealth, Anthem/Elevance
Case Management via Telehealth
Remote case managers coordinate care for patients with complex conditions — chronic illness, post-surgical recovery, mental health, substance use. You communicate via phone and video, connecting patients to resources and monitoring their progress.
- More relationship-based than triage; you often follow the same patients over time
- Requires case management experience or certification (CCM credential helps)
- Typical pay: $30–50/hour
Telehealth Direct Patient Care
Some platforms let nurses (with appropriate licensure and scope of practice in their state) provide direct patient care via video: health assessments, education, chronic disease management coaching.
- Scope of practice varies significantly by state
- Nurse practitioners have the most options here, but RNs can participate in structured programs under physician oversight
- Typical pay: $28–45/hour through platforms
Virtual ICU (vICU) Nursing
Advanced practice nurses and experienced ICU RNs monitor ICU patients remotely, providing real-time support to bedside nurses and physicians. This is specialized, high-paying, and requires significant ICU experience.
- Typical pay: $45–75/hour
- Major systems with vICU programs: AdvanceMed (Sentara), Advocate Health, Mercy Virtual
What Telehealth Side Hustle Work Pays
Realistic income ranges for common telehealth nursing roles, per hour:
| Role | Hourly Range |
|---|---|
| Telephone triage (contract) | $30–52/hr |
| Utilization management review | $32–55/hr |
| Remote case management | $30–50/hr |
| Telehealth direct care (NP) | $40–85/hr |
| Virtual ICU (experienced ICU RN) | $45–75/hr |
At 10–15 hours per week doing triage or UM review, you're looking at $1,200–2,000/month supplemental income without a second commute.
Where to Find Telehealth Nursing Work
Direct Employer Hiring
These organizations consistently hire remote nurses:
- Optum/UnitedHealth Group — the largest single employer of remote nurses; hires triage, UM, case management
- CVS Health/Aetna — remote clinical roles in case management and UM
- Cigna — triage and utilization review
- Humana — large remote nursing workforce, case management emphasis
- Elevance Health (Anthem) — UM and care management
- Teladoc Health — telehealth direct care (primarily for NPs and MDs, but some RN roles)
- Hims & Hers — direct care roles for NPs
- Truepill, Wheel, Sesame — telehealth platforms with remote nursing roles
Search their careers pages directly; these openings often aren't well-indexed on general job boards.
Staffing Agencies for Telehealth
Some staffing agencies specialize in remote clinical placements:
- Supplemental Health Care — telehealth and remote nurse placement
- Trusted Nurse Staffing — includes remote roles
- Medical Staffing Network — some remote/telehealth roles
- PPR Healthcare — has telehealth contracts
Freelance Platforms
Less common but available:
- Upwork — healthcare companies sometimes post contracts for nurse consultants, triage, and content review
- Care.com — primarily home care but some telehealth posting
- Bark.com — local and remote healthcare consulting
What You Need to Get Started
Licensure
Most remote nursing work requires licensure in the state where the patient is located. The Nurse Licensure Compact (NLC) allows RNs to practice across 41+ member states on a single license — a significant advantage if you want to take triage or telehealth calls from patients nationwide.
If you don't have a compact license, check whether your state is an NLC member and apply for multistate privilege. It takes 2–6 weeks and costs $50–200+ depending on state.
Equipment
Telehealth nursing from home is low-cost to set up:
- Reliable laptop or desktop
- Wired internet connection (reduces audio drops; most employers require this)
- Decent headset with microphone (Jabra or Logitech are standard)
- Quiet, private workspace (HIPAA requires you to ensure patient privacy)
- Backup phone or internet for redundancy
Some employers provide laptops for their remote nursing staff. Ask before you buy.
HIPAA Compliance at Home
Working remotely with patient information requires your home setup to meet HIPAA standards:
- Password-protected computer with screen lock
- VPN when accessing employer systems (usually provided)
- No one else in the room during calls
- No screenshots or photos of patient information
- Secure document disposal
Most employers will train you on their specific compliance requirements. Take this seriously — HIPAA violations are career-ending.
Is Telehealth Nursing Taxed Differently?
If you pick up a per diem or contract role through an agency, you'll likely receive a W-2 or 1099. Key points:
- 1099 contractor income: You're responsible for self-employment tax (~15.3%) in addition to income tax. Set aside 25–30% of gross income for taxes if you're a contractor.
- Business expenses: If you're a 1099 contractor, your home office, equipment, internet, and professional development costs may be deductible. Keep records.
- State taxes: If you're doing multistate telehealth under a compact license, understand which state's tax laws apply to your income.
Worth a quick conversation with an accountant if your telehealth income exceeds $5,000/year.
Realistic Expectations
Telehealth isn't passive income — you're still trading hours for dollars. But the advantages are real:
- No commute
- Work in your own space
- Set your own schedule (especially with per diem or contract arrangements)
- Physically less demanding than bedside care
- Your existing skills are the product — no startup investment or audience building required
For nurses whose primary constraint is physical recovery from demanding shifts, telehealth is one of the most compatible side income options available.
Find Your Best Side Income Fit
Telehealth is one of several options well-suited to nurses' schedules and credentials. If you want a personalized view of which side income paths match your specific experience and availability, Sidequest can help. Enter your nursing background for a report tailored to your skills.