Is on LinkedIn?
Job not on LinkedIn
🕒 2 days ago
Job not on LinkedIn
Utilization Management Nurse Consultant reviewing clinical information for CVS Health, a healthcare company. Supporting coverage decisions, care coordination, and improved member outcomes in remote 24/7 operations.
🕒 Yesterday
Utilization review clinician assessing post-acute care for WellSky’s healthcare technology platform. Applying clinical guidelines, coordinating transitions, and supporting better outcomes and lower costs.
🤠 Texas – Remote
💰 Private Equity Round on 2020-07
⏰ Full Time
🟡 Mid-level
🟠 Senior
✨ Clinician
🦅 H1B Visa Sponsor
🕒 2 days ago
Utilization Review Coordinator reviewing medical necessity and care levels for HPI, a third-party administrator of employer health-benefit solutions. Coordinating provider reviews, referrals, discharge needs, and HIPAA-compliant documentation.
Job not on LinkedIn
🕒 2 days ago
Job not on LinkedIn
Oscar Health physician reviewing inpatient, outpatient, and pharmacy services for U.S. members. Applying evidence-based medical-necessity criteria and documenting clinical determinations.
🌵 Arizona, Florida, +1 more states – Remote
💵 $219k - $286.9k / year
💰 $140M Private Equity Round on 2020-12
⏰ Full Time
🟡 Mid-level
🟠 Senior
🦅 H1B Visa Sponsor
Job not on LinkedIn
🕒 2 days ago
Job not on LinkedIn
Registered Nurse conducting medical necessity and utilization review for Tenet Healthcare hospitals. Securing payer authorizations, managing disputes, and coordinating appropriate patient care levels.
Job not on LinkedIn
🕒 3 days ago
Job not on LinkedIn
Utilization management clinician coordinating member care for PacificSource, a not-for-profit health insurer. Reviewing authorizations, inpatient stays, discharge plans, and cost-effective healthcare resources.
Job not on LinkedIn
🕒 3 days ago
Job not on LinkedIn
1001 - 5000
Utilization Management Clinician coordinating member care and authorizations for PacificSource, a health insurance provider. Reviewing medical necessity, discharge planning, provider resources, and cost-effective treatment across care settings.
🕒 3 days ago
SSM Health nursing manager overseeing remote utilization management, care coordination, reviews, compliance, staffing, and patient-care outcomes. Leading UM operations and teams across Missouri, Oklahoma, Illinois, and Wisconsin.
🕒 3 days ago
Remote RN reviewing home health documentation, OASIS, coding, and care plans for Concierge Home Care. Ensuring Medicare compliance, reimbursement integrity, and quality assurance across high-volume clinical records.
Job not on LinkedIn
🕒 3 days ago
Job not on LinkedIn
Utilization Management Nurse reviewing inpatient and outpatient care for Valenz, a healthcare platform reducing costs and improving quality. Ensuring compliant, cost-effective outcomes through clinical reviews and care coordination.
🕒 3 days ago
SSM Health manager leading remote Utilization Management operations and nursing teams across Missouri, Oklahoma, Illinois, and Wisconsin. Ensuring compliant, cost-effective patient care and strong outcomes.
🌽 Illinois, Oklahoma, +2 more states – Remote
💰 Debt Financing on 2019-11
⏰ Full Time
🟠 Senior
🔴 Lead
🦅 H1B Visa Sponsor
Job not on LinkedIn
🕒 5 days ago
Job not on LinkedIn
Utilization Management Nurse Consultant coordinating clinical coverage decisions for CVS Health members. Assessing clinical information, facilitating care, and identifying referral and quality-improvement opportunities.
Job not on LinkedIn
🕒 5 days ago
Job not on LinkedIn
CVS Health utilization management nurse coordinating clinical coverage decisions for Pennsylvania members. Assessing clinical information, facilitating care, and supporting quality healthcare benefit utilization.
Job not on LinkedIn
🕒 6 days ago
Job not on LinkedIn
PRN Clinical Review Nurse supporting CorroHealth’s revenue-cycle services through medical necessity reviews and payer appeal submissions. Reviewing inpatient and outpatient records remotely while meeting quality and turnaround expectations.
🕒 6 days ago
Utilization Review Nurse evaluating medical necessity and level of care for Personify Health’s personalized health platform. Applying evidence-based criteria, documenting determinations, and supporting appeals.
Job not on LinkedIn
🕒 August 1
Job not on LinkedIn
Utilization Management Clinician coordinating healthcare services for members at PacificSource. Collaborating with medical professionals to promote quality, cost-effective healthcare outcomes.
🕒 July 31
Utilization Review Nurse managing outpatient and inpatient treatment requests for medical necessity. Ensuring timely patient transitions and accurate documentation while adhering to clinical guidelines.
🕒 July 31
Utilization Review Nurse managing outpatient and inpatient treatment requests for medical necessity. Ensuring timely patient transitions and accurate documentation while adhering to clinical guidelines.
+28 More Utilization Review Nurse Jobs Available!
The average salary for remote utilization review nurses is $87,704 per year. This is based on data from 10 job openings. Our advanced AI searches the internet for remote job openings and posts them on our website. We use the salary data from these job postings to calculate salary expectations.
Below is a breakdown of salary data by years of experience:
| Experience | Number of roles analyzed | Average Salary |
|---|---|---|
🟢 Junior Utilization Review Nurse (1-2 yrs) | 2 | $64,000 |
🟡 Mid-level Utilization Review Nurse (2-4 yrs) | 8 | $93,630 |
We analyzed 6 job listings in the last year and found it takes about 20 days for employers to close a job opening.
We reviewed 10 job postings and found the top 10 skills employers are asking for most often are:
You need strong critical thinking and analytical skills, attention to detail, effective communication, and a solid understanding of healthcare regulations. Proficiency with electronic health records (EHR) systems and clinical assessment skills are also important.
Typically, you need a registered nursing (RN) license and may require a bachelor's degree in nursing or a related field. Experience in clinical nursing and certifications in utilization management or case management can enhance your qualifications.
Responsibilities include reviewing patient treatment plans for medical necessity, collaborating with healthcare providers, ensuring compliance with regulations, documenting findings, and recommending appropriate care levels. You'll also communicate with patients and insurance companies as needed.
Benefits include flexible work hours, the ability to work from home, reduced commuting costs, and a better work-life balance. Remote roles also offer the chance to make a significant impact on patient care while enjoying a varied work environment.
We scan the internet everyday and find jobs not posted on LinkedIn or other job boards.
We find jobs as soon as they're posted, so you can apply before everyone else.
Most members hear back within the first week
We find jobs other job boards miss.
