Selected: ✨ Utilization Review Nurse.
Selected: 🆕 Date Added.
🔥 20 hours ago
Clinical Review Nurse conducting inpatient utilization reviews and medical necessity determinations for Centene’s healthcare services. Coordinating care, discharge planning, and provider collaboration across Georgia or Florida.
🕒 Yesterday
Utilization management clinician reviewing behavioral healthcare services for Detroit Wayne Integrated Health Network. Coordinating authorizations, complex care, referrals, and continuity of care.
🕒 Yesterday
Utilization Management Nurse conducting evidence-based reviews for Cambia’s person-focused health care system. Collaborating with clinical teams to support quality, compliant, cost-effective care.
🥔 Idaho, Oregon, +2 more states – Remote
💵 $34 - $55 / hour
⏰ Full Time
🟡 Mid-level
🟠 Senior
👻 Ghost score 0%
🕒 Yesterday
Remote utilization management RN reviewing Medicare clinical cases and coverage determinations for CVS Health. Coordinating treatment and improving member outcomes using evidence-based guidelines.
🌵 Arizona, California, +7 more states – Remote
💵 $29 - $62 / hour
⏰ Full Time
🟡 Mid-level
🟠 Senior
💼 Consultant
👻 Ghost score 0%
🕒 Yesterday
Clinical Review Nurse conducting concurrent utilization reviews for Centene healthcare members. Evaluating medical necessity, care levels, and discharge planning remotely in North Carolina.
🕒 2 days ago
Remote RN case manager assessing patients, coordinating discharges, and reviewing utilization. Supporting INTEGRIS Health, Oklahoma’s largest not-for-profit health system.
🕒 2 days ago
CVS Health utilization management nurse reviewing clinical information for coverage decisions. Coordinating care and referrals to improve member outcomes remotely.
🕒 2 days ago
Prior Authorization Utilization Review Nurse evaluating medical necessity and supporting cost-effective care decisions for Gainwell’s healthcare programs. Reviewing requests and collaborating virtually with providers and internal teams.
🇺🇸 United States – Remote
💵 $64.5k - $82k / year
💰 Grant on 2023-06
⏰ Full Time
🟢 Junior
🟡 Mid-level
🦅 H1B Visa Sponsor
👻 Ghost score 0%
🕒 2 days ago
Clinical Review Nurse conducting concurrent reviews for Centene healthcare members. Evaluating medical necessity, utilization, care levels, and discharge planning remotely in California.
🕒 2 days ago
Utilization Management RN reviewing healthcare services and coverage recommendations for CVS Health. Collaborating with providers to improve member care and outcomes remotely from Illinois.
🕒 5 days ago
Utilization Review Specialist managing behavioral-health authorizations and medical-necessity reviews. Supporting Bradford Health Services’ addiction-treatment network, payer approvals, and patient-care continuity.
🏈 Alabama – Remote
💵 $60k - $75k / year
⏰ Full Time
🟢 Junior
🟡 Mid-level
🚫👨🎓 No degree required
👻 Ghost score 0%
🕒 5 days ago
Utilization Review Specialist supporting Bradford Health Services’ addiction treatment programs. Managing payer authorizations, clinical reviews, appeals, and behavioral-health care coordination.
🏈 Alabama – Remote
💵 $60k - $75k / year
⏰ Full Time
🟢 Junior
🟡 Mid-level
🚫👨🎓 No degree required
👻 Ghost score 0%
🕒 5 days ago
Utilization Management RN reviewing clinical information and coverage determinations for CVS Health. Coordinating quality, cost-effective care with providers and internal teams.
🕒 5 days ago
Remote Utilization Review Case Manager gathering clinical data and certifying medical necessity for CorVel’s workers’ compensation risk management services. Assigning lengths of stay and making treatment certification decisions.
🏄 California – Remote
💵 $30 - $45 / hour
⏰ Full Time
🟡 Mid-level
🟠 Senior
👔 Manager
🦅 H1B Visa Sponsor
👻 Ghost score 0%
🕒 5 days ago
CVS Health Utilization Management RN reviewing clinical information and supporting coverage determinations. Coordinating care and improving healthcare outcomes from home.
🕒 5 days ago
Utilization Management Clinician reviewing behavioral health authorizations and medical necessity for Lucet’s members. Coordinating care and discharge planning remotely across the United States.
🇺🇸 United States – Remote
💵 $72k - $77k / year
⏰ Full Time
🟢 Junior
🟡 Mid-level
✨ Clinician
👻 Ghost score 0%
🕒 5 days ago
Utilization Management Nurse Consultant reviewing clinical information and coordinating care for CVS Health members. Remote RN role supporting evidence-based coverage decisions and healthcare outcomes.
🕒 5 days ago
Utilization Management Nurse Consultant reviewing clinical information and coordinating care for CVS Health. Supporting coverage decisions, quality outcomes, and effective healthcare utilization from Pennsylvania.
🕒 5 days ago
51 - 200
💼 Consulting
⚖️ Legal
🛡️ Insurance
Utilization Review Specialist reviewing medical necessity, authorizations, and coding for Cobalt Benefits Group’s health-plan operations. Coordinating utilization reviews and claims decisions with clinical and administrative teams.
🗻 New Hampshire, Vermont – Remote
💵 $20 - $22 / hour
⏰ Full Time
🟢 Junior
🚫👨🎓 No degree required
👻 Ghost score 4%
🕒 September 17
Remote per-diem RN managing clinically based appeals for Providence healthcare services. Advocating for compliant reimbursement across California-region payers.
🏄 California – Remote
💵 $57 - $88 / hour
⏱ Part Time
🟡 Mid-level
🟠 Senior
👔 Manager
🦅 H1B Visa Sponsor
👻 Ghost score 0%
+31 More Utilization Review Nurse Jobs Available!
The average salary for remote utilization review nurses is $86,147 per year. This is based on data from 19 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) | 4 | $68,625 |
🟡 Mid-level Utilization Review Nurse (2-4 yrs) | 15 | $90,819 |
We analyzed 10 job listings in the last year and found it takes about 14 days for employers to close a job opening.
We reviewed 19 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 minutes after 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.