Utilization Review Nurse
Tempe, AZ · Remote
$35 - $45.94/hr
You will report into the Supervisor, Utilization Review. Work Location ... This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois;
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Tempe, AZ · Remote
$35 - $45.94/hr
You will report into the Supervisor, Utilization Review. Work Location ... This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois;
Quick apply
Tempe, AZ · Remote
$35 - $45.94/hr
You will report into the Supervisor, Utilization Review. Work Location ... This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois;
The Utilization Management (UM) Clinical Reviewer is responsible for performing utilization review ... Review and process prior authorization, reauthorization, and continued stay requests for home ...
The Utilization Management (UM) Clinical Reviewer is responsible for performing utilization review ... Review and process prior authorization, reauthorization, and continued stay requests for home ...
Phoenix, AZ · Remote
$42 - $43.50/hr
Review medical records to identify potential quality, safety, and utilization concerns * Conduct ... Analyze trends and assist in identifying patterns in care delivery and outcomes * Collaborate with ...
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Phoenix, AZ · Remote
$42 - $43.50/hr
Review medical records to identify potential quality, safety, and utilization concerns * Conduct ... Analyze trends and assist in identifying patterns in care delivery and outcomes * Collaborate with ...
Phoenix, AZ · Remote
$17.25 - $23.25/hr
The Administrative Assistant plays a critical part in our tax preparation and fulfillment ... Ability to type accurately and efficiently to perform essential job functions Please review this ...
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Phoenix, AZ · Remote
$17.25 - $23.25/hr
The Administrative Assistant plays a critical part in our tax preparation and fulfillment ... Ability to type accurately and efficiently to perform essential job functions Please review this ...
Phoenix, AZ · Remote
$41 - $44/hr
USA- Remote in approved states Overview: TEEMA is partnering with a leading organization supporting ... Review medical records to identify potential quality, safety, and utilization concerns * Conduct ...
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Phoenix, AZ · Remote
$41 - $44/hr
USA- Remote in approved states Overview: TEEMA is partnering with a leading organization supporting ... Review medical records to identify potential quality, safety, and utilization concerns * Conduct ...
Remote: not held to onsite requirements, however, leadership can request presence onsite for ... review, utilization review and other managed care functions Required Education * Medical Degree ...
Remote: not held to onsite requirements, however, leadership can request presence onsite for ... review, utilization review and other managed care functions Required Education * Medical Degree ...
Phoenix, AZ · Remote
Medical
Dental
Vision
Life
Retirement
PTO
... utilization review, clinical criteria configuration, and pharmacy system implementations, with ... This is a fully remote, full time engagement with an anticipated duration of ten months and an ...
Quick apply
Phoenix, AZ · Remote
Medical
Dental
Vision
Life
Retirement
PTO
... utilization review, clinical criteria configuration, and pharmacy system implementations, with ... This is a fully remote, full time engagement with an anticipated duration of ten months and an ...
Phoenix, AZ · Remote
Medical
Dental
Vision
Life
Retirement
PTO
... utilization review, clinical criteria configuration, and pharmacy system implementations, with ... This is a fully remote, full time engagement with an anticipated duration of ten months and an ...
Phoenix, AZ · Remote
Medical
Dental
Vision
Life
Retirement
PTO
... utilization review, clinical criteria configuration, and pharmacy system implementations, with ... This is a fully remote, full time engagement with an anticipated duration of ten months and an ...
Scottsdale, AZ · On-site +1
Medical
Dental
Life
Retirement
PTO
Perform Utilization Review activities prospectively, concurrently or retrospectively in accordance ... May assist in training/orientation of new staff as requested * Other duties may be assigned.
Scottsdale, AZ · On-site +1
Medical
Dental
Life
Retirement
PTO
Perform Utilization Review activities prospectively, concurrently or retrospectively in accordance ... May assist in training/orientation of new staff as requested * Other duties may be assigned.
Phoenix, AZ · On-site +1
Medical
Dental
Vision
Retirement
PTO
You will review UM activities, including prospective, concurrent, and retrospective reviews, and ... This is a fully remote position, and we'll provide all the necessary equipment! * Work Environment:
Phoenix, AZ · On-site +1
Medical
Dental
Vision
Retirement
PTO
You will review UM activities, including prospective, concurrent, and retrospective reviews, and ... This is a fully remote position, and we'll provide all the necessary equipment! * Work Environment:
Phoenix, AZ · Remote
Medical
Dental
Vision
Retirement
PTO
You will review UM activities, including prospective, concurrent, and retrospective reviews, and ... This is a fully remote position, and we'll provide all the necessary equipment! * Work Environment:
Quick apply
Phoenix, AZ · Remote
Medical
Dental
Vision
Retirement
PTO
You will review UM activities, including prospective, concurrent, and retrospective reviews, and ... This is a fully remote position, and we'll provide all the necessary equipment! * Work Environment:
Scottsdale, AZ · On-site +1
Medical
Dental
Life
Retirement
PTO
Perform Utilization Review activities prospectively, concurrently or retrospectively in accordance ... May assist in training/orientation of new staff as requested * Other duties may be assigned.
Scottsdale, AZ · On-site +1
Medical
Dental
Life
Retirement
PTO
Perform Utilization Review activities prospectively, concurrently or retrospectively in accordance ... May assist in training/orientation of new staff as requested * Other duties may be assigned.
Be Seen First
Phoenix, AZ · Remote
$53 - $55/hr
Medical
Dental
Vision
Life
Retirement
Drug Utilization Review (DUR) * Strong understanding of CMS regulations and managed care pharmacy ... Remote Work Requirements Candidates must have: * A dedicated, quiet workspace free from ...
New
Quick apply
Be Seen First
Phoenix, AZ · Remote
$53 - $55/hr
Medical
Dental
Vision
Life
Retirement
Drug Utilization Review (DUR) * Strong understanding of CMS regulations and managed care pharmacy ... Remote Work Requirements Candidates must have: * A dedicated, quiet workspace free from ...
New
Phoenix, AZ · Remote
$140 - $145/hr
... peer reviews, utilization management, and provider engagement initiatives. This long-term ... delivery on a national scale, all from a flexible remote environment. Duties ...
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Phoenix, AZ · Remote
$140 - $145/hr
... peer reviews, utilization management, and provider engagement initiatives. This long-term ... delivery on a national scale, all from a flexible remote environment. Duties ...
Phoenix, AZ · Remote
$29 - $52/hr
Retirement
Utilization Review experience *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local ...
New
Phoenix, AZ · Remote
$29 - $52/hr
Retirement
Utilization Review experience *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local ...
New
Phoenix, AZ · Remote
... remote administrative operations and 25% (1 day per week) to your own private practice or locum ... Duties & ResponsibilitiesClinical Governance & Utilization Review * Coverage Determinations:
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Phoenix, AZ · Remote
... remote administrative operations and 25% (1 day per week) to your own private practice or locum ... Duties & ResponsibilitiesClinical Governance & Utilization Review * Coverage Determinations:
Glendale, AZ · Remote
$26.41 - $51.49/hr
... utilization management (UM) policies and procedures. Required Qualifications • At least 2 years experience, including experience in hospital acute care, inpatient review, prior authorization ...
Glendale, AZ · Remote
$26.41 - $51.49/hr
... utilization management (UM) policies and procedures. Required Qualifications • At least 2 years experience, including experience in hospital acute care, inpatient review, prior authorization ...
Phoenix, AZ · Remote
$26.41 - $51.49/hr
... utilization management (UM) policies and procedures. Required Qualifications • At least 2 years experience, including experience in hospital acute care, inpatient review, prior authorization ...
Phoenix, AZ · Remote
$26.41 - $51.49/hr
... utilization management (UM) policies and procedures. Required Qualifications • At least 2 years experience, including experience in hospital acute care, inpatient review, prior authorization ...
Avondale, AZ · Remote
$26.41 - $51.49/hr
... utilization management (UM) policies and procedures. Required Qualifications • At least 2 years experience, including experience in hospital acute care, inpatient review, prior authorization ...
Avondale, AZ · Remote
$26.41 - $51.49/hr
... utilization management (UM) policies and procedures. Required Qualifications • At least 2 years experience, including experience in hospital acute care, inpatient review, prior authorization ...
Gilbert, AZ · Remote
$26.41 - $51.49/hr
... utilization management (UM) policies and procedures. Required Qualifications • At least 2 years experience, including experience in hospital acute care, inpatient review, prior authorization ...
Gilbert, AZ · Remote
$26.41 - $51.49/hr
... utilization management (UM) policies and procedures. Required Qualifications • At least 2 years experience, including experience in hospital acute care, inpatient review, prior authorization ...
$11.46 - $13.47
1% of jobs
$13.47 - $15.49
1% of jobs
$15.49 - $17.51
4% of jobs
$17.51 - $19.53
9% of jobs
$20.49 is the 25th percentile. Wages below this are outliers.
$19.53 - $21.55
21% of jobs
The median wage is $23.30 / hr.
$21.55 - $23.56
16% of jobs
$23.56 - $25.58
18% of jobs
$26.59 is the 75th percentile. Wages above this are outliers.
$25.58 - $27.60
10% of jobs
$27.60 - $29.62
10% of jobs
$29.62 - $31.64
6% of jobs
$31.64 - $33.65
4% of jobs
$11
$24
$33
| Aspect | Assistant Remote Utilization Review | Utilization Review Nurse |
|---|---|---|
| Credentials | Typically requires a nursing license, certification in case management or utilization review | Registered Nurse (RN) license, often with additional certifications in case management or utilization review |
| Work Environment | Remote, administrative setting, telehealth or telecommuting | Remote or hospital/clinic settings, primarily telehealth or administrative |
| Employer & Industry | Health insurance companies, managed care organizations, healthcare providers | Hospitals, insurance companies, healthcare organizations |
Both roles involve reviewing patient cases to determine appropriate care and resource utilization. The Assistant Remote Utilization Review typically supports the process with administrative tasks and basic review, while the Utilization Review Nurse performs more in-depth clinical assessments. Both require nursing credentials and often work remotely within healthcare or insurance industries.

6.9
Based on 6 frontline employees who took The Breakroom Quiz
252nd of 304 rated insurance
Hi, we're Oscar. We're hiring a Utilization Review Nurse to join our Utilization Review team.
About the role:
You will perform frequent case reviews, check medical records and speak with care providers regarding treatment as needed. You will make recommendations regarding the appropriateness of care for identified diagnoses based on the research results for those conditions.
You will report into the Supervisor, Utilization Review.
Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois; Iowa; Kansas; Michigan; Missouri; Nebraska; New Jersey; North Carolina; Ohio; Oklahoma; Pennsylvania; South Carolina; Tennessee; Texas; or Virginia. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events.
Pay Transparency: The base pay for this role is: $35.00 - $45.94 per hour. You are also eligible for employee benefits and monthly vacation accrual at a rate of 15 days per year.
Responsibilities:
Requirements:
Bonus points:
This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.
At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.
Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.
Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.
Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known.
California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.
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Insurance services
1,001 - 5,000 Employees
New York, NY, US
2012