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Director Remote Utilization Review Jobs (NOW HIRING)

Emory Healthcare

Utilization Review Specialist

Atlanta, GA · Remote

$47.40 - $54.95/hr

... Medical Director of UR. Operational Support: 1. Conducts thorough medical necessity reviews to ... Work Type: This position is a remote position outside traditional office, often from home or ...

Oscar Health

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;

Dane Street, LLC

Utilization Review Physician

Perform utilization review for: * Preauthorization requests * Appeals (first and second level ... Remote work from home * Full-time, Monday-Friday * Availability for occasional weekends and holiday ...

Bracane Co

Utilization Review Nurse

Plano, TX · Remote

***REMOTE - Candidates must be based in Texas: Austin area - Travis/Williamson Counties or Richardson ... This position is responsible for performing initial, concurrent review activities; discharge care ...

Village Care

Utilization Review Nurse

Manhattan, NY · Remote

$95K - $105K/yr

RN- Utilization Review Nurse Inpatient *Hybrid* Must reside within the New York Tri-State Area - N ... Frequently collaborates and communicates with physician peer reviewers and medical directors in ...

Umpqua Health

Utilization Review Nurse

Roseburg, OR · On-site +1

$85K - $105K/yr

UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR ... Escalate complex cases to Medical Directors and request additional documentation as needed

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Director Remote Utilization Review information

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How much do director remote utilization review jobs pay per hour?

As of Jun 20, 2026, the average hourly pay for director remote utilization review in the United States is $42.28, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 per hour, depending on experience, location, and employer.

What is the difference between Director Remote Utilization Review vs Utilization Review Nurse?

AspectDirector Remote Utilization ReviewUtilization Review Nurse
CredentialsTypically requires a nursing license, advanced degree, and management experienceRegistered Nurse (RN) license, relevant clinical experience
Work EnvironmentOversees teams remotely, strategic planning, policy developmentConducts patient reviews, collaborates with healthcare providers, often remote or onsite
Employer & Industry UsageHealth insurance companies, managed care organizationsHospitals, insurance companies, healthcare facilities

The main difference is that the Director Remote Utilization Review focuses on managing teams and policies remotely, while the Utilization Review Nurse performs clinical reviews directly related to patient care. The director has a broader strategic role, whereas the nurse role is more clinical and operational.

What is a Director of Remote Utilization Review?

A Director of Remote Utilization Review is a healthcare leader responsible for overseeing teams that assess the necessity, appropriateness, and efficiency of medical services, typically from a remote or virtual environment. This role ensures compliance with regulatory guidelines, optimizes resource use, and helps manage healthcare costs while maintaining quality patient care. Directors collaborate with physicians, nurses, and insurance providers to review clinical cases and develop utilization review strategies. They also monitor performance metrics and implement process improvements for remote teams.

How does a Director of Remote Utilization Review typically collaborate with clinical and administrative teams to ensure effective patient care management?

A Director of Remote Utilization Review plays a pivotal role in bridging clinical staff, case managers, and administrative teams to optimize patient care and resource utilization. This is often achieved through regular virtual meetings, data sharing, and cross-departmental strategy sessions to review utilization trends and address barriers to care. The director ensures that remote teams adhere to regulatory standards and organizational goals, fostering open communication to streamline workflows and resolve complex cases efficiently. Successful collaboration enhances patient outcomes, reduces unnecessary costs, and maintains compliance, all while supporting a positive remote team environment.

What are the key skills and qualifications needed to thrive as a Director of Remote Utilization Review, and why are they important?

To thrive as a Director of Remote Utilization Review, you need in-depth knowledge of healthcare regulations, utilization management processes, and a relevant clinical background, typically supported by an RN or other clinical licensure and experience in case management. Familiarity with utilization review software, electronic health records (EHR), and certifications such as CCM or UM are often required. Leadership, analytical thinking, and strong communication skills are vital for guiding teams and collaborating with stakeholders. These skills ensure effective oversight of remote teams, regulatory compliance, and optimal patient care outcomes.
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What cities are hiring for Director Remote Utilization Review jobs? Cities with the most Director Remote Utilization Review job openings:
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Director Remote Utilization Review jobs near you
Infographic showing various Director Remote Utilization Review job openings in the United States as of June 2026, with employment types broken down into 1% As Needed, 93% Full Time, and 6% Part Time. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.
Travel Utilization Review RN - $2,130 per week

Travel Utilization Review RN - $2,130 per week

Vivian Health

Apple Valley, CA • Remote

$2.1K/wk

Other

Medical, Dental, Life, Retirement

Posted 2 days ago

Job description

American Consultants is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Apple Valley, California.

Job Description & Requirements
  • Specialty: Utilization Review
  • Discipline: RN
  • Start Date: 07/13/2026
  • Duration: 13 weeks
  • 40 hours per week
  • Shift: 8 hours, days
  • Employment Type: Travel
Job Opportunity – Registered Nurse, Utilization Review – Apple Valley, CA 92307

Start Date: July 13, 2026

Location: Apple Valley, California

Schedule: Day shift, 5x8-hour shifts (08:00 - 16:30). Minimum of 4 weekend shifts required within a 6-week period. Patient ratio 1:35-45. Remote utilization review position.

Highlights:
  • Remote utilization review opportunity with an acute care facility
  • 13-week assignment with competitive compensation and travel support
  • Work with Epic charting system and InterQual criteria
  • 40 hours of paid orientation provided
  • Business attire dress code for a professional environment
  • Serve diverse patient populations including neonates, adolescents, adults, and geriatrics
Requirements:
  • Active California RN license (pending licenses accepted if active by start date)
  • Minimum 3 years of acute medical Care Manager/Utilization Management experience in a hospital setting (health plan or medical group experience does not qualify)
  • Recent proficiency with Epic charting system within the last 6-12 months (required)
  • Experience with InterQual criteria (required)
  • Seasoned travel nursing experience required
  • Experience managing patient ratios of 35-45
  • Knowledge of Medicare regulations including CC44s, ABNs, HINNs, and MCSNs
  • Experience with HMOs, IPAs, and California Medi-Cal programs preferred
  • Proficiency in concurrent review, pre-certification, prior authorization, and appeals/denials processes
Why Join Us?

This remote utilization review position offers an excellent opportunity for experienced case management nurses seeking a structured day shift schedule in a professional acute care setting. You'll receive comprehensive orientation, competitive travel compensation, and the flexibility to work from home while supporting multiple facilities. The role provides up to 7 days of requested time off and requires commitment to 3 of 5 major holidays, ensuring work-life balance within a supportive travel nursing framework.

American Consultants Job ID #18533836. Pay package is based on 8 hour shifts and 40.0 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: RN:Case Manager,07:00:00-15:00:00

About American Consultants

Since 1989, American Consultants has been the leader in national healthcare staffing and consulting services. We have successfully placed thousands of healthcare professionals in executive, clinical, laboratory, financial, consulting, and HIT roles across the country. We specialize in Healthcare Search and Staffing, IT Staffing and Solutions, and Executive Search and Interim Services. American Consultants takes a consultative approach to help our clients solve their talent acquisition and HIT challenges. We are truly the healthcare people.

Why Vivian Health?

Be sure to apply via Vivian Health to increase your chances of landing your perfect job. Just complete your Vivian Health profileonce, and get access to thousands of opportunities across the country. Then keep up to date with your job application process and conversations with our easy to use app.

Benefits
  • Medical benefits
  • Dental benefits
  • Life insurance
  • Weekly pay
  • License and certification reimbursement
  • Holiday Pay
  • 401k retirement plan
  • Referral bonus

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