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Director Remote Utilization Review Jobs (NOW HIRING)

Managed Staffing

Medical Director/Medical Officer

RI · Remote

$130 - $135/hr

Medical Director (Remote - USA) 100% Remote | Must have an active, unrestricted state medical ... This is a fully remote role supporting clinical teams, utilization review, and healthcare program ...

Umpqua Health

Utilization Review Nurse

Roseburg, OR · On-site +1

$85K - $105K/yr

UTILIZATION REVIEW NURSE REMOTE, ability to travel to 3031 NE STEPHENS ST. ROSEBURG, OR 97470, as ... Escalate complex cases to Medical Directors and request additional documentation as needed

Enterprise Engineering

Be Seen First

Concurrent Utilization Review (UR) Nurse

OR · Remote

$30 - $38/hr

Concurrent Utilization Review (UR) Nurse Remote Opportunity Contract to Hire Must be licenses in ... The UR Nurse collaborates with the Medical Director and clinical leadership for complex cases ...

VIVA USA INC

Utilization Review Nurse

Albuquerque, NM · On-site +1

Position Overview Remote position in any state except, NY, CA, HI, or AK Summary This Position Is ... Consult with supervisor/Medical Director regarding complex or difficult cases. 20.Provide ...

Medica

Utilization Review III

$70K - $120K/yr

Collaborate with Medical Directors for cases requiring physician review and support case ... This position is a Remote role. To be eligible for consideration, candidates must have a primary ...

Medix

Utilization Review Nurse - Remote

Tempe, AZ · On-site +1

$40 - $45/hr

Job Summary Our client is seeking a Utilization Review Nurse to perform frequent case reviews, check medical records, and communicate with care providers regarding treatment as needed. The nurse will ...

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All JobsDirector Remote Utilization Review Jobs

Director Remote Utilization Review information

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$21

$42

$68

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.
More about Director Remote Utilization Review jobs
What cities are hiring for Director Remote Utilization Review jobs? Cities with the most Director Remote Utilization Review job openings:
What are the most commonly searched types of Remote Utilization Review jobs? The most popular types of Remote Utilization Review jobs are:
What states have the most Director Remote Utilization Review jobs? States with the most job openings for Director Remote Utilization Review jobs include:
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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.
Medical Director/Medical Officer

Medical Director/Medical Officer

Managed Staffing

RI • Remote

$130 - $135/hr

Contractor

Posted 12 days ago

Be an early applicant

Job description

Medical Director (Remote – USA)

100% Remote | Must have an active, unrestricted state medical license

About the Role

Seeking an experienced Medical Director to provide clinical oversight, support medical policy implementation, and ensure quality assurance across programs. This is a fully remote role supporting clinical teams, utilization review, and healthcare program operations.

Key Responsibilities

  • Provide clinical oversight and decision-making to support medical management programs.
  • Oversee utilization review, quality assurance, and case management support.
  • Collaborate with clinical staff, account teams, and healthcare providers to improve care outcomes.
  • Review and interpret regulatory and compliance requirements (HIPAA, credentialing, documentation standards).
  • Participate in the development and evaluation of clinical/medical programs.

Required Qualifications

M.D. or D.O., Board Certified in a recognized specialty with post-graduate direct patient care experience.
Active, unrestricted U.S. state medical license
2–3 years of leadership experience as a Medical Director (or equivalent) in clinical oversight or healthcare operations.
Strong regulatory/compliance expertise and ability to prepare/utilize medical documentation effectively.
Epic EMR experience and strong computer skills.
Private home office with reliable high-speed internet.

Preferred Qualifications

  • Health plan/payor or managed care experience.
  • Experience collaborating with multidisciplinary clinical teams.
  • Strong knowledge of appeals, authorizations, and denial management.