ZipRecruiter

Log In

2

Director Remote Utilization Review Jobs (NOW HIRING)

CorVel

CA Utilization Review Nurse I

$30.64 - $45.80/hr

CA Utilization Review Nurse I The Utilization Review Nurse gathers demographic and clinical ... This is a remote position. Essential Functions & Responsibilities: * Identifies the necessity of ...

Corvel

CA Utilization Review Nurse I

Rancho Cucamonga, CA · Remote

$30.64 - $45.80/hr

The Utilization Review Nurse gathers demographic and clinical information on prospective ... This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Identifies the necessity of ...

Actalent

Remote Appeals Clinical Reviewer LPN

$28 - $33/hr

The nurse collaborates closely with Medical Directors, providers, claims teams, and utilization ... Review and evaluate member and provider appeals related to medical necessity determinations ...

New

Actalent

Remote Appeals Clinical Review LPN

$28 - $33/hr

The nurse collaborates closely with Medical Directors, providers, claims teams, and utilization ... Review and evaluate member and provider appeals related to medical necessity determinations ...

New

next page

Showing results 1-20

All JobsUtilization Review JobsDirector Remote Utilization Review Jobs

Director Remote Utilization Review information

See salary details

$21

$42

$68

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

As of Jul 11, 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.
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:
Director Remote Utilization Review jobs near you
Physician Reviewer - Orthopedic Spine Surgery (Utilization Review)

Physician Reviewer - Orthopedic Spine Surgery (Utilization Review)

Dane Street, LLC

New York, NY • On-site, Remote

Contractor

Re-posted 2 days ago

Job description

Dane Street, a nationally recognized Independent Review Organization (IRO), is expanding its panel of Physician Reviewers. We are currently seeking Board-Certified Orthopedic Spine Surgeons with an active New York medical license and Workers' Compensation Board Certification to conduct Utilization Reviews.
This is a fully remote, non-clinical role offering supplemental income with flexible scheduling. Physicians provide objective, evidence-based opinions on the medical necessity of treatment requests and appeals. No patient contact, no treatment, and no doctor-patient relationship is established.
Key Responsibilities:
  • Review medical records to determine the medical necessity of services
  • Utilize state-specific workers' compensation guidelines and nationally recognized criteria
  • Submit clear, concise, and well-supported determinations
  • Complete reviews within required timeframes (typically 1-5 business days)
  • Participate in peer-to-peer calls as needed (coordinated by Dane Street)
  • Complete addenda when new information is provided

Role Highlights:
  • Independent contractor (1099) status
  • Average case takes 15 minutes or less
  • Flat rate per case - consistent, supplemental income
  • Fully remote - work from anywhere
  • You control volume and availability
  • No direct patient interaction or treatment
  • Chronological, pre-organized medical records provided
  • User-friendly portal and streamlined case management
  • Full onboarding and ongoing support included

Requirements:
  • Board Certification in Orthopedic Surgery (Spine focus preferred)
  • Active, unrestricted New York medical license
  • Workers' Compensation Board Certification (New York)
  • Active clinical practice

About Dane Street:
Dane Street is a national leader in Utilization Review and Independent Medical Review services. We partner with highly qualified, actively practicing physicians to ensure high-quality, evidence-based clinical decisions that support better outcomes across the healthcare system.
Apply today to join our Physician Review Panel and start earning on your schedule.

Apply