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Full Time Remote Physical Therapy Utilization Review Jobs

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 ...

Utilization Review Nurse

Miami, FL · Remote

$35 - $45.94/hr

This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois ... Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 ...

Utilization Review Nurse

Dallas, TX · Remote

$35 - $45.94/hr

This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois ... Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 ...

Utilization Review Nurse

Tempe, AZ · Remote

$35 - $45.94/hr

This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois ... Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 ...

Utilization Review Nurse

Atlanta, GA · Remote

$35 - $45.94/hr

This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois ... Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 ...

***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 ...

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Full Time Remote Physical Therapy Utilization Review information

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$21

$42

$68

How much do full time remote physical therapy utilization review jobs pay per hour?

As of Jul 27, 2026, the average hourly pay for full time remote physical therapy 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 Full Time Remote Physical Therapy Utilization Review vs Full Time Remote Physical Therapist?

AspectFull Time Remote Physical Therapy Utilization ReviewFull Time Remote Physical Therapist
CredentialsPT license, certification in utilization reviewPT license, state licensure
Work EnvironmentRemote, administrative settingRemote, clinical setting
Employer & IndustryInsurance companies, healthcare organizationsHospitals, outpatient clinics, rehab centers
Job FocusReviewing medical necessity, authorizationsProviding direct patient care, therapy services

Full Time Remote Physical Therapy Utilization Review focuses on evaluating medical necessity and authorizations remotely, while Full Time Remote Physical Therapists provide direct patient care from home. Both roles require a PT license, but differ in daily responsibilities and work environment.

What cities are hiring for Full Time Remote Physical Therapy Utilization Review jobs? Cities with the most Full Time Remote Physical Therapy Utilization Review job openings:
What are the most commonly searched types of Remote Physical Therapy Utilization Review jobs? The most popular types of Remote Physical Therapy Utilization Review jobs are:
What job categories do people searching Full Time Remote Physical Therapy Utilization Review jobs look for? The top searched job categories for Full Time Remote Physical Therapy Utilization Review jobs are:

Utilization Management Clinical Reviewer (Remote)

Tango Care

Phoenix, AZ • On-site, Remote

Full-time

Posted 2 days ago


Job description

Description
tango is a leader in the home health management industry and is preparing for significant growth! Our mission is to deliver innovative, home-based, post-acute solutions through proprietary technology and proven processes. We partner with health plans to provide a comprehensive suite of products and services designed to manage the total cost of care.
We are currently looking for Clinical Reviewers to join our growing Utilization Management team.
The Utilization Management (UM) Clinical Reviewer is responsible for performing utilization review activities to ensure the appropriate, efficient, and cost-effective use of home health services. This role evaluates medical necessity for skilled nursing and therapy services (physical therapy, occupational therapy, and speech-language pathology) in accordance with company policies, CMS guidelines (including Medicare Chapter 7), and established clinical criteria such as Milliman Care Guidelines.
The UM Clinical Reviewer collaborates with providers, internal teams, and payer partners to promote high-quality patient outcomes, ensure regulatory compliance, and support optimal care planning across disciplines.
Key Responsibilities:
  • Review and process prior authorization, reauthorization, and continued stay requests for home health services (nursing and therapy)
  • Evaluate medical records and clinical documentation to determine medical necessity and appropriateness of care
  • Apply CMS guidelines, NCQA standards, and internal clinical policies when making authorization determinations
  • Refer complex or non-compliant cases to Physician Advisors or Medical Directors as appropriate
  • Collaborate with providers to support appropriate utilization of skilled nursing and therapy visits
  • Serve as a clinical resource to internal team members and external partners, including providers, payers, and case managers
  • Facilitate effective communication to ensure alignment on care plans, documentation standards, and authorization decisions
  • Monitor adherence to home health regulations, documentation standards, and medical necessity criteria
  • Maintain accurate and timely documentation of reviews, decisions, and communications
  • Identify trends or issues impacting quality or utilization and escalate to leadership or quality committees as needed 7
  • Participate in interdisciplinary collaboration and support continuous improvement initiatives
  • Meet productivity, turnaround time, and quality standards for review completion 8
  • Participate in periodic weekend/holiday coverage based on business needs 9 10
  • Perform additional duties as assigned

Office Location:
  • Office located at 2415 E Camelback Road, Suite 700, Phoenix, AZ 85016
  • Remote

Qualifications:
Education & Licensure (one of the following required):
  • Graduate of an accredited nursing program (RN, LPN, or LVN), or
  • Graduate of an accredited Physical Therapy (PT), Occupational Therapy (OT), or Speech-Language Pathology (SLP) program
  • Active, unrestricted clinical license in good standing (multi-state licensure preferred where applicable)

Experience:
  • Minimum 2-5 years of clinical experience (home health, medical/surgical, or therapy setting)
  • Experience in utilization review, case management, or managed care strongly preferred
  • Home health experience strongly preferred

Knowledge and Experience:
  • Strong understanding of home health regulations, CMS guidelines, and medical necessity criteria
  • Knowledge of utilization management principles and care coordination practices
  • Familiarity with NCQA and URAC standards preferred
  • Ability to analyze clinical documentation and make independent, evidence-based decisions
  • Excellent written and verbal communication skills
  • Strong organizational skills with the ability to manage multiple priorities and meet deadlines
  • Ability to work independently while collaborating effectively across teams
  • Customer-service oriented mindset when working with providers and partners
  • Proficiency in Microsoft Office and electronic medical management systems

Additional Expectations
Employees are expected to:
  • Participate in ongoing education and training
  • Stay current on regulatory updates and clinical guidelines
  • Contribute to a culture of quality, compliance, and continuous improvement

tango provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. tango will make reasonable accommodations for qualified individuals with known disabilities unless doing so would result in an undue hardship.