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Independent Contractor Remote Utilization Management Nurse Jobs

Intus, Inc

Contract Utilization Management Nurse

$42/hr

Coordination and review of all other services delivered by contracted providers and identified by ... This is a fully remote role based in the United States. Sponsorship: This position is not eligible ...

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How much do independent contractor remote utilization management nurse jobs pay per hour?

As of Aug 4, 2026, the average hourly pay for independent contractor remote utilization management nurse 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.

How does an independent contractor remote utilization management nurse typically collaborate with healthcare teams while working remotely?

As an Independent Contractor Remote Utilization Management Nurse, you will regularly communicate and collaborate with physicians, case managers, and other healthcare professionals through secure digital platforms, email, and conference calls. Despite working remotely, strong teamwork is essential for reviewing patient cases, discussing complex situations, and ensuring appropriate care decisions. Maintaining clear and timely communication, as well as building professional relationships with both internal and external stakeholders, helps facilitate efficient utilization reviews and high-quality patient care. You may also attend virtual team meetings and contribute to interdisciplinary discussions to stay aligned with organizational goals.

What is the difference between Independent Contractor Remote Utilization Management Nurse vs Utilization Review Nurse?

AspectIndependent Contractor Remote Utilization Management NurseUtilization Review Nurse
CredentialsRN license, certification in case management or utilization review often preferredRN license, certification in case management or utilization review often required
Work EnvironmentRemote, independent contractor basis, flexible scheduleTypically employed by healthcare organizations, may be remote or onsite
Employer & Industry UsageContract basis, used by insurance companies, healthcare providers, or third-party administratorsFull-time or part-time employee, used within hospitals, insurance companies, or managed care organizations

The main difference is that the Independent Contractor Remote Utilization Management Nurse works on a contract basis, often remotely, providing specialized review services independently. In contrast, the Utilization Review Nurse is usually employed directly by healthcare organizations or insurers, with a more structured work environment. Both roles require similar credentials and focus on evaluating medical necessity and appropriateness of care.

What is an independent contractor remote utilization management nurse?

An Independent Contractor Remote Utilization Management Nurse is a licensed nurse, typically a registered nurse (RN), who works remotely as a contractor rather than a full-time employee. Their primary responsibilities include reviewing medical records, evaluating the necessity and efficiency of healthcare services, and ensuring that patient care aligns with established guidelines and insurance requirements. These nurses communicate with healthcare providers to facilitate approvals or denials of medical services, often for insurance companies or third-party administrators. Working remotely allows for schedule flexibility and the ability to serve multiple clients, but also requires strong organizational and communication skills.

What are the key skills and qualifications needed to thrive as an independent contractor remote utilization management nurse?

To thrive as an Independent Contractor Remote Utilization Management Nurse, you need a current RN license, clinical experience (often in acute care), and strong knowledge of utilization review processes. Familiarity with case management software, electronic medical records (EMRs), and industry-standard guidelines like Milliman or InterQual is typically required. Exceptional time management, critical thinking, and effective communication skills help you excel when working independently and collaborating virtually with healthcare teams. These competencies ensure accurate utilization reviews, regulatory compliance, and optimal patient care outcomes in a remote setting.
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Independent Contractor Remote Utilization Management Nurse jobs near you
Infographic showing various Independent Contractor Remote Utilization Management Nurse job openings in the United States as of July 2026, with employment types broken down into 1% Locum Tenens, 74% Full Time, 7% Part Time, and 18% Contract. Highlights an 90% Physical, 1% Hybrid, and 9% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

Contract Utilization Management Nurse

Intus, Inc

Remote

$42/hr

Full-time

Posted 7 days ago

Job description

About IntusCare
IntusCare is the only end-to-end ecosystem built specifically to help Programs of All-Inclusive Care for the Elderly (PACE) programs deliver exceptional care, strengthen financial performance, and stay compliant. IntusCare replaces outdated technology and manual workarounds with purpose-built solutions for care coordination, risk adjustment, population health, and utilization management. IntusCare empowers teams to take control of their operations and improve outcomes for dual-eligible seniors - some of the most socially vulnerable and clinically complex individuals in the US healthcare system.
Role Overview
The Contract Utilization Management Nurse plays a critical role in ensuring high-quality, cost-effective, and compliant care for PACE participants supported by IntusCare. This individual partners closely with PACE Interdisciplinary Teams, Medical Directors, and provider networks to review service utilization, guide care decisions and support timely, appropriate transitions across care settings. Blending clinical expertise with analytical thinking, the Utilization Management Nurse ensures services are medically necessary, aligned with care plans and consistent with PACE regulations and best practices. This role is essential to maintaining program integrity, improving participant outcomes and supporting the delivery of coordinated, value-based care.
Responsibilities
  • Rigorous adherence to PACE program service authorization policies, ensuring that participant care and related claims are:
    • Reasonable and necessary for diagnosis or treatment and consistent with PCP coordination decisions.
    • In accordance with accepted medical standards and consistent with the participant care needs including level of care and advanced care planning principles.
  • Active involvement in various aspects of the utilization management process, including:
    • Concurrent review of all hospital admissions (observation and inpatient) with the Interdisciplinary Team driving efficient and timely transitions of care, retrospective review of inpatient admissions under 48 hours, and claims submitted inconsistent with the service authorization.
    • Concurrent review of all subacute and SNF admissions with the Interdisciplinary Team driving efficient and timely discharge plans and transitions of care.
    • Coordination and review of all other services delivered by contracted providers and identified by the PACE program assuring consistency with Interdisciplinary Team service authorization, care plans, and PCP coordination decisions.
  • Employ effective use of knowledge, critical thinking, and skills to:
    • Advocate quality care and enhanced quality of life
    • Advocate decreased hospital stay when appropriate
    • Maintain accurate records of all patient related interactions
  • Appeal Management - In cases of claim rejection, the IntusCare Utilization Management Nurse will lead the provider appeals process. Responsibilities Include:
    • Comprehensive review of provider network appeals.
    • Collaboration with the PACE Program's Medical Director to review and respond to appeal requests, ensuring issuance of a written determination consistent with the PACE program policies.

Qualifications
  • 3 to 5 years of utilization management experience.
  • Current RN license
  • Proven experience working in risk based integrated models of care.
  • Ability to use data to drive decisions and collaboration with internal and external stakeholders.
  • Strong strategic thinking, problem solving, and decision making skills.
  • Excellent communication and leadership abilities, capable of motivating and guiding teams toward timely and efficient care management strategies

What We Offer
  • 1 year contract with the possibility of extension
  • A chance to be a part of a trailblazing team in healthcare technology.
  • A collaborative, inclusive, and dynamic work environment.

Compensation: The range for this role is $42.00/Hour.
Work location: This is a fully remote role based in the United States.
Sponsorship: This position is not eligible for sponsorship.

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