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Independent Contractor Remote Utilization Management Nurse Jobs in Florida

Liveops

Remote Customer Service Agent

Jupiter, FL · Remote

$15.25 - $20.25/hr

Customer Service Agent -- Independent Contractor (Remote) Location: Remote (US-Based) Liveops is seeking independent contractors to provide virtual customer service support for a variety of client ...

Liveops

Remote Customer Service Agent

Hollywood, FL · Remote

$14.25 - $19/hr

Customer Service Agent -- Independent Contractor (Remote) Location: Remote (US-Based) Liveops is seeking independent contractors to provide virtual customer service support for a variety of client ...

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Independent Contractor Remote Utilization Management Nurse information

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.

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 are the most commonly searched types of Remote Utilization Management Nurse jobs in Florida?

The most popular types of Remote Utilization Management Nurse jobs in Florida are:

What are popular job titles related to Independent Contractor Remote Utilization Management Nurse jobs in Florida?

For Independent Contractor Remote Utilization Management Nurse jobs in Florida, the most frequently searched job titles are:

What job categories do people searching Independent Contractor Remote Utilization Management Nurse jobs in Florida look for?

The top searched job categories for Independent Contractor Remote Utilization Management Nurse jobs in Florida are:

What cities in Florida are hiring for Independent Contractor Remote Utilization Management Nurse jobs?

Cities in Florida with the most Independent Contractor Remote Utilization Management Nurse job openings:

Independent Contractor Remote Utilization Management Nurse jobs near you

Remote Utilization Review RN (Hospital-Based Experience Required)

HealthPlus Staffing

Fort Lauderdale, FL • Remote

$80K - $105K/yr

Full-time

Re-posted 5 days ago

Job description

Quick Job Details:

Setting: Fully Remote – Utilization Review
Schedule: Full-Time, Monday–Friday
Hours: Standard Business Hours

Job Requirements:
  • Active RN license with Multi-State/Compact License required
  • Minimum 2 years of Utilization Review experience within a hospital or health system (provider-side required)
  • Payer/insurance-only Utilization Management experience is not eligible
  • Minimum 3 years of acute care/hospital RN experience
  • Strong understanding of medical necessity, utilization management, healthcare reimbursement, and clinical documentation improvement
  • Experience applying InterQual and/or MCG criteria preferred
  • Excellent communication, analytical, and critical thinking skills
  • Ability to work independently in a remote environment
Responsibilities:
  • Conduct admission, concurrent/continued stay, and observation reviews
  • Apply medical necessity criteria to determine appropriate level of care
  • Escalate cases to Physician Advisors when appropriate
  • Collaborate with physicians, case managers, and insurance payers
  • Support denial prevention, documentation improvement, and revenue cycle initiatives
  • Ensure compliance with payer guidelines, CMS, and regulatory requirements
  • Analyze clinical and financial data to identify quality improvement opportunities

Compensation: Competitive; based on experience

Benefits: Comprehensive benefits package

About Us

HealthPlus Staffing is a national leader in healthcare staffing. We partner with leading healthcare organizations nationwide to connect highly qualified professionals with exceptional career opportunities.

Our Promise
  • Direct access to hiring decision-makers
  • Timely feedback throughout the interview process
  • Dedicated support to help you make an informed career decision

If you're interested in this opportunity, please submit your application or call 561-291-7787 to speak with one of our experienced recruiters. We look forward to helping you find your next opportunity!

The HealthPlus Team