ZipRecruiter

Log In

2

Independent Contractor Remote Utilization Management Nurse Jobs in Florida

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 ...

next page

Showing results 1-20

All JobsIndependent Contractor Utilization Management Nurse JobsIndependent Contractor Remote Utilization Management Nurse JobsIndependent Contractor Remote Utilization Management Nurse Jobs in Florida

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 Registered Nurse - Utilization Review - RRNUR 26-10215

Compu-Vision - Healthcare

Tampa, FL • Remote

$1.9K/wk

Full-time

Posted 5 days ago

Job description

Remote Registered Nurse – Utilization Review

Location: Fort Myers, FL 33916
Work Arrangement: Remote
Duration: Contract - 13 Weeks
Schedule: Monday–Friday, 8:00 AM–4:30 PM
Weekend: Every 5th weekend rotation
Radius Requirement: 50-mile radius rule applies — travelers only

Position Overview

We are seeking an experienced Registered Nurse – Utilization Review for a remote Utilization Management position. The ideal candidate will have strong provider-side Utilization Management experience, along with hands-on experience using Dragonfly and Epic.

This role requires an experienced RN who can independently perform utilization review activities in a remote environment and effectively collaborate with providers and healthcare teams.

Key Responsibilities
  • Perform Utilization Review and Utilization Management activities in a provider-side healthcare environment.
  • Review clinical documentation to determine medical necessity and appropriate levels of care.
  • Apply established clinical criteria, policies, and guidelines to utilization decisions.
  • Collaborate with providers, physicians, case management teams, and other healthcare professionals.
  • Review patient records and clinical information using Epic EMR.
  • Utilize Dragonfly for utilization management activities.
  • Identify potential gaps in care and escalate issues appropriately.
  • Maintain accurate and timely documentation of utilization review activities.
  • Communicate effectively with clinical and administrative teams.
  • Support organizational quality, compliance, and utilization management objectives.
  • Float to sister campuses when required.
Required Qualifications
  • Active Registered Nurse (RN) license.
  • Minimum 2 years of relevant experience.
  • Provider-side Utilization Management experience required.
    • Payer-only Utilization Management experience does not qualify.
  • Dragonfly experience required.
  • Epic EMR experience required.
  • CCM or CMCN certification required.
  • Strong clinical assessment, analytical, and documentation skills.
  • Comfortable working independently in a remote environment.
  • Strong computer skills and ability to work effectively with remote technology.
  • Must have access to a personal computer/laptop; equipment is not provided.
  • Prior travel nursing experience highly preferred.
  • Degree accreditation verification required, or 5 years of qualifying experience.
Additional Requirements
  • Must be willing to participate in an every 5th weekend rotation.
  • Must meet the 50-mile radius rule and qualify as a traveler.
  • Floating to sister campuses may be required.
  • Must be comfortable working remotely with minimal supervision.
  • Excellent communication and organizational skills required.