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Internship Remote Utilization Review Nurse Jobs (NOW HIRING)

Personify Health

Utilization Review Nurse - RN

$35 - $43/hr

Current, unrestricted RN license in the United States or a U.S. territory (compact license accepted ... Utilization review/utilization management experience preferred Technical Skills: * Proficiency with ...

Personify Health

Utilization Review Nurse - RN

$35 - $43/hr

Current, unrestricted RN license in the United States or a U.S. territory (compact license accepted ... Utilization review/utilization management experience preferred Technical Skills: * Proficiency with ...

Personify Health

Utilization Review Nurse - RN

$35 - $43/hr

Current, unrestricted RN license in the United States or a U.S. territory (compact license accepted ... Utilization review/utilization management experience preferred Technical Skills: * Proficiency with ...

Gateway Rehab

Utilization Review Liaison - REMOTE

Registered Nurse (RN) with current Pennsylvania licensure. * Previous experience with utilization ... Remote. * Prolonged periods of sitting and working on a computer. * Minimal physical demands.

24-MAG LLC

Utilization Review Specialist

Manhattan, NY · Remote

$80/hr

This role supports current and upcoming remote consulting opportunities focused on AI-assisted ... review, nursing, healthcare operations, payer operations, medical necessity review, or care ...

24-MAG LLC

Utilization Review Specialist

Manhattan, NY · Remote

$80/hr

This role supports current and upcoming remote consulting opportunities focused on AI-assisted ... review, nursing, healthcare operations, payer operations, medical necessity review, or care ...

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How much do internship remote utilization review nurse jobs pay per hour?

As of Sep 6, 2026, the average hourly pay for internship remote utilization review nurse in the United States is $16.77, according to ZipRecruiter salary data. Most workers in this role earn between $14.42 and $18.75 per hour, depending on experience, location, and employer.

What is an internship remote utilization review nurse?

An Internship Remote Utilization Review Nurse is a nursing student or recent graduate who works remotely to learn the process of reviewing medical records and determining the necessity and appropriateness of healthcare services. Under supervision, they help ensure patients receive the proper level of care and that healthcare resources are used efficiently. This internship provides hands-on experience in case management, medical documentation, and insurance review processes, all from a remote setting.

What are the key skills and qualifications needed to thrive as an internship remote utilization review nurse?

To thrive as an Internship Remote Utilization Review Nurse, you need a strong understanding of clinical care, medical terminology, and case review processes, typically backed by an active RN license and relevant nursing education. Familiarity with utilization management software, electronic health records (EHRs), and healthcare regulatory guidelines is essential. Strong analytical skills, attention to detail, and effective communication are crucial soft skills for this remote, review-focused position. These abilities ensure accurate assessments, compliance with regulations, and clear coordination with healthcare teams to optimize patient care and resource use.

What are some common challenges faced by remote utilization review nurse interns, and how can they be addressed?

Remote utilization review nurse interns often face challenges such as adapting to virtual communication, managing time effectively without direct supervision, and staying updated on constantly changing insurance guidelines. To address these, it's important to establish clear daily routines, actively participate in team meetings via video calls or chat, and utilize available resources like online training modules and mentorship. Building relationships with experienced team members can also provide valuable support and guidance throughout the internship.

What is the difference between Internship Remote Utilization Review Nurse vs Remote Utilization Review Nurse?

AspectInternship Remote Utilization Review NurseRemote Utilization Review Nurse
CredentialsTypically in progress or recent graduation, may lack full licensureLicensed Registered Nurse (RN) with required certifications
Work EnvironmentSupervised internship setting, learning-focusedFull-time remote work, independent review tasks
Employer & IndustryHospitals, healthcare providers, or training programsInsurance companies, healthcare organizations, utilization management

The Internship Remote Utilization Review Nurse is a training position for aspiring nurses gaining experience in utilization review, often without full licensure. In contrast, the Remote Utilization Review Nurse is a fully licensed professional responsible for conducting reviews independently. The internship role emphasizes learning and supervision, while the full nurse role involves autonomous decision-making in a remote setting.

What cities are hiring for Internship Remote Utilization Review Nurse jobs?

Cities with the most Internship Remote Utilization Review Nurse job openings:

What are the most commonly searched types of Remote Utilization Review Nurse jobs?

The most popular types of Remote Utilization Review Nurse jobs are:

What states have the most Internship Remote Utilization Review Nurse jobs?

States with the most job openings for Internship Remote Utilization Review Nurse jobs include:

Internship Remote Utilization Review Nurse jobs near you

PRN Utilization Review Nurse Reviewer

Dane Street, LLC

Remote

Full-time, Per diem

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 8 days ago

Job description

The Utilization Management Nurse Reviewer plays a crucial role in healthcare systems by ensuring that medical services are used efficiently and appropriately. They review medical records, treatment plans, and patient information to determine the necessity and appropriateness of medical procedures, tests, and treatments.
Utilization Management Nurse Reviewers collaborate with healthcare providers, insurance companies, and patients to optimize healthcare delivery, control costs, and maintain quality care. Their responsibilities include assessing medical necessity, coordinating care, conducting utilization reviews, providing recommendations for care plans, and ensuring adherence to regulations and guidelines. This role requires strong clinical knowledge, critical thinking skills, communication abilities, and the ability to make informed decisions regarding patient care pathways.
Our PRN Nursing Program is designed for flexible, as-needed staffing to support our team during peak times, weekends, and holidays.
  • PRN nurses will be required to work at least one weekend per month, one major holiday, and one minor holiday per year.
  • A minimum number of shifts per month will be mandated to ensure that PRN nurses maintain their QA skills and familiarity with processes.

MAJOR DUTIES & RESPONSIBILITIES
  • Conduct assessments of medical services to validate their appropriateness using established criteria and guidelines, ensuring the medical necessity of treatments (e.g., CMS, Milliman Care Guidelines, InterQual, or health plan specific guidelines/criteria).
  • Examine and evaluate patient records to verify the quality of patient care and the necessity of provided services.
  • Offer clinical expertise and serve as a clinical reference for non-clinical staff members.
  • Input and manage essential clinical details within various medical management platforms.
  • Keep up-to-date with regulatory prerequisites (such as URAC) and state standards for utilization review.
  • Apply clinical reasoning to determine the suitable evidence-based guidelines.
  • Foster efficient and high-quality patient care by effectively communicating with management teams, physicians, and the Medical Director.

Requirements
  • Proficient in both written and spoken communication.
  • Capable of maintaining professional communication with physicians and clients.
  • Skilled at handling multiple tasks and adjusting swiftly in a dynamic office setting.
  • Possesses a keen organizational sense and pays close attention to details.
  • Adept at resolving intricate and multifaceted problems.
  • Experienced with Microsoft tools such as Word, Excel, PowerPoint, and Outlook.
  • Background in medical or clinical practice through education, training, or professional engagement.
  • Holds an unrestricted LVN/RN license from an accredited vocational nursing program (for LVNs) or a nursing degree from an accredited college (for RNs).

Additional Duties
  • May provide oversight to the work of the team members.
  • Continuously improves processes that help to facilitate better turnaround time, peer to peer success rates and lessens returned reports by clients for clarification purposes, ultimately resulting in higher client satisfaction.
  • Responsible for the final approval on cases for release to the client.
  • Will act as a liaison and coordinate quality issue reports along with all new reviewer reports with the VP of Clinical Operations.

EDUCATION/CREDENTIALS:
Licensed Practical/Vocational Nurse with an active and unrestricted license to practice.
JOB RELEVANT EXPERIENCE:
2 yrs minimum clinical nursing experience is required.
One year of previous experience in Utilization Management is required.
JOB RELATED SKILLS/COMPETENCIES:
Demonstrate strong abilities in both spoken and written communication, along with effective interpersonal skills. Possess a proficient understanding of computer operations, particularly the Internet, Microsoft Word, Microsoft Access, Microsoft Excel, and Windows. Show the capability to acquire new skills and competencies to address the evolving requirements of systems, software, and hardware.
WORKING CONDITIONS/PHYSICAL DEMANDS:
Any lifting, bending, traveling, etc. required to do the job duties listed above. Long periods of sitting and computer work.
WORK FROM HOME TECHNICAL REQUIREMENTS:
Supply and support their own internet services.
Maintaining an uninterrupted internet connection is a requirement of all work from home position.
Requirements
Beginning compensation will depend on several factors including the candidate's experience, education, and specific skills. In addition to the base salary, we offer a comprehensive benefits package including health insurance, retirement plans, and performance bonuses.
Our Commitment:
We are committed to providing fair and competitive compensation that reflects each employee's contributions and performance. We value diversity and strive to create an inclusive environment for all employees.
Benefits
Join our team at Dane Street and enjoy a comprehensive benefits package designed to support your well-being and peace of mind. We offer a range of benefits including medical, dental, and vision coverage for you and your family. Additionally, we offer voluntary life insurance options for you, your spouse, and your children. We also offer other voluntary benefits which include hospital indemnity, critical illness, accident indemnity, and pet insurance plans. Employees receive basic life insurance, short-term disability, and long-term disability coverage at no cost. Our generous paid time off policy ensures you have time to relax and recharge, while our 401k plan with a company match helps you plan for your future. Apple equipment and a media stipend are provided for remote workspace.
ABOUT DANE STREET:
A fast-paced, Inc. 500 Company with a high-performance culture, is seeking insightful forward-thinking professionals. We process over 200,000 insurance claims annually for leading national and regional Workers' Compensation, Disability, Auto, and Group Health Carriers, Third-Party Administrators, Managed Care Organizations, Employers, and Pharmacy Benefit Managers. We provide customized Independent Medical Exams and Peer Review programs that assist our clients in reaching the appropriate medical determination as part of the claims management process.

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