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Overnight Remote Utilization Review Jobs in Florida

Remote Job Overview We are seeking experienced Hospitalist Physicians to contribute their medical ... Experience with utilization review, medical coding, or healthcare quality assurance. * Familiarity ...

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Overnight Remote Utilization Review information

What is an overnight remote utilization review?

An Overnight Remote Utilization Review position involves evaluating medical records and healthcare services during nighttime hours to ensure that treatments are medically necessary and meet established guidelines. Professionals in this role usually work from home, reviewing patient cases, authorizing or denying services, and collaborating with healthcare providers. This job is crucial for maintaining quality care while controlling healthcare costs, and it often requires clinical credentials such as RN, LPN, or other relevant certifications. Strong analytical, communication, and computer skills are important for success in this remote role.

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

To thrive as an Overnight Remote Utilization Review nurse, you need a current RN license, strong clinical judgment, and experience in acute care or case management. Familiarity with utilization management software, electronic health records (EHRs), and knowledge of insurance guidelines such as Medicare/Medicaid are typically required. Excellent critical thinking, attention to detail, and the ability to communicate clearly in written and verbal forms are vital soft skills for this role. These skills ensure accurate, timely case reviews and effective collaboration with healthcare providers while maintaining compliance with payer requirements.

What are the main challenges faced by overnight remote utilization review professionals, and how can they be addressed?

Overnight remote utilization review professionals often encounter challenges such as working independently during non-traditional hours, limited immediate access to colleagues or supervisors, and the need to make timely decisions with potentially less available support. To address these challenges, it is important to develop strong self-management skills, establish clear communication channels with team members, and utilize comprehensive digital resources and documentation. Employers typically provide thorough training and access to on-call support to help ensure that overnight staff can make confident, accurate determinations and maintain high-quality patient care standards.

What is the difference between Overnight Remote Utilization Review vs Daytime Remote Utilization Review?

AspectOvernight Remote Utilization ReviewDaytime Remote Utilization Review
Work HoursTypically overnight shifts, often 10 PM to 6 AMStandard daytime hours, usually 8 AM to 4 PM
CertificationsSame as utilization review roles, e.g., RN, CPC, or other healthcare credentialsSame as overnight roles, requiring similar certifications
Work EnvironmentRemote, focused on reviewing cases during night hoursRemote, reviewing cases during daytime hours
Employer & IndustryHealthcare insurance companies, third-party administratorsSame as overnight, within healthcare and insurance sectors

Overnight Remote Utilization Review involves reviewing cases during night hours, providing flexibility for healthcare providers and insurers. Daytime Remote Utilization Review occurs during regular business hours. Both roles require similar credentials and work environments but differ mainly in shift timing, catering to different operational needs.

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

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

What cities in Florida are hiring for Overnight Remote Utilization Review jobs?

Cities in Florida with the most Overnight Remote Utilization Review job openings:

Infographic showing various Overnight Remote Utilization Review job openings in Florida as of August 2026, with employment types broken down into 96% Full Time, and 4% Part Time. Highlights an 4% In-person, and 96% Remote job distribution.

Licensed Physician Reviewer, Ophthalmology - Remote PRN

ChenMed, LLC

Miami, FL • On-site, Remote

$204K - $292K/yr

Part-time

Re-posted 2 days ago


ChenMed rating

8.4

Company rating: 8.4 out of 10

Based on 40 frontline employees who took The Breakroom Quiz

1st of 242 rated social care providers


Job description

We're unique. You should be, too.
We're changing lives every day. For both our patients and our team members. Are you innovative and entrepreneurial minded? Is your work ethic and ambition off the charts? Do you inspire others with your kindness and joy?
We're different than most primary care providers. We're rapidly expanding and we need great people to join our team.
The Physician Reviewer is the primary physician reviewer for Utilization Management (UM) cases in our organization. Other duties include advising other physician reviewers and attending daily calls with health plan teams and our local teams assisting with this function and coordinating care for our patients. The position will also participate in Process and Quality improvement in our developing area of Delegated Utilization Management.
  • Provides Delegated UM by covering the specified territories as assigned:
    • Establish 2-3 cases a day for each market covered (up to 6 markets); ensures attendance on all health plan and local calls; calls in for the weekly Primary Care Provider (PCP) and Skilled Nursing Facility (SNF) meetings covering the assigned territories.
  • Advises other physician reviewers.
  • Other duties as assigned and modified by manager.

KNOWLEDGE, SKILLS AND ABILITIES:
  • Excellent analytical and deductive reasoning skills
  • Good judgement and problem-solving skills
  • Professional and effective communication skills
  • Strong organizational skills
  • Written and verbal fluency in English
  • Proficient in the use of Microsoft Office products such as Outlook, Excel, Word and PowerPoint

EDUCATION AND EXPERIENCE CRITERIA:
  • Graduate from accredited Medical School with a valid, unrestricted license is required
  • Completion of Internal Medicine or Family Practice residency
  • Board Certification - Ophthalmology
  • Two (2) years' experience in Hospital medicine preferred
  • At least one (1) year of utilization review experience preferred

PAY RANGE:
$204,761 - $292,515 Salary
The posted pay range represents the base hourly rate or base annual full-time salary for this position. Final compensation will depend on a variety of factors including but not limited to experience, education, geographic location, and other relevant factors. This position may also be eligible for a bonuses or commissions.
EMPLOYEE BENEFITS
https://chenmed.makeityoursource.com/helpful-documents
We're ChenMed and we're transforming healthcare for seniors and changing America's healthcare for the better. Family-owned and physician-led, our unique approach allows us to improve the health and well-being of the populations we serve. We're growing rapidly as we seek to rescue more and more seniors from inadequate health care.
ChenMed is changing lives for the people we serve and the people we hire. With great compensation, comprehensive benefits, career development and advancement opportunities and so much more, our employees enjoy great work-life balance and opportunities to grow. Join our team who make a difference in people's lives every single day.
Current employees, if you want to apply to our internal career site, please click HERE
Current Contingent Worker please see job aid HERE to apply
#LI-Remote

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About ChenMed

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We're expanding healthcare equity across America. We're already in 15 states with 100+ medical centers. As a rapidly growing, physician-led organization, we have one central focus: rescue any and every senior from a healthcare system that has failed them. Our family of brands include Chen Senior Medical Center, JenCare Senior Medical Center, and Dedicated Senior Medical Center. Recently named a 2021 Best Places To Work and one of the only healthcare companies recognized in Fortune's 2020 "Change The World" list, ChenMed prides itself on creating a culture that enables career growth and promotes inclusion for all.

Industry

Health care and social assistance

Company size

5,001 - 10,000 Employees

Headquarters location

Miami, FL, US

Year founded

1985

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