ZipRecruiter

Log In

3

Part Time Remote Utilization Review Nurse Jobs (NOW HIRING)

McBee Associates

Utilization Review Nurse (PRN)

Review, analyze, and identify utilization patterns and trends, problems, or inappropriate ... Comfortable with remote work arrangements and virtual collaboration tools * Physical demands ...

Centerbrite

BCBA (Part-time) (Remote)

Fairfax, VA · Remote

$80 - $110/hr

BCBA (Board Certified Behavior Analyst) - Part-time $80110/hr Flexible Schedule Hybrid (Remote + In ... Own documentation quality , utilization reviews, and oversight of treatment plans * Supervise RBTs ...

Saintfrancis

Utilization Management Coordinator

Minimum Education: Has completed the basic professional curricula of a school of nursing as ... Reviews eligibility and benefits of patients, matching the level of care utilization. Assures ...

Centerbrite

BCBA (Part-time) (Remote)

Newark, NJ · Remote

$90 - $110/hr

BCBA (Board Certified Behavior Analyst) - Part-time $100110/hr Flexible Schedule Hybrid (Remote ... Own documentation quality , utilization reviews, and oversight of treatment plans * Supervise RBTs ...

Corrohealth

PRN Clinical Review Nurse (RN)

This is a remote position. ESSENTIAL DUTIES AND RESPONSIBILITIES: Note: The essential duties and ... Minimum 3-5 years of clinical experience * 2+ years of Utilization Review, Appeals, or Clinical ...

CorroHealth

PRN Clinical Review Nurse (RN)

This is a remote position. ESSENTIAL DUTIES AND RESPONSIBILITIES: Note: The essential duties and ... Minimum 3-5 years of clinical experience * 2+ years of Utilization Review, Appeals, or Clinical ...

Defined.ai

Psychiatrists (Part-Time, Remote)

We are looking for experienced Psychiatrists to join an exciting, remote, part-time pilot project ... Review de-identified clinical transcripts provided through a secure platform * Review AI-generated ...

LIBERTY DENTAL

$74 - $82/hr

Employment Type: Part-Time, Non-Exempt Work Arrangement: Fully Remote Schedule: 20 hours per week ... Experience in dental claims review, utilization management, managed care, or payer environments.

next page

Showing results 1-20

All Jobsremote Jobspart time JobsHealthcare JobsNursing JobsNurse Case Manager JobsPart Time Remote Utilization Review Nurse Jobs

Part Time Remote Utilization Review Nurse information

See salary details

$21

$42

$68

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

As of Aug 24, 2026, the average hourly pay for part time remote utilization review 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.

What does a part time remote utilization review nurse do?

A Part Time Remote Utilization Review Nurse evaluates medical records and treatment plans to ensure that healthcare services are medically necessary and comply with insurance guidelines. Working remotely, they review patient cases, communicate with healthcare providers, and make recommendations on the appropriateness of care. Their role helps manage healthcare costs and ensures patients receive appropriate care while adhering to regulatory and insurance standards.

What are the key skills and qualifications needed to thrive as a part time remote utilization review nurse?

To thrive as a Part Time Remote Utilization Review Nurse, you need an active RN license, strong clinical judgment, and experience in case management or utilization review. Familiarity with medical coding systems (like ICD-10 and CPT), healthcare management software, and payer guidelines is often required. Excellent written communication, attention to detail, and the ability to work independently are essential soft skills for remote success. These competencies ensure accurate review of medical records, compliance with regulations, and effective coordination with healthcare teams while working remotely.

How does a part time remote utilization review nurse typically collaborate with physicians and other healthcare professionals?

Part-time remote Utilization Review Nurses often communicate with physicians, case managers, and insurance representatives through secure digital platforms, emails, and scheduled virtual meetings. They review patient records and coordinate care authorizations, frequently clarifying clinical information or policy requirements with providers. Balancing asynchronous communication and timely responses is essential, as collaboration impacts both patient outcomes and reimbursement processes. Building strong professional relationships and maintaining clear documentation are key to effective teamwork in this remote setting.

What is the difference between Part Time Remote Utilization Review Nurse vs Part Time Remote Case Manager?

AspectPart Time Remote Utilization Review NursePart Time Remote Case Manager
CredentialsRN license, certifications in utilization review (e.g., CUC, URAC)RN or social work license, case management certification (e.g., CCM)
Work EnvironmentRemote, reviewing medical records and authorizationsRemote, coordinating care and discharge planning
Employer & IndustryInsurance companies, healthcare providers, third-party administratorsInsurance companies, healthcare organizations, managed care firms

The Part Time Remote Utilization Review Nurse primarily evaluates medical necessity for insurance approvals, focusing on documentation review. In contrast, the Part Time Remote Case Manager manages patient care plans, coordinating services and discharge planning. Both roles are remote, require healthcare credentials, and are common in the insurance and healthcare industries, but they differ in daily responsibilities and focus areas.

More about Part Time Remote Utilization Review Nurse jobs

What cities are hiring for Part Time Remote Utilization Review Nurse jobs?

Cities with the most Part Time 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 Part Time Remote Utilization Review Nurse jobs?

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

What job categories do people searching Part Time Remote Utilization Review Nurse jobs look for?

The top searched job categories for Part Time Remote Utilization Review Nurse jobs are:

Part Time Remote Utilization Review Nurse jobs near you
Infographic showing various Part Time Remote Utilization Review Nurse job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 14% Part Time, 3% Contract, and 1% Nights. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

Utilization Review Nurse (PRN)

Remote

McBee Associates
201 - 500 employees
Learn more about McBee Associatesexternal

Part-time

Posted 14 days ago

Job description

Job Description

Responsibilities

  • Review and evaluate electronic medical records of emergency department admissions and screen for medical necessity using InterQual or MCG criteria

  • Apply evidence-based clinical guidelines and criteria to assess and ensure proper utilization of healthcare resources

  • Participate in telephonic discussions with emergency department physicians relative to documentation and admission status

  • Enter clinical review information into system for transmission to insurance companies for authorization

  • Review, analyze, and identify utilization patterns and trends, problems, or inappropriate utilization of resources

Qualifications
Required

  • Current and unrestricted RN license

  • At least 3 years clinical experience in acute care setting in emergency room, critical care and/or medical/surgical nursing

  • At least 2 years utilization management experience in acute admission and concurrent reviews

  • Intermediate level experience with InterQual and/or MCG criteria within the last two years

  • Proficiency in medical record review in an electronic medical record (EMR)

  • Experience in Microsoft Suite including Office and basic Excel

  • Ability to thrive in a fast-paced, dynamic environment and adapt to frequent changing business needs

  • Passing score(s) on job-related pre-employment assessment(s)

Preferred

  • At least 5 years clinical experience in acute care setting in emergency room, critical care and/or medical/surgical nursing

  • At least 3 years utilization management experience within the hospital setting

  • Bachelor's of Science in Nursing (BSN)

  • Case Management Certifications such as Certified Case Manager (CCM), Accredited Case Manager (ACM), Certified Managed Care Nurse (CMCN), Case Management, Board Certified (CMGT-BC)

Expectations

  • Comfortable with remote work arrangements and virtual collaboration tools

  • Physical demands include extended periods of sitting, computer use, and telephone communication

Netsmart is proud to be an equal opportunity workplace and is an affirmative action employer, providing equal employment and advancement opportunities to all individuals. We celebrate diversity and are committed to creating an inclusive environment for all associates. All employment decisions at Netsmart, including but not limited to recruiting, hiring, promotion and transfer, are based on performance, qualifications, abilities, education and experience. Netsmart does not discriminate in employment opportunities or practices based on race, color, religion, sex (including pregnancy), sexual orientation, gender identity or expression, national origin, age, physical or mental disability, past or present military service, or any other status protected by the laws or regulations in the locations where we operate.

Netsmart desires to provide a healthy and safe workplace and, as a government contractor, Netsmart is committed to maintaining a drug-free workplace in accordance with applicable federal law. Pursuant to Netsmart policy, all post-offer candidates are required to successfully complete a pre-employment background check, including a drug screen, which is provided at Netsmart's sole expense. In the event a candidate tests positive for a controlled substance, Netsmart will rescind the offer of employment unless the individual can provide proof of valid prescription to Netsmart's third party screening provider.

If you are located in a state which grants you the right to receive information on salary range, pay scale, description of benefits or other compensation for this position, please use this form to request details which you may be legally entitled.

All applicants for employment must be legally authorized to work in the United States. Netsmart does not provide work visa sponsorship for this position.

Netsmart's Job Applicant Privacy Notice may be found here.

Apply