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Remote Dental Utilization Review Jobs (NOW HIRING)

Umpqua Health

Utilization Review Nurse

Roseburg, OR · On-site +1

$85K - $105K/yr

UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR ... Medical, dental, and vision insurance * 401(k) with company match (fully vested immediately)

Umpqua Health

Utilization Review Nurse

Roseburg, OR · Remote

$85K - $105K/yr

UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR ... Medical, dental, and vision insurance * 401(k) with company match (fully vested immediately)

Umpqua Health

Utilization Review Nurse

Roseburg, OR · On-site +1

$85K - $105K/yr

UTILIZATION REVIEW NURSE REMOTE, ability to travel to 3031 NE STEPHENS ST. ROSEBURG, OR 97470, as ... Medical, dental, and vision insurance * 401(k) with company match (fully vested immediately)

VIVA USA INC

Utilization Review Nurse

Albuquerque, NM · On-site +1

Position Overview Remote position in any state except, NY, CA, HI, or AK Summary This Position Is ... Review Service Requests, Collect Clinical And Non-Clinical Data, Verify Eligibility, Determine ...

Medica

Utilization Review III

$70K - $120K/yr

This position is a Remote role. To be eligible for consideration, candidates must have a primary ... medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver ...

Pacer Group

RN - UTILIZATION REVIEW

Everett, WA · Remote

$65/hr

Fully Remote Position Job Title : RN - UTILIZATION REVIEW Location: Everett, WA 98201 Start Date: 05/04/2026 Duration: 13 weeks Schedule Shift: Day 5x8-Hour (08:00 - 16:30) Shift Notes: Days (5×8 ...

Corvel

CA Utilization Review Nurse I

Rancho Cucamonga, CA · Remote

$30.64 - $45.80/hr

This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Identifies the necessity of ... Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options ...

Enterprise Engineering

Be Seen First

Concurrent Utilization Review (UR) Nurse

OR · Remote

$28 - $32/hr

Concurrent Utilization Review (UR) Nurse Remote Opportunity Contract to Hire Must be licenses in California The Concurrent Utilization Review (UR) Nurse is responsible for conducting real-time ...

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Remote Dental Utilization Review information

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How much do remote dental utilization review jobs pay per hour?

As of Jun 17, 2026, the average hourly pay for remote dental utilization review in the United States is $31.94, according to ZipRecruiter salary data. Most workers in this role earn between $22.36 and $40.62 per hour, depending on experience, location, and employer.

What is the difference between Remote Dental Utilization Review vs Remote Dental Claims Examiner?

AspectRemote Dental Utilization ReviewRemote Dental Claims Examiner
CredentialsDental background, certifications in utilization reviewDental coding, claims processing certifications
Work EnvironmentRemote, review-focusedRemote, claims processing
Industry UsageInsurance companies, healthcare providersInsurance companies, third-party administrators

Remote Dental Utilization Review professionals focus on evaluating the necessity and appropriateness of dental services, often requiring clinical knowledge and utilization review certifications. In contrast, Remote Dental Claims Examiners primarily process and adjudicate dental insurance claims, emphasizing coding and claims knowledge. Both roles are remote and serve the dental insurance industry, but their core responsibilities and required credentials differ.

What are the typical challenges faced by a Remote Dental Utilization Review specialist and how can they be managed?

Remote Dental Utilization Review specialists often encounter challenges such as interpreting complex dental claims without direct patient interaction, staying updated with continually evolving dental coding and insurance policies, and effectively communicating findings with both providers and insurance teams. Managing these challenges requires strong attention to detail, continuous professional development through training, and leveraging secure digital communication tools to collaborate with other team members. Building organizational skills and seeking feedback from peers can also help in efficiently handling a high volume of cases while maintaining accuracy.

What is a Remote Dental Utilization Review job?

A Remote Dental Utilization Review job involves evaluating dental claims and treatment plans submitted by dentists to ensure that they are necessary, appropriate, and in line with insurance policies and clinical guidelines. Professionals in this role, often dental hygienists or dentists, work from home to review documentation and make determinations about coverage or reimbursement. They may also communicate with providers for additional information and help prevent fraud or unnecessary procedures. This job requires knowledge of dental terminology, insurance processes, and strong attention to detail.

Do remote dental billers need a home office?

Remote dental billers typically need a dedicated home office space with reliable internet and computer equipment to perform billing tasks efficiently. A quiet, organized environment helps ensure accuracy and productivity while working remotely.

How to become a utilization reviewer?

To become a remote dental utilization reviewer, candidates typically need a dental or healthcare background, such as a dental assistant, hygienist, or dental office staff, along with knowledge of insurance policies and medical coding. Relevant certifications like the Certified Professional Coder (CPC) or dental-specific credentials can enhance prospects. Strong attention to detail, analytical skills, and familiarity with review software are also important for success in this role.

What are the key skills and qualifications needed to thrive as a Remote Dental Utilization Review Specialist, and why are they important?

To thrive as a Remote Dental Utilization Review Specialist, you need a solid background in dental hygiene or dentistry, typically supported by a dental degree or RDH license, and experience in clinical or insurance review settings. Familiarity with dental coding systems (such as CDT codes), electronic health records, and utilization review software is crucial. Strong analytical skills, attention to detail, effective communication, and the ability to work independently are standout soft skills for this role. These competencies ensure accurate claim assessments, regulatory compliance, and clear communication between providers, insurers, and patients.

What are some remote dental jobs?

Remote dental jobs include roles such as dental utilization review specialists, where professionals assess insurance claims and treatment plans remotely. These positions often require knowledge of dental procedures, insurance policies, and relevant certifications, and they typically involve working with digital records and communication tools from home.

What is the highest paying job in dental?

In dental, the highest paying roles are typically specialized practitioners such as oral and maxillofacial surgeons, who often earn the highest salaries due to their advanced training and surgical expertise. These professionals usually require additional certifications and perform complex procedures, often working in private practices or hospitals. General dentists and dental specialists like orthodontists also earn high salaries but generally less than oral surgeons.
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What are the most commonly searched types of Dental Utilization Review jobs? The most popular types of Dental Utilization Review jobs are:
What states have the most Remote Dental Utilization Review jobs? States with the most job openings for Remote Dental Utilization Review jobs include:
What job categories do people searching Remote Dental Utilization Review jobs look for? The top searched job categories for Remote Dental Utilization Review jobs are:
Remote Dental Utilization Review jobs near you
Utilization Review Nurse

Utilization Review Nurse

Umpqua Health

Roseburg, OR • On-site, Remote

$85K - $105K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 14 days ago

Job description

UTILIZATION REVIEW NURSE
REMOTE
Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR, 97457, as needed for business operations.
EMPLOYMENT TYPE: Full-Time, Exempt
About Umpqua Health
At Umpqua Health, we're more than a healthcare organization-we're a community-driven Coordinated Care Organization (CCO) dedicated to improving the health and well-being of individuals and families throughout Douglas County, Oregon. We provide integrated, whole-person care through primary care, specialty care, behavioral health services, and care coordination. Our collaborative approach ensures members receive high-quality, personalized care while supporting a stronger, healthier community.
POSITION PURPOSE
The Utilization Management Nurse evaluates clinical service requests to ensure medically necessary, cost-effective, and evidence-based care for members. This role conducts prior authorizations, facilitates care coordination, and supports safe transitions across care settings, ensuring compliance with Oregon Health Plan (OHP), Medicare, and applicable regulations. The UM Nurse collaborates with interdisciplinary teams and community providers to promote integrated, high-quality care.
ESSENTIAL JOB RESPONSIBILITIES
  • Perform clinical assessments and prior authorizations to determine medical necessity
  • Escalate complex cases to Medical Directors and request additional documentation as needed
  • Collaborate with care coordinators, discharge planners, and interdisciplinary teams for care transitions
  • Liaise with internal departments to resolve eligibility, benefits, or service issues
  • Participate in discharge planning for members transitioning from acute, long-term, or residential care
  • Conduct audits and support quality improvement initiatives
  • Provide training and mentorship on UM protocols and workflows
  • Maintain relationships with community providers and service organizations
  • Ensure compliance with organizational policies, clinical standards, and federal/state regulations
  • Perform other nursing-related duties as assigned

CHALLENGES
  • Working with a variety of personalities, maintaining a consistent and fair communication style.
  • Satisfying the needs of a fast-paced and challenging company.

MINIMUM QUALIFICATIONS
  • Active, unrestricted RN license (BSN or MSN) in Oregon or a compact state
  • Graduation from an accredited nursing program
  • Minimum 5 years of direct patient care experience
  • Proficiency with Microsoft Office, EHR systems, and UM software
  • Strong clinical knowledge, communication, and organizational skills
  • No suspension, exclusion, or debarment from federal healthcare programs

PREFERRED QUALIFICATIONS
  • 2+ years of utilization review or case management experience in managed care
  • Oregon residency and license
  • Bilingual or translation skills a plus
  • Experience with quality improvement audits and diverse team collaboration
  • Ability to work independently in fast-paced environments
SCHEDULE
Monday through Friday - 8:00am - 5:00pm; standard business hours with flexibility to meet service timelines.
SALARY
Wage Band: $85,000- $105,340
BENEFITS
  • Salary is dependent on skills, experience, and education
  • Generous benefits package including vacation PTO, sick leave, federal holidays, and birthday leave
  • Medical, dental, and vision insurance
  • 401(k) with company match (fully vested immediately)
  • Company-sponsored life insurance and additional benefits
  • Fitness reimbursement program
  • Tuition reimbursement and more

Why Umpqua Health?
We are committed to advancing health equity by collaborating across communities, addressing systemic barriers, and ensuring fair access to care and resources. At Umpqua Health, every team member plays a vital role in making a meaningful impact, empowering healthier lives and strengthening the communities we serve.
Inclusive Culture
We foster a respectful, inclusive environment where employees feel valued, supported, and empowered.
Growth & Development
We support ongoing learning through mentorship, clear career pathways, and professional development opportunities.
Work/Life Balance
We promote flexibility and well-being so employees can thrive both professionally and personally.
Equal Opportunity
Umpqua Health is an equal opportunity employer that embraces individuals from all backgrounds. We prohibit discrimination and harassment of any kind, ensuring that all employment decisions are based on qualifications, merit, and the needs of the business. Our dedication to fairness and equality extends to all aspects of employment, including hiring, training, promotion, and compensation, without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, veteran status, or any other protected category under federal, state, or local law.

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