ZipRecruiter

Log In

2

Remote Hca Utilization Review Jobs in Miami, FL (NOW HIRING)

Oscar Health

Utilization Review Nurse

Miami, FL · Remote

$35 - $45.94/hr

You will report into the Supervisor, Utilization Review. Work Location ... This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois;

next page

Showing results 1-20

All JobsHca Utilization Review JobsRemote Hca Utilization Review JobsRemote Hca Utilization Review Jobs in Miami, FL

Remote Hca Utilization Review information

See Miami, FL salary details

$20

$40

$65

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

As of Sep 1, 2026, the average hourly pay for remote hca utilization review in Miami, FL is $40.44, according to ZipRecruiter salary data. Most workers in this role earn between $31.97 and $46.44 per hour, depending on experience, location, and employer.

What is the difference between Remote Hca Utilization Review vs Remote Hca Case Manager?

AspectRemote Hca Utilization ReviewRemote Hca Case Manager
CredentialsTypically requires healthcare-related certifications, such as RN or licensed healthcare professionalOften requires RN, social work, or case management certifications
Work EnvironmentPrimarily reviewing medical necessity and insurance coverage remotelyManaging patient cases, coordinating care, and discharge planning remotely
Employer & Industry UsageUsed by health insurance companies, healthcare providers, and utilization review organizationsEmployed by hospitals, insurance companies, and healthcare organizations

Remote Hca Utilization Review focuses on assessing medical necessity and insurance coverage, while Remote Hca Case Managers handle patient care coordination and discharge planning. Both roles require healthcare credentials and are integral to healthcare management, but they differ in daily responsibilities and focus areas.

How do I get into a remote HCA utilization review?

To become a remote HCA utilization review specialist, candidates typically need a healthcare background such as nursing or medical coding, along with knowledge of insurance policies and medical terminology. Relevant certifications like Certified Professional Coder (CPC) or Certified Medical Reimbursement Specialist (CMRS) can improve job prospects. Employers often require prior experience in medical review or utilization management and proficiency with electronic health record (EHR) systems, with many roles offering flexible or remote schedules.

Is remote HCA utilization review work from home?

Remote HCA utilization review jobs are often performed from home, allowing reviewers to assess healthcare claims and authorizations remotely. These roles typically require familiarity with healthcare software, strong communication skills, and adherence to confidentiality standards. Many employers offer flexible or fully remote schedules for this position.

What are popular job titles related to Remote Hca Utilization Review jobs in Miami, FL?

For Remote Hca Utilization Review jobs in Miami, FL, the most frequently searched job titles are:

What job categories do people searching Remote Hca Utilization Review jobs in Miami, FL look for?

The top searched job categories for Remote Hca Utilization Review jobs in Miami, FL are:

What cities near Miami, FL are hiring for Remote Hca Utilization Review jobs?

Cities near Miami, FL with the most Remote Hca Utilization Review job openings:

Remote Hca Utilization Review jobs near you
Infographic showing various Remote Hca Utilization Review job openings in Miami, FL as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution, with an average salary of $84,116 per year, or $40.4 per hour.

Utilization Review RN (Remote)

HealthPlus Staffing

Fort Lauderdale, FL • Remote

Full-time

Re-posted 20 days ago

Job description

Quick Job Details:

Setting: Fully Remote – Utilization Review
Schedule: Full-Time, Monday–Friday
Hours: Standard business hours
Patient Volume: N/A
Job Requirements:

  • Active RN license with Multi-State/Compact license required
  • Minimum 2 years of Utilization Review experience
  • Minimum 3 years of clinical nursing experience (acute care/hospital preferred)
  • Strong understanding of medical necessity, utilization management, healthcare reimbursement, and clinical documentation improvement
  • Excellent communication, analytical, and critical thinking skills
  • Ability to work independently in a remote environment

Responsibilities:

  • Conduct admission, continued stay, and observation reviews
  • Apply medical necessity criteria to determine appropriate level of care
  • Review cases for Physician Advisor escalation when appropriate
  • Collaborate with physicians, case managers, and insurance payers
  • Support denial prevention, documentation improvement, and revenue cycle initiatives
  • Ensure compliance with payer guidelines and regulatory requirements
  • Analyze clinical and financial data to identify quality improvement opportunities

Compensation: Competitive; based on experience

Benefits: Comprehensive benefits package

About Us:

HealthPlus Staffing is a national leader in the healthcare staffing industry. We partner with top healthcare organizations nationwide to connect highly qualified professionals with outstanding career opportunities.

Our Promise:

  • We will put you in front of the decision makers.
  • We will provide feedback on your application.
  • We will work on your behalf to obtain as much information as possible to help you make a well-informed decision.

If you're interested in this opportunity, please submit an application or call 561-291-7787 to speak with one of our experienced consultants. We look forward to helping you find your next opportunity!

The HealthPlus Team