ZipRecruiter

Log In

2

Remote Nicu Utilization Review Jobs in Arizona (NOW HIRING)

Oscar Health

Utilization Review Nurse

Tempe, AZ · Remote

$35 - $45.94/hr

... of care for identified diagnoses based on the research results for those conditions. You will report into the Supervisor, Utilization Review. Work Location: This is a remote position, open to ...

University of Kentucky

Supervisor, Utilization Review Work Location: UK Chandler Hospital, Pavilion A Grade Level: 11 Type ... Provides collaboration with multidisciplinary teams to support patient care coordination, discharge ...

Valenz Health

Medical Director - Part Time

Phoenix, AZ · On-site +1

Ensure clinical programs, utilization review activities, and medical management processes align ... Managed care or health insurance industry experience Where You'll Work: This is a fully remote ...

Tango Care

Physician Reviewer (Remote)

Phoenix, AZ · On-site +1

... care. We are currently looking for a Physician Reviewer to join our growing team on a full time ... Provides medical guidance and review activities for home health utilization management and medical ...

next page

Showing results 1-20

All JobsNicu Utilization Review JobsRemote Nicu Utilization Review JobsRemote Nicu Utilization Review Jobs in Arizona

Remote Nicu Utilization Review information

What is a remote NICU utilization review nurse?

A Remote NICU Utilization Review nurse is a registered nurse who evaluates the necessity, appropriateness, and efficiency of care provided to newborns in Neonatal Intensive Care Units (NICU) from a remote location. They review patient records, treatment plans, and hospital stays to ensure that the care provided meets established clinical guidelines and insurance policies. This role helps optimize patient outcomes, control healthcare costs, and facilitate communication between healthcare providers, insurers, and families. Working remotely, these nurses use secure digital platforms to access medical records and collaborate with medical teams.

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

To excel as a Remote NICU Utilization Review Nurse, you need a valid RN license, strong clinical expertise in neonatal intensive care, and experience with utilization management practices. Familiarity with case management software, electronic health records (EHRs), and UR-specific platforms such as InterQual or MCG is essential. Outstanding critical thinking, attention to detail, and effective written and verbal communication set top performers apart. These skills ensure accurate assessments, regulatory compliance, and optimized patient outcomes while working remotely in a highly specialized healthcare environment.

What are some common challenges faced in a remote NICU utilization review role and how can they be managed?

In a remote NICU Utilization Review position, professionals often encounter challenges such as ensuring thorough communication with clinical teams, navigating different electronic health record (EHR) systems, and maintaining up-to-date knowledge of evolving NICU care standards. Successfully managing these challenges typically involves establishing clear communication channels with onsite staff, participating in regular virtual team meetings, and dedicating time for ongoing education and training. Proficiency in telehealth technologies and strong organizational skills are also essential for accurate documentation and timely case reviews.

What is the difference between Remote Nicu Utilization Review vs Remote Pediatric Utilization Review?

AspectRemote Nicu Utilization ReviewRemote Pediatric Utilization Review
CredentialsRN, NICU experience, utilization review certificationRN, pediatric experience, utilization review certification
Work EnvironmentHome-based, healthcare facilities, insurance companiesHome-based, healthcare facilities, insurance companies
Industry UsageHospitals, insurance, healthcare managementHospitals, insurance, healthcare management
Search IntentCompare roles, job requirements, salary, responsibilitiesCompare roles, job requirements, salary, responsibilities

Remote Nicu Utilization Review involves evaluating NICU patient cases to ensure appropriate care and resource use, requiring NICU experience. Remote Pediatric Utilization Review focuses on pediatric cases, requiring pediatric nursing background. Both roles involve reviewing medical necessity and optimizing healthcare resources remotely within the healthcare and insurance industries.

What are the most commonly searched types of Nicu Utilization Review jobs in Arizona?

The most popular types of Nicu Utilization Review jobs in Arizona are:

What are popular job titles related to Remote Nicu Utilization Review jobs in Arizona?

For Remote Nicu Utilization Review jobs in Arizona, the most frequently searched job titles are:

What job categories do people searching Remote Nicu Utilization Review jobs in Arizona look for?

The top searched job categories for Remote Nicu Utilization Review jobs in Arizona are:

What cities in Arizona are hiring for Remote Nicu Utilization Review jobs?

Cities in Arizona with the most Remote Nicu Utilization Review job openings:

Remote Nicu Utilization Review jobs near you
Infographic showing various Remote Nicu Utilization Review job openings in Arizona as of August 2026, with employment types broken down into 75% Full Time, and 25% Part Time. Highlights an 100% Remote job distribution.

Utilization Review Nurse

Oscar Health

Tempe, AZ • Remote

$35 - $45.94/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 21 days ago

Oscar Health rating

6.9

Company rating: 6.9 out of 10

Based on 6 frontline employees who took The Breakroom Quiz

262nd of 315 rated insurance

Job description

Hi, we're Oscar. We're hiring a Utilization Review Nurse to join our Utilization Review team.

About the role:

You will perform frequent case reviews, check medical records and speak with care providers regarding treatment as needed. You will make recommendations regarding the appropriateness of care for identified diagnoses based on the research results for those conditions.

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; Iowa; Kansas; Michigan; Missouri; Nebraska; New Jersey; North Carolina; Ohio; Pennsylvania; South Carolina; Tennessee; Texas; or Virginia. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events.

Pay Transparency: The base pay for this role is: $35.00 - $45.94 per hour. You are also eligible for employee benefits and monthly vacation accrual at a rate of 15 days per year.

Responsibilities:

  • Complete medical necessity reviews and level of care reviews for requested services using clinical judgment and Oscar Clinical Guidelines, Milliman Care Guidelines
  • Obtain the information necessary (via telephone and fax) to assess a member's clinical condition, and apply the appropriate evidence-based guidelines
  • Meet required decision-making SLAs
  • Refer members for further care engagement when needed
  • Compliance with all applicable laws and regulations
  • Other duties as assigned

Requirements:

  • Active, unrestricted RN licensure from the United States in [state], OR, active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC)
  • Associate Degree - Nursing or Graduate of Accredited School of Nursing Or Successful completion of Nursing Diploma Program in Accredited School of Nursing
  • Ability to obtain additional state licenses to meet business needs
  • 1+ year of utilization review experience in a managed care setting
  • Strong experience utilizating MCG (Milliman Care Gudielines) or InterQual
  • 1+ years of clinical experience (including at least 1+ year clinical practice in an acute care setting, i.e., ER or hospital)
  • Weekend availability is required; all applicants must be able to work at least one weekend day (Saturday or Sunday) each week.

Bonus points:

  • BSN
  • Previous experience conducting concurrent or inpatient reviews for a managed care plan

This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here. 

At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.

Pay Transparency:  Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.

Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known.

California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.

What Oscar Health employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply