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Remote Nicu Utilization Review Jobs in Florida (NOW HIRING)

Utilization Review Nurse

Miami, FL ยท 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 ...

RN Utilization Review

Southport, FL ยท On-site +1

$84K - $118K/yr

Remote Facility: Ascension Network Services Department: Utilization Management Schedule: Days l ... Review admissions and service requests within assigned unit for prospective, concurrent and ...

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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 Florida?

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

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

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

Infographic showing various Remote Nicu Utilization Review job openings in Florida as of August 2026, with employment types broken down into 86% Full Time, 6% Part Time, and 8% Contract. Highlights an 2% In-person, and 98% Remote job distribution.

Utilization Review Specialist

Banyan Treatment Centers - Texas

Pompano Beach, FL โ€ข Remote

$45K - $65K/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 25 days ago


Job description

Utilization Review Specialist | Remote | Full-Time
$50,000 โ€“ $65,000 Annually | Weekdays (Weekend Availability as Needed)

Banyan Treatment Centers is seeking an experienced and detail-driven Utilization Review Specialist to join our corporate team. In this remote role, you'll manage a caseload of 50โ€“75 patients, conducting admission and continuing-stay reviews, coordinating authorizations, and serving as a key liaison between Banyan's clinical operations and the managed care organizations that fund patient treatment. Your work directly protects patient access to care and keeps the business running.

This is a high-volume, relationship-driven role for someone who thrives on precision, knows how to navigate managed care, and understands the stakes on both sides of the authorization process.

About Banyan Treatment Centers

Banyan Treatment Centersย is a leading national provider of intensive treatment for individuals facing substance use and mental health disorders. Backed byย TPG, one of the nationโ€™s largest private equity investors, Banyan is rapidly expanding access to high-quality, compassionate care.

Why Join Our Team?

  • Mission-driven work with real business impact โ€” your authorizations directly determine whether patients stay in treatment. Few roles sit closer to the intersection of clinical care and organizational sustainability.
  • Nationally recognized organization โ€” Joint Commissionโ€“accredited, with 18 locations and telehealth services nationwide, and the infrastructure to support your work at scale.
  • Remote flexibility โ€” work from anywhere while collaborating with clinical, billing, and operations teams across the country.
  • Collaborative environment โ€” partner closely with clinical, operational, and billing teams to resolve outstanding case issues, support discharge planning, and ensure timely reimbursement.
  • Room to grow โ€” join a rapidly expanding organization where UR professionals have visibility across the enterprise and opportunities to advance.
  • Comprehensive benefits including medical, dental, and vision insurance; whole and term life insurance; short- and long-term disability; 401(k) with employer match; paid time off and holidays; wellness incentives; and employee assistance and referral programs.

Key Responsibilities

  • Manage a caseload of 50โ€“75 patients, authorizing 15โ€“25 cases daily and ensuring timely utilization reviews and appropriate level of care determinations
  • Conduct admission and continuing-stay reviews to assess medical necessity and ensure compliance with treatment standards
  • Verify insurance benefits, coordinate authorizations, and communicate effectively with external case managers and managed care organizations
  • Establish and maintain contracts with managed care companies and request rate increases when appropriate
  • Collaborate with clinical and billing departments to support discharge planning, documentation, and timely reimbursement
  • Identify and address over- and underutilization trends
  • Assist in resolving outstanding case issues with insurers

Qualifications

Required:

  • High school diploma or equivalent
  • Minimum one year of utilization review experience in a psychiatric or chemical dependency setting
  • Strong organizational, documentation, and communication skills
  • Ability to manage high caseloads with accuracy and efficiency
  • Comfortable working independently in a remote environment

Preferred:

  • Graduate degree in a health or behavioral health related field
  • Clinical licensure (LCSW, LMHC, LPC, RN, or equivalent) โ€” valued but not required
  • Experience working with managed care organizations, insurance authorization, and level of care criteria
  • Familiarity with Joint Commission standards and behavioral health regulatory requirements

Apply Now

If you're experienced in utilization review, thrive in a fast-paced and high-volume environment, and want your work to matter beyond the spreadsheet, we'd like to meet you. Apply today to join the Banyan Treatment Centers corporate team.

Banyan Treatment Centers is an equal opportunity employer.