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Remote Physical Therapy Utilization Review Jobs (NOW HIRING)

Utilization Review Nurse

Roseburg, OR ยท Remote

$85K - $105K/yr

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 ...

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Utilization Review Nurse

Newark, NJ ยท Remote

$38 - $40/hr

Position is 100% remote but will have to go to Newark, NJ to pick up equipment and short ... Serves as mentor/trainer to new RN's and other staff as needed, completes audits, reviews and ...

Utilization Review Manager

Denver, CO ยท On-site +1

$93K - $117K/yr

Remote : Mondays and Fridays * On-site in our Denver Office: Tuesdays, Wednesdays, and Thursdays The compensation range for this position is based upon candidate experience and market expectations.

Remote Physical Therapist

Dallas, TX ยท On-site +1

$1K - $2K/wk

Conduct virtual physical therapy evaluations and assessments using teletherapy tools. * Develop personalized treatment plans tailored to each patient's needs and goals. * Provide remote therapy ...

Remote Physical Therapist

Austin, TX ยท On-site +1

$1K - $2K/wk

Conduct virtual physical therapy evaluations and assessments using teletherapy tools. * Develop personalized treatment plans tailored to each patient's needs and goals. * Provide remote therapy ...

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Remote Physical Therapy Utilization Review information

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$21

$42

$68

How much do remote physical therapy utilization review jobs pay per hour?

As of Jun 13, 2026, the average hourly pay for remote physical therapy utilization review 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 are the key skills and qualifications needed to thrive in the Remote Physical Therapy Utilization Review position, and why are they important?

To excel as a Remote Physical Therapy Utilization Review professional, you need a background in physical therapy (often with licensure), clinical knowledge, and experience in utilization management or case review. Familiarity with electronic health records (EHR), claims management systems, and industry tools such as InterQual or Milliman criteria is typically required. Strong analytical skills, attention to detail, effective written communication, and the ability to work independently are valuable soft skills for this position. These abilities are crucial for accurately evaluating medical necessity, facilitating reimbursement, and ensuring compliance with healthcare guidelines in a remote setting.

What does a typical day look like for someone in a Remote Physical Therapy Utilization Review role?

A typical day involves reviewing physical therapy documentation and treatment plans submitted by providers to determine if they meet established medical necessity criteria. You may spend most of your workday analyzing patient records, applying evidence-based guidelines, documenting your recommendations, and collaborating virtually with providers, insurance representatives, and your clinical review team. Frequent video meetings and written communications are common as you clarify treatment justifications or support appeals. The role is fast-paced and detail-oriented, requiring strong organizational skills to manage multiple case files and deadlines efficiently. While remote, you remain an integral part of a clinical decision-making team, contributing directly to patient care quality and cost-effective service delivery.

What is a Remote Physical Therapy Utilization Review job?

A Remote Physical Therapy Utilization Review job involves evaluating physical therapy treatment plans and medical records to ensure they meet insurance guidelines and medical necessity. Professionals in this role work remotely to review claims, provide recommendations, and collaborate with healthcare providers and insurance companies. The goal is to ensure appropriate care while preventing unnecessary treatments or costs. This position typically requires a background in physical therapy, strong analytical skills, and knowledge of insurance policies and medical guidelines.

More about Remote Physical Therapy Utilization Review jobs
What cities are hiring for Remote Physical Therapy Utilization Review jobs? Cities with the most Remote Physical Therapy Utilization Review job openings:
What states have the most Remote Physical Therapy Utilization Review jobs? States with the most job openings for Remote Physical Therapy Utilization Review jobs include:
Infographic showing various Remote Physical Therapy Utilization Review job openings in the United States as of June 2026, with employment types broken down into 88% Full Time, 7% Part Time, and 5% Contract. Highlights an 100% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.
Utilization Review Nurse

Utilization Review Nurse

Umpqua Health

Roseburg, OR โ€ข Remote

$85K - $105K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 10 days ago


Job description


UTILIZATION REVIEW NURSEย 
REMOTE
Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR, 97457, as needed for business operations.ย 

EMPLOYMENT TYPE: Full-Time, Exempt

About Umpqua Health

At Umpqua Health, weโ€™re more than a healthcare organizationโ€”weโ€™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
ย 
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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