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Remote Psychiatric Utilization Review Jobs (NOW HIRING)

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, 97457, as needed for business operations. EMPLOYMENT TYPE: Full-Time, Exempt About Umpqua Health At ...

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, 97457, as needed for business operations. EMPLOYMENT TYPE: Full-Time, Exempt About Umpqua Health At ...

Ascension

Registered Nurse Utilization Review

Austin, TX · Remote

$78K - $110K/yr

Remote Facility: Ascension Network Services Department: Utilization Management Schedule: Days l PRN Salary range: $78,561.60 - $110,905.60 per year (Texas) | Pay ranges vary based on candidate ...

Ascension

Registered Nurse Utilization Review

Austin, TX · Remote

$84K - $118K/yr

Remote Facility: Ascension Network Services Department: Utilization Management Schedule: Days l ... Reviewed admissions and service requests for medical necessity, reimbursement compliance, and ...

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

As of Jul 22, 2026, the average hourly pay for remote psychiatric 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 some common challenges faced by professionals in Remote Psychiatric Utilization Review roles, and how can they be addressed?

Professionals in Remote Psychiatric Utilization Review often encounter challenges such as interpreting clinical documentation remotely, ensuring timely case reviews, and maintaining effective communication with providers and insurance companies. Staying organized and developing strong time-management skills are key to managing caseloads efficiently. Regularly participating in team meetings and leveraging secure digital communication tools can help bridge the gap between remote team members and facilitate collaboration. Continuous education on evolving mental health regulations and payer guidelines is also essential to remain effective in the role.

What is a Remote Psychiatric Utilization Review position?

A Remote Psychiatric Utilization Review position involves evaluating mental health treatment plans and services to ensure they are medically necessary and meet insurance or regulatory guidelines. Professionals in this role typically review clinical documentation, assess the appropriateness of care, and make recommendations regarding the coverage of psychiatric services, all while working remotely. They collaborate with healthcare providers, insurance companies, and sometimes patients, to facilitate quality care and manage costs. Strong knowledge of mental health diagnoses, treatment protocols, and insurance policies is essential for success in this position.

What is the difference between Remote Psychiatric Utilization Review vs Remote Mental Health Case Manager?

AspectRemote Psychiatric Utilization ReviewRemote Mental Health Case Manager
CredentialsLicensed Psychiatrist, Psychologist, or Certified Utilization Review ProfessionalLicensed Clinical Social Worker, Mental Health Counselor, or Case Management Certification
Work EnvironmentReviewing medical records, insurance documentation, and making utilization decisions remotelyCoordinating care, assessing client needs, and providing support remotely
Employer & Industry UsageInsurance companies, health plans, and utilization review organizationsHealthcare providers, community agencies, and insurance companies

Remote Psychiatric Utilization Review focuses on evaluating medical necessity for psychiatric services, often within insurance and healthcare organizations. In contrast, Remote Mental Health Case Managers actively coordinate and support patient care. Both roles require mental health credentials but differ in daily tasks and focus areas.

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

To thrive as a Remote Psychiatric Utilization Review specialist, you need a clinical background in nursing, social work, or mental health counseling, typically with relevant licensure (such as RN, LCSW, or LPC) and experience in psychiatric care. Familiarity with utilization review platforms, electronic health records (EHRs), and managed care systems is essential, along with certifications like CCM (Certified Case Manager) being advantageous. Strong analytical thinking, attention to detail, and effective verbal and written communication skills are crucial for evaluating cases and coordinating with providers. These competencies ensure accurate assessments, compliance with regulations, and optimal patient outcomes while managing costs in a remote work environment.
More about Remote Psychiatric Utilization Review jobs
What cities are hiring for Remote Psychiatric Utilization Review jobs? Cities with the most Remote Psychiatric Utilization Review job openings:
What are the most commonly searched types of Psychiatric Utilization Review jobs? The most popular types of Psychiatric Utilization Review jobs are:
What states have the most Remote Psychiatric Utilization Review jobs? States with the most job openings for Remote Psychiatric Utilization Review jobs include:
What job categories do people searching Remote Psychiatric Utilization Review jobs look for? The top searched job categories for Remote Psychiatric Utilization Review jobs are:
Remote Psychiatric Utilization Review jobs near you
Infographic showing various Remote Psychiatric Utilization Review job openings in the United States as of July 2026, with employment types broken down into 3% As Needed, 81% Full Time, 13% Part Time, and 3% Contract. Highlights an 95% Physical, 1% Hybrid, and 4% 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 • Remote

$85K - $105K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 20 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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