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Remote Rn Utilization Review Nurse Jobs in Arizona

Valenz Health

Medical Director - Part Time

Phoenix, AZ ยท On-site +1

Serve as a trusted clinical resource and advisor to physicians, nurses, utilization review staff ... This is a fully remote position, and we'll provide all the necessary equipment! * Work Environment:

CommonSpirit Health

Care Transformation RN

Phoenix, AZ ยท Remote

$41.14 - $67.88/hr

Job Summary and Responsibilities Thiis is a remote position requring travel to support enterprise ... Serve as a Virtual RN (VIC RN) for 50% of the role, providing direct patient care during ...

UnitedHealth Group

Case Manager RN

Tucson, AZ ยท Remote

$60K - $107K/yr

... utilization. This role includes high-volume telephonic outreach, patient education, and ... reviews, scheduling timely follow up appointments, and providing education on discharge ...

Oscar Health

Case Management RN

Tempe, AZ ยท Remote

$32.60 - $42.79/hr

This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas ... Active, unrestricted RN licensure from the United States in [state], OR, active compact multistate ...

Varsity Tutors

NCLEX-RN Tutor

Tucson, AZ ยท Remote

$18 - $40/hr

Adapts instruction using UWorld, Kaplan, or ATI practice question banks, content review materials, and test-taking strategy workshops to support BSN and ADN graduates preparing for registered nurse ...

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All JobsRn Utilization Review Nurse JobsRemote Rn Utilization Review Nurse JobsRemote Rn Utilization Review Nurse Jobs in Arizona

Remote Rn Utilization Review Nurse information

See Arizona salary details

$19

$39

$64

How much do remote rn utilization review nurse jobs pay per hour?

As of Aug 22, 2026, the average hourly pay for remote rn utilization review nurse in Arizona is $39.40, according to ZipRecruiter salary data. Most workers in this role earn between $31.15 and $45.24 per hour, depending on experience, location, and employer.

What is a Remote RN Utilization Review Nurse?

A Remote RN Utilization Review Nurse is a registered nurse who evaluates medical records and healthcare services from a remote location to ensure that patients receive appropriate, necessary, and cost-effective care. They review treatment plans, check for compliance with insurance and healthcare guidelines, and often work with healthcare providers, insurance companies, and patients to coordinate care. This role typically involves assessing the medical necessity of procedures, authorizing services, and helping prevent unnecessary treatments or hospitalizations.

What are the key skills and qualifications needed to thrive as a Remote RN Utilization Review Nurse?

To thrive as a Remote RN Utilization Review Nurse, you need an active RN license, strong clinical knowledge, and experience in case management or utilization review. Proficiency with healthcare review software, electronic health records (EHRs), and familiarity with insurance guidelines or regulatory requirements is vital. Excellent communication, critical thinking, and time management skills distinguish top performers in remote settings. These skills enable nurses to make accurate, timely decisions about patient care while ensuring compliance and efficient resource utilization.

What are some common challenges faced by Remote RN Utilization Review Nurses, and how can they be addressed?

Remote RN Utilization Review Nurses often encounter challenges such as managing large caseloads, maintaining effective communication with interdisciplinary teams, and staying updated with ever-changing insurance guidelines. Balancing productivity expectations while ensuring thorough case reviews can be demanding. To address these challenges, nurses can utilize robust organizational tools, participate in ongoing training sessions, and leverage regular virtual meetings to stay connected with colleagues and supervisors, ensuring both efficiency and high-quality patient care.

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

AspectRemote Rn Utilization Review NurseRemote Rn Case Manager
CertificationsRN license, possibly UR or CCM certificationRN license, CCM or other case management certification
Work EnvironmentReviewing medical records, insurance guidelines, and authorizationsCoordinating patient care, discharge planning, and resource management
Employer & Industry UsageHealth insurance companies, third-party administratorsHospitals, health plans, healthcare providers

Remote Rn Utilization Review Nurses primarily evaluate medical necessity for insurance approvals, focusing on documentation and guidelines. In contrast, Remote Rn Case Managers coordinate patient care, discharge planning, and resource allocation. Both roles require RN licensure and related certifications but differ in daily tasks and work focus.

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

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

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

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

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

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

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

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

Remote Rn Utilization Review Nurse jobs near you
Infographic showing various Remote Rn Utilization Review Nurse job openings in Arizona as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution, with an average salary of $81,956 per year, or $39.4 per hour.

Medical Director - Part Time

Valenz Health

Phoenix, AZ โ€ข On-site, Remote

Part-time

Medical, Dental, Vision, Retirement, PTO

Re-posted yesterday

Job description

Vฤlenzยฎ Health is the platform to simplify healthcare - the destination for employers, payers, providers and members to reduce costs, improve quality, and elevate the healthcare experience. The Valenz mindset and culture of innovation combine to create a distinctly different approach to an inefficient, uninspired health system. With fully integrated solutions, Valenz engages early and often to execute across the entire patient journey - from care navigation and management to payment integrity, plan performance and provider verification. With a 99% client retention rate, we elevate expectations to a new level of efficiency, effectiveness and transparency where smarter, better, faster healthcare is possible.
About This Opportunity:
As the Part-Time Medical Director, you'll provide physician leadership for the organization's medical management and utilization review programs. You'll help ensure clinical decisions, medical policies, and review processes align with evidence-based medicine, regulatory requirements, and organizational standards.
In this role, you'll support quality improvement initiatives, complex medical necessity determinations, and the ongoing development of clinical programs while serving as a trusted clinical advisor to operational leadership and interdisciplinary teams.
Things You'll Do Here:
  • Provide physician leadership in the development, implementation, and ongoing evaluation of evidence-based clinical guidelines, medical policies, and utilization management protocols to support high-quality, clinically appropriate decision-making.
  • Ensure clinical programs, utilization review activities, and medical management processes align with current standards of care, evidence-based medicine, accreditation requirements, and applicable federal and state regulations.
  • Serve as the clinical authority for complex, high-risk, or escalated utilization review cases by providing medical expertise, benefit interpretation, and final medical necessity determinations as appropriate.
  • Promote consistency, accuracy, and defensibility in medical decision-making by applying sound clinical judgment and established medical necessity criteria across all review activities.
  • Collaborate with Clinical Operations, Compliance, Legal, and executive leadership to develop, review, and revise clinical and administrative policies, medical necessity guidelines, and benefit interpretation criteria.
  • Monitor changes in clinical practice guidelines, healthcare regulations, payer requirements, and industry best practices, recommending updates to organizational policies and review processes as necessary.
  • Provide physician oversight for quality and performance initiatives by reviewing medical management outcomes, analyzing quality metrics, and participating in quarterly Quality Committee meetings and reporting.
  • Participate in internal audits, accreditation activities, regulatory reviews, and quality improvement initiatives to ensure compliance with organizational standards and continuous operational excellence.
  • Partner with operational leadership to ensure clinical standards are effectively integrated into utilization review workflows, promoting efficient, evidence-based, and member-focused medical management.
  • Provide clinical consultation and recommendations regarding post-service medical necessity determinations, appeals, and other medically complex cases requiring physician review.
  • Serve as a trusted clinical resource and advisor to physicians, nurses, utilization review staff, and cross-functional business partners by providing education, guidance, and consultation on medical policy and clinical best practices.
  • Participate in interdisciplinary committees, physician advisory groups, and organizational meetings to provide clinical insight and support strategic initiatives.
  • Foster collaborative relationships with internal and external stakeholders to promote quality outcomes, regulatory compliance, and continuous improvement across medical management programs.
  • Perform other duties as assigned.
Reasonable accommodation may be made to enable individuals with disabilities to perform essential duties.
What You'll Bring to the Team:
Required Qualifications
  • MD or DO degree with an active, unrestricted medical license
  • Board certification in a recognized specialty
  • Experience with utilization management, medical policy development, and clinical program oversight
  • Familiarity with applicable regulations (e.g., CMS, URAC, and state-specific requirements)
  • Strong interpersonal, organizational, and analytical skills
Licensure Requirements
  • Active, unrestricted Texas medical license (full licensure, not an administrative license)
  • Must hold active medical licenses in states that require physician licensure to perform utilization reviews. Current priorities include Maryland, New Hampshire, West Virginia, and Texas. Additional state licenses are preferred as business needs evolve.
A Plus If You Have
  • 5+ years of clinical experience
  • Managed care or health insurance industry experience

Where You'll Work: This is a fully remote position, and we'll provide all the necessary equipment!
  • Work Environment: You'll need a quiet workspace that is free from distractions.
  • Technology: Reliable internet connection-if you can use streaming services, you're good to go!
  • Security: Adherence to company security protocols, including the use of VPNs, secure passwords, and company-approved devices/software.
  • Location: You must be US based, in a location where you can work effectively and comply with company policies such as HIPAA.

Why You'll Love Working Here
Valenz is proud to be recognized by Inc. 5000 as one of America's fastest-growing private companies. Our team is committed to delivering on our promise to engage early and often for smarter, better, faster healthcare.With this commitment, you'll find an engaged culture - one that stands strong, vigorous, and healthy in all we do.
Benefits
  • Generously subsidized company-sponsored Medical, Dental, and Vision insurance, with access to services through our own products, Healthcare Blue Book and KISx Card.
  • Spending account options: HSA, FSA, and DCFSA
  • 401K with company match and immediate vesting
  • Flexible working environment
  • Generous Paid Time Off to include vacation, sick leave, and paid holidays
  • Employee Assistance Program that includes professional counseling, referrals, and additional services
  • Paid maternity and paternity leave
  • Pet insurance
  • Employee discounts on phone plans, car rentals and computers
  • Community giveback opportunities, including paid time off for philanthropic endeavors

At Valenz, we celebrate, support, and thrive on inclusion, for the benefit of our associates, our partners, and our products. Valenz is committed to the principle of equal employment opportunity for all associates and to providing associates with a work environment free of discrimination and harassment. All employment decisions at Valenz are based on business needs, job requirements, and individual qualifications, without regard to race, color, religion or belief, national, social, or ethnic origin, sex (including pregnancy), age, physical, mental or sensory disability, HIV Status, sexual orientation, gender identity and/or expression, marital, civil union or domestic partnership status, past or present military service, family medical history or genetic information, family or parental status, or any other status protected by the laws or regulations in the locations where we operate. We will not tolerate discrimination or harassment based on any of these characteristics.

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