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Remote Rn Utilization Review Nurse Jobs in Florida

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Bill Review Nurse

Lakeland, FL · On-site +1

$76K - $108K/yr

The person hired for this position may work full-time remote depending on availability. #LI-Hybrid ... R.N. (Registered Nurse) required. Experience: Generally, a minimum of 14 years of case management ...

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

Remote Rn Utilization Review Nurse information

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$15

$31

$51

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

As of Jul 15, 2026, the average hourly pay for remote rn utilization review nurse in Florida is $31.60, according to ZipRecruiter salary data. Most workers in this role earn between $24.95 and $36.30 per hour, depending on experience, location, and employer.

How to make an extra 2000 a month as a nurse?

A remote RN utilization review nurse can increase income by taking on additional shifts, working overtime, or pursuing specialized certifications such as CCM or CPHQ to qualify for higher-paying roles. Developing skills in case management, telehealth, or documentation can also open opportunities for freelance or consulting work to earn extra income.

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.

How to get into utilization review as a nurse?

To become a utilization review nurse, you typically need to be a registered nurse (RN) with clinical experience and obtain knowledge of insurance processes and healthcare regulations. Many employers prefer candidates with certifications such as the Certified Professional in Healthcare Quality (CPHQ) or Certified Case Manager (CCM). Gaining experience in case management, medical records review, or insurance settings can improve your chances of entering utilization review roles.

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, and why are they important?

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.

How can I make $2000 a week working from home?

A Remote Rn Utilization Review Nurse can potentially earn $2000 or more weekly by working full-time hours, often requiring specialized nursing experience, certification, and strong clinical assessment skills. Increasing income may involve taking on additional shifts, working for multiple employers, or gaining advanced certifications to qualify for higher-paying roles. Flexibility and efficiency with electronic health record tools can also enhance earning potential.

How to become a remote nurse reviewer?

To become a remote RN utilization review nurse, candidates typically need an active nursing license, experience in case management or utilization review, and familiarity with healthcare software and medical records. Certification in case management or utilization review, such as the Certified Case Manager (CCM), can enhance job prospects. Strong communication skills and the ability to work independently are also important for remote roles.
What are the most commonly searched types of Rn Utilization Review Nurse jobs in Florida? The most popular types of Rn Utilization Review Nurse jobs in Florida are:
What are popular job titles related to Remote Rn Utilization Review Nurse jobs in Florida? For Remote Rn Utilization Review Nurse jobs in Florida, the most frequently searched job titles are:
What job categories do people searching Remote Rn Utilization Review Nurse jobs in Florida look for? The top searched job categories for Remote Rn Utilization Review Nurse jobs in Florida are:
What cities in Florida are hiring for Remote Rn Utilization Review Nurse jobs? Cities in Florida 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 Florida as of July 2026, with employment types broken down into 2% As Needed, 62% Full Time, 19% Part Time, 1% Temporary, and 16% Contract. Highlights an 99% Physical, and 1% Remote job distribution, with an average salary of $65,722 per year, or $31.6 per hour.
Manager, Utilization Review

Manager, Utilization Review

Health Business Solutions LLC

Cooper City, FL • Remote

Full-time

Posted 8 days ago

Job description

The Manager, Utilization Review is responsible for overseeing the daily operations of the Utilization Review for one of our clients and leading a team of Utilization Review Nurses. This role involves ensuring efficient care coordination, managing healthcare costs, and maintaining high-quality patient care standards. The Manager, Utilization Review will collaborate with various healthcare professionals to improve patient outcomes and streamline care processes.

Key Responsibilities:

1. Leadership and Team Management:

• Supervise and mentor a team of Utilization Review Nurses, providing guidance and support to ensure excellent performance.

• Foster a collaborative and cohesive work environment within the department.

• Conduct regular staff meetings, performance evaluations, and staff development activities.

2. Care Coordination and Oversight:

• Oversee the development and implementation of individualized care plans for patients.

• Collaborate with the healthcare team to ensure coordinated and efficient patient care across different healthcare settings.

• Monitor and assess the appropriateness of care plans and resource utilization.

3. Quality Improvement:

• Implement and monitor quality improvement initiatives to enhance patient outcomes and compliance with healthcare regulations.

• Analyze data and metrics to identify areas for improvement in care coordination processes.

4. Budget Management:

• Manage the department's budget and resource allocation efficiently while maintaining high-quality patient care.

• Collaborate with finance and administrative teams to optimize resource utilization.

5. Staff Development:

• Provide ongoing training and education to Utilization Review Nurses to keep them updated on best practices and regulatory changes.

• Encourage professional growth and development within the department.

6. Patient Advocacy:

• Serve as a patient advocate, ensuring that patients' needs and preferences are addressed throughout their healthcare journey.

• Participate in complex case reviews and offer guidance on challenging patient cases.

7. Documentation and Compliance:

• Ensure accurate and timely documentation of patient records, care plans, and progress notes in accordance with regulatory standards.

Qualifications:

• Current RN (Registered Nurse) license. Compact or Multi-State License strongly preferred.

• Bachelor's degree in Nursing (BSN) required Masters (MSN) preferred.

• Previous experience in case management or care coordination, with at least 2 years in a leadership role.

• Strong clinical assessment and critical thinking skills.

• Excellent communication and interpersonal skills.

• Knowledge of healthcare regulations, insurance processes, and quality improvement methodologies.

• Proficiency in electronic health records (EHR) and healthcare software.

• Dedication to patient-centered care and a commitment to ethical practice.

If you are an experienced and visionary nurse leader who is passionate about improving patient care and outcomes, we invite you to apply for the Utilization Review Nurse Manager position. Join our team and lead the way in optimizing patient care. Apply today!


Health Business Solutions (HBiz) is an Equal Opportunity Employer. We are committed to providing equal employment opportunities to all employees and applicants without regard to race, color, religion, sex (including pregnancy, sexual orientation, or gender identity), national origin, age, disability, genetic information, veteran status, or any other status protected by applicable federal, state, or local law.

HBiz complies with all applicable employment laws for remote and multi-state hiring and provides reasonable accommodations as required by law.


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