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Remote Rn Utilization Review Nurse Jobs in Florida

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Remote Rn Utilization Review Nurse information

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$15

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$51

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

As of Aug 11, 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.

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 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 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:
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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 August 2026, with employment types broken down into 84% Full Time, 7% Part Time, and 9% Contract. Highlights an 100% Remote job distribution, with an average salary of $65,722 per year, or $31.6 per hour.

Utilization Review Specialist (Remote) - Behavioral Health

Adolescent Wellness Academy

Davie, FL • Remote

Full-time

Posted 4 days ago

Job description

Remote Authorization Specialist

Remote | Full-Time | 9a-5p Monday-Friday | $24-$26/hour

About the Role
This role manages insurance authorization for clients across our PHP and IOP programs - completing pre-certifications, concurrent reviews, verifying benefits, obtaining Single Case Agreements, and managing appeals so that client access to treatment is never disrupted by a payer issue.

Backgrounds that translate well: Utilization Review Insurance Authorization/Precertification Behavioral Health Case Management

What You'll Do

  • Verify benefits and eligibility prior to admission and throughout treatment
  • Complete pre-certifications, concurrent reviews, and re-certifications for PHP/IOP levels of care
  • Obtain Single Case Agreements with out-of-network payers
  • Build the medical necessity case using ASAM, LOCUS, and CALOCUS criteria
  • Prepare and submit appeals on denied authorizations
  • Maintain accurate, audit-ready authorization, denial, and SCA records

What We're Looking For

Required

  • 2+ years of experience as a UR/authorization specialist at the PHP and IOP levels of care for a mental health or substance use facility
  • Working knowledge of ASAM, LOCUS, and CALOCUS criteria and medical necessity standards
  • Strong organizational skills with the ability to manage multiple authorizations and deadlines concurrently
  • Strong familiarity with EMR platforms and authorization software
  • Strong written and verbal communication skills, with the ability to advocate effectively with payers
  • Eligible for DCF and AHCA Level 2 Background Check

Preferred

  • CPT/ICD-10 and DSM-5 familiarity
  • Multi-payer SCA experience
  • Bilingual (English/Spanish)
  • Kipu or similar EMR experience

AWA and PRC are dual behavioral health organizations operating PHP and IOP programs across South Florida. We exist to serve clients and families at their most critical moments - and this role sits at the front door of that mission.


Learn More: Adolescent Wellness Academy Principles Recovery Center

Employment Type: FULL_TIME

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