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Remote Rn Utilization Review Nurse Jobs in Florida

Guardian Recovery

UR COORDINATOR

Delray Beach, FL · On-site +1

$60K - $70K/yr

The Utilization Review Coordinator (UR Coordinator) is responsible to perform the process of ... Master's degree from an accredited college or university in social work, mental health, nursing, or ...

Dermave Spa

Registered Nurse Trainer

Orlando, FL · On-site +1

$22 - $27/hr

Registered Nurse Trainer Employment Type: Full-Time Work Schedule: 80% Remote / 20% Travel Role Overview We are looking for a licensed RN or APRN with experience in aesthetics or med spa settings to ...

DermaVe Spa

Registered Nurse Trainer

Orlando, FL · Remote

$22 - $27/hr

Registered Nurse Trainer Employment Type: Full-Time Work Schedule: 80% Remote / 20% Travel Role Overview We are looking for a licensed RN or APRN with experience in aesthetics or med spa settings to ...

DermaVe Spa

Travel Nurse Trainer

Sarasota, FL · Remote

$22 - $27/hr

Travel Nurse Trainer (RN/APRN) - Join Our Wellness Network Top Highlights: * 80% remote | 20% travel * First 2 weeks on-site orientation * Create training modules and conduct virtual sessions

Dermave Spa

Travel Nurse Trainer

Sarasota, FL · On-site +1

$22 - $27/hr

Travel Nurse Trainer (RN/APRN) - Join Our Wellness Network Top Highlights: * 80% remote | 20% travel * First 2 weeks on-site orientation * Create training modules and conduct virtual sessions

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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 Aug 10, 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:
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 1% As Needed, 83% Full Time, 13% Part Time, 1% Temporary, and 2% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $65,722 per year, or $31.6 per hour.

Care Review Clinician (RN) - Remote in FL

Molina Healthcare

Miami, FL • Remote

$26.41 - $43/hr

Full-time

Re-posted 11 days ago

Molina Healthcare rating

8.0

Company rating: 8.0 out of 10

Based on 198 frontline employees who took The Breakroom Quiz

163rd of 304 rated insurance

Job description

JOB DESCRIPTION 

Must reside in Florida

Job Summary

Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care. 
Essential Job Duties 
Assesses services for members to ensure optimum outcomes, cost-effectiveness and compliance with all state/federal regulations and guidelines. 
Analyzes clinical service requests from members or providers against evidence based clinical guidelines. 
Identifies appropriate benefits, eligibility and expected length of stay for requested treatments and/or procedures. 
Conducts reviews to determine prior authorization/financial responsibility for Molina and its members. 
Processes requests within required timelines. 
Refers appropriate cases to medical directors (MDs) and presents them in a consistent and efficient manner. 
Requests additional information from members or providers as needed. 
Makes appropriate referrals to other clinical programs. 
Collaborates with multidisciplinary teams to promote the Molina care model. 
Adheres to utilization management (UM) policies and procedures. 
Required Qualifications 
At least 2 years experience, including experience in hospital acute care, inpatient review, prior authorization, managed care, or equivalent combination of relevant education and experience. 
Registered Nurse (RN). License must be active and unrestricted in state of practice. 
Ability to prioritize and manage multiple deadlines. 
Excellent organizational, problem-solving and critical-thinking skills. 
Strong written and verbal communication skills. 
Microsoft Office suite/applicable software program(s) proficiency. 
Preferred Qualifications 
Certified Professional in Healthcare Management (CPHM). 
Recent hospital experience in an intensive care unit (ICU) or emergency room.

  • Utilization Management (UM) experience highly preferred. 

#PJHS3

#LI-AC1
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. 
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $26.41 - $43 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Employment Type: Full Time

What Molina Healthcare employees say

Pay

Benefits

Hours and flexibility

Workplace

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About Molina Healthcare

Sourced by ZipRecruiter

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Long Beach, CA, US

Year founded

1980

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