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$39K

$89.5K

$163K

How much do remote um nurse jobs pay per year?

As of Jul 25, 2026, the average yearly pay for remote um nurse in the United States is $89,483.00, according to ZipRecruiter salary data. Most workers in this role earn between $64,500.00 and $104,500.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive in the Remote Um Nurse position, and why are they important?

To excel as a Remote UM Nurse, you need an active RN license, strong clinical assessment skills, and experience in utilization management or case review. Familiarity with utilization management software, electronic health records (EHRs), and medical coding systems such as ICD-10 and CPT is typically required, along with certifications like CCM or CPUR being advantageous. Exceptional organizational abilities, clear written/verbal communication, and self-motivation are critical soft skills for success in this autonomous, remote position. These competencies allow Remote UM Nurses to accurately evaluate medical necessity, efficiently manage case loads, and collaborate effectively with healthcare teams on care decisions.

What are some common challenges faced by Remote UM Nurses and how are they addressed?

Remote UM Nurses often encounter challenges such as managing high case volumes, interpreting complex medical documentation, and coordinating care across various providers without direct patient contact. These challenges are typically addressed through strong organizational skills, continuous professional development, and efficient use of digital tools for communication and case management. Many employers provide thorough onboarding, standardized protocols, and ongoing support from team leads and peers to help UM Nurses excel. Staying current with changing guidelines and participating in regular team meetings are also essential strategies for success in this role.

What is a Remote UM Nurse job?

A Remote Utilization Management (UM) Nurse reviews medical records and authorization requests to ensure that healthcare services are medically necessary and cost-effective. They work from home, using clinical guidelines and insurance policies to determine approvals or denials. Their role helps balance quality patient care with cost efficiency by coordinating with healthcare providers and insurance companies.

More about Remote Um Nurse jobs
What cities are hiring for Remote Um Nurse jobs? Cities with the most Remote Um Nurse job openings:
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What job categories do people searching Remote Um Nurse jobs look for? The top searched job categories for Remote Um Nurse jobs are:
Remote Um Nurse jobs near you
Infographic showing various Remote Um Nurse job openings in the United States as of July 2026, with employment types broken down into 3% As Needed, 57% Full Time, 15% Part Time, and 25% Contract. Highlights an 99% Physical, and 1% Remote job distribution, with an average salary of $89,483 per year, or $43 per hour.
Care Review Clinician (RN) Remote (Must Reside In AZ)

Care Review Clinician (RN) Remote (Must Reside In AZ)

Molina Healthcare

Tucson, AZ • Remote

$26.41 - $51.49/hr

Full-time

This job post has expired 1 day ago. Applications are no longer accepted.

Molina Healthcare rating

8.0

Company rating: 8.0 out of 10

Based on 196 frontline employees who took The Breakroom Quiz

147th of 281 rated insurance

Job description

JOB DESCRIPTION 

This position will support the Arizona state Plan. We are seeking a candidate with an Arizona RN licensure.  The ideal candidate will have experience with UM and prior authorization with both inpatient and outpatient.  Candidates with a Behavioral Health background are highly preferred. Further details to be discussed during our interview process. Prefers candidates with 3 years of experience.

Remote position, must reside in Arizona.

Work hours: Monday - Friday 8:30am- 5:00pm Mountain Time with some weekends and holidays. 

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. 
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 - $51.49 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

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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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