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Remote Utilization Management Jobs (NOW HIRING)

Centene

Supervisor, Utilization Management

$75K - $135K/yr

Supervises day-to-day activities of utilization management team. Key Details: Must be authorized to ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...

Centene

Director, Utilization Management

$133K - $247K/yr

Leads utilization management team on performance, improvement, and career growth path ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...

Intus Care

Utilization Management Nurse

$80K - $95K/yr

Utilization Management Nurse IntusCare is the only end-to-end ecosystem built specifically to help ... This is a fully remote role based in the United States. Sponsorship: This position is not eligible ...

Providence Health & Service

Utilization Review RN

Utilization Review RN - Remote Utilization Review RN - REMOTE position. This position is Part time ... remote UR environment or working as an acute hospital case manager. Preferred Qualifications:

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Intus, Inc

Utilization Management Nurse

$80K - $95K/yr

Role Overview The Utilization Management Nurse plays a critical role in ensuring high-quality, cost ... This is a fully remote role based in the United States. Sponsorship: This position is not eligible ...

INTUS INC

Utilization Management Nurse

$80K - $95K/yr

Role Overview The Utilization Management Nurse plays a critical role in ensuring high-quality, cost ... This is a fully remote role based in the United States. Sponsorship: This position is not eligible ...

Appworks

Utilization Management Registered Nurse

Utilization Management Registered Nurse (UM RN) We're seeking a dedicated and detail-oriented ... This is a fully remote opportunity requiring discipline, accuracy, and effective collaboration ...

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How much do remote utilization management jobs pay per hour?

As of Sep 13, 2026, the average hourly pay for remote utilization management in the United States is $42.28, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 per hour, depending on experience, location, and employer.

What is remote utilization management?

Remote utilization management is a process in which healthcare professionals, such as nurses or case managers, review and assess the necessity, efficiency, and appropriateness of medical services—often from a remote location. These professionals typically work for insurance companies, hospitals, or healthcare organizations to ensure that patients receive the right care while controlling costs. By working remotely, they use electronic health records, phone calls, and other digital tools to collaborate with providers and patients. This role helps improve healthcare quality and cost-effectiveness while allowing employees flexible work arrangements.

What are the key skills and qualifications needed to thrive in remote utilization management?

Success as a Remote Utilization Management Nurse requires a registered nursing license, clinical experience, and strong knowledge of medical necessity criteria and insurance guidelines. Familiarity with utilization review software, electronic health records (EHRs), and case management systems is typically necessary. Exceptional communication, critical thinking, and organizational skills help professionals excel in evaluating cases and coordinating with providers remotely. These skills are crucial for ensuring appropriate care, cost-effective resource use, and regulatory compliance in a remote healthcare setting.

How does a remote utilization management professional typically collaborate with healthcare providers and insurance teams?

Remote Utilization Management professionals frequently interact with both healthcare providers and insurance teams through secure digital platforms, phone calls, and virtual meetings. They review patient records, assess the necessity of medical services, and communicate their recommendations or authorization decisions. Effective collaboration requires clear documentation, timely responses, and strong communication skills to ensure that care is both medically appropriate and cost-effective. While the work is often independent, regular coordination with interdisciplinary teams is essential for maintaining high-quality patient outcomes and adhering to regulatory standards.

What is the difference between Remote Utilization Management vs Remote Case Management?

AspectRemote Utilization ManagementRemote Case Management
CredentialsRN, LPN, or licensed healthcare professionalsRN, LPN, or social workers
Work EnvironmentHealthcare facilities, insurance companies, telehealthHealthcare providers, insurance, community agencies
Industry UsageInsurance, healthcare, telehealthHealthcare, social services, insurance
Primary FocusReviewing medical necessity, authorizationsCoordinating patient care, support services

Remote Utilization Management primarily involves reviewing medical necessity and authorizations, while Remote Case Management focuses on coordinating patient care and support services. Both roles require healthcare credentials and are used within healthcare and insurance industries, but they serve different functions in patient care and resource allocation.

More about Remote Utilization Management jobs

What cities are hiring for Remote Utilization Management jobs?

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What are the most commonly searched types of Utilization Management jobs?

The most popular types of Utilization Management jobs are:

What states have the most Remote Utilization Management jobs?

States with the most job openings for Remote Utilization Management jobs include:

What are popular job titles related to Remote Utilization Management jobs?

For Remote Utilization Management jobs, the most frequently searched job titles are:

Remote Utilization Management jobs near you
Infographic showing various Remote Utilization Management job openings in the United States as of September 2026, with employment types broken down into 1% As Needed, 83% Full Time, 14% Part Time, and 2% Contract. Highlights an 82% Physical, 2% Hybrid, and 16% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

Registered Nurse-Utilization Review

Remote

3B Healthcare, Inc.
Health Care and Social Assistance • 51 - 200 employees
Learn more about 3B Healthcare, Inc.external

Other

Re-posted 15 days ago

Job description

Registered Nurse – Utilization Review (Remote)

This is a fully remote Utilization Review RN role supporting multiple service lines and levels of care, including Inpatient, Extended Hospital Outpatient, and Observation (OBS).

Minimum of 3 years acute medical Care Management/Utilization Review experience in a hospital setting (experience in health plans or medical groups is not applicable).

InterQual experience is mandatory; candidates without this will not be considered.

Proficient in Epic, with recent use within the last 6–12 months.

Experience working with HMOs, IPAs, and similar managed care organizations.

Strong knowledge of Medicare regulations and associated utilization management processes, including:

  • Condition Code 44 (CC44)
  • Advance Beneficiary Notices (ABNs)
  • Hospital-Issued Notices of Noncoverage (HINNs)
  • Medicare Coverage Status Notices (MCSNs)

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