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Remote Utilization Management Nurse Jobs in Brandon, MS

FCCI Insurance Group

Medical Case Manager

Ridgeland, MS · On-site +1

$62K - $96K/yr

We are seeking a licensed Registered Nurse to provide telephonic case management on assigned ... s) through utilization of established guidelines to determine appropriate medical treatment ...

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Remote Utilization Management Nurse information

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How much do remote utilization management nurse jobs pay per hour?

As of Sep 4, 2026, the average hourly pay for remote utilization management nurse in Brandon, MS is $40.83, according to ZipRecruiter salary data. Most workers in this role earn between $32.26 and $46.88 per hour, depending on experience, location, and employer.

What is a remote utilization management nurse?

A Remote Utilization Management Nurse is a registered nurse who works from a remote location, such as their home, to review patient medical records and determine the necessity, appropriateness, and efficiency of healthcare services. They collaborate with healthcare providers and insurance companies to ensure that patients receive appropriate care while managing costs. Their main responsibilities include reviewing clinical documentation, conducting pre-authorization reviews, and ensuring compliance with healthcare regulations and insurance guidelines.

What does a remote utilization management nurse do?

As a remote utilization management nurse, you work from home to perform a variety of duties and responsibilities, such as corresponding with and interviewing physicians, modifying patient treatment plans, analyzing investigation information, and auditing patient records. As a UM nurse, you may also deal with other clinical tasks, referrals, authorizations, and reviews. You usually work for insurance companies and healthcare providers to help to determine if patients should receive authorization for needed treatments or for those that they already receive. In some cases, you may monitor processes to ensure that hospital patients are getting what they need during their stay.

What are the key skills and qualifications needed to thrive as a remote utilization management nurse?

To thrive as a Remote Utilization Management Nurse, you need a valid RN license, clinical experience (often in acute care), and a solid understanding of utilization review and healthcare regulations. Familiarity with case management software, electronic medical records (EMRs), and tools like InterQual or Milliman Care Guidelines is typically required. Strong analytical skills, attention to detail, and effective written and verbal communication are essential soft skills for successful remote collaboration and decision-making. These skills ensure accurate assessments, compliance with standards, and the delivery of cost-effective, quality patient care from a remote setting.

What are some common challenges faced by remote utilization management nurses, and how can they be addressed?

Remote Utilization Management Nurses often face challenges such as maintaining effective communication with interdisciplinary teams, staying updated on changing insurance guidelines, and managing a high volume of case reviews. To address these issues, it's helpful to establish regular virtual check-ins with team members, utilize digital tools for efficient documentation, and participate in ongoing training on payer requirements. Developing strong organizational skills and proactively seeking clarification on complex cases can also contribute to success in this role.

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

AspectRemote Utilization Management NurseRemote Case Manager
CredentialsRN license, certifications like CCM or ANCCRN license, certifications like CCM or similar
Work EnvironmentHealthcare organizations, insurance companies, telehealthInsurance companies, healthcare providers, telehealth
Job FocusReviewing medical necessity, authorizations, and utilizationCoordinating patient care, discharge planning, resource management

Both roles require RN licensure and similar certifications, often working remotely within healthcare or insurance settings. The main difference lies in focus: Utilization Management Nurses primarily review medical necessity and authorization requests, while Case Managers coordinate patient care and discharge planning. Understanding these distinctions helps job seekers identify the role that best matches their skills and career goals.

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Remote Utilization Management Nurse jobs near you
Infographic showing various Remote Utilization Management Nurse job openings in Brandon, MS as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 15% Part Time, 2% Contract, and 1% Nights. Highlights an 80% Physical, 2% Hybrid, and 18% Remote job distribution, with an average salary of $84,931 per year, or $40.8 per hour.

Remote - Care Coordinator - LPN - LVN - $21/hr - Day Shift

CareHarmony

Jackson, MS • Remote

$28/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 6 days ago

CareHarmony rating

4.0

Company rating: 4.0 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

Job description

CareHarmony’s Care Coordinators (LPN) (NLC) (LVN) work comprehensively with providers to deliver value-based care management initiatives for their patients.

CareHarmony is seeking an experienced Licensed Practical Nurse – LPN Nurse (LPN) (NLC) (LVN) with at least 3 years of direct patient-facing work experience; that thrives in a fast-paced environment, is self-motivated, has impeccable attention to detail, and values the impact they can have on a patient’s healthcare journey.

You will have experience identifying resources and coordinating needs for chronic care management patients.

What's in it for you?

  • Fully remote position - Work from the comfort of your own home in cozy clothes without a commute. Score!
  • Consistent schedule - Full-Time Monday – Friday, no weekends, rotational on-call-once per year on average.
  • Career growth - Many of our team members move up in the company at a faster-than-average rate. We love to see our people succeed!

Requirements

Responsibilities:

  • Manage patient census with a resolution-driven approach to close gaps in clinical and non-clinical patient care.
  • Identify and coordinate community resources with patients that would benefit their care.
  • Provide patient education and health literacy on the management of chronic conditions.
  • Perform medication management, including identifying potential medication concerns, reconciliation, adherence, and coordinating refills.
  • Assist in ensuring timely delivery of services to your patients; Home Health, DME, Home Infusion, and other critical needs.
  • Resolve patients' questions and create an open dialogue to understand needs.
  • Assist/Manage referrals and appointment scheduling.

Additional Requirements:

  • Active Compact/Multi-State license (LPN) (LVN)
  • Technical aptitude – Microsoft Office Suite
  • Excellent written and verbal communication skills

Plusses:

  • Epic Experience
  • Bilingual
  • Additional Single State licensures

Remote Requirements:

  • Must have active high-speed Wi-Fi
  • Must have a home office or HIPAA-compliant workspace

Physical Requirements

  • This position is sedentary and will require sitting for long periods of time
  • This position will require the ability to speak clearly and listen attentively, often by telephone, for an extended period of time 
  • The position will require the ability to understand, process, and take thorough notes in real-time on telephone conversations 

Benefits:

  • Health Benefits (core medical, dental, vision)
  • Paid Holidays
  • Paid Time Off (PTO)
  • Sick Time Off (STO)
  • 401k with company match
  • Company laptop provided

Pay:

  • The position starts at $21/hr with the ability to earn up to $28/hr based on production
  • Quarterly bonus program
  • Opportunities to pick up OT to increase earnings

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