ZipRecruiter

Log In

2

Remote Utilization Management Nurse Jobs (NOW HIRING)

Allmed Staffing Inc

$20.80/hr

Remote (Must have Compact or TX License) Contract: 06/08/2026 to 09/04/2026 Schedule: Monday - Friday, 8:00 AM - 5:00 PM Position Overview: The Utilization Management LPN supports daily utilization ...

Allmed Staffing Inc

$20.80/hr

Remote (Must have Compact or TX License) Contract: 06/08/2026 to 09/04/2026 Schedule: Monday - Friday, 8:00 AM - 5:00 PM Position Overview: The Utilization Management LPN supports daily utilization ...

Sagility LLC

RN Utilization Management Reviewer

$35 - $40/hr

The Nurse Utilization Management Reviewer has a key role in ensuring the client meets CMS ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...

Sagility LLC

RN Utilization Management Reviewer

$35 - $40/hr

The Nurse Utilization Management Reviewer has a key role in ensuring the client meets CMS ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...

Bracane Co

Utilization Review Nurse

Plano, TX · Remote

Austin area - Travis/Williamson Counties or Richardson area - Dallas/Collin Counties*** RN working ... Utilization management experience LOCATION: REMOTE in Texas ( Richardson area ? Dallas/Collin ...

Umpqua Health

Utilization Review Nurse

Roseburg, OR · On-site +1

$85K - $105K/yr

UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR ... POSITION PURPOSE The Utilization Management Nurse evaluates clinical service requests to ensure ...

next page

Showing results 1-20

All JobsRemote Utilization Management Nurse Jobs

Remote Utilization Management Nurse information

See salary details

$21

$42

$68

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

As of Jun 8, 2026, the average hourly pay for remote utilization management nurse 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 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.

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, and why are they important?

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.
More about Remote Utilization Management Nurse jobs
What cities are hiring for Remote Utilization Management Nurse jobs? Cities with the most Remote Utilization Management Nurse job openings:
What are the most commonly searched types of Utilization Management Nurse jobs? The most popular types of Utilization Management Nurse jobs are:
What states have the most Remote Utilization Management Nurse jobs? States with the most job openings for Remote Utilization Management Nurse jobs include:
What job categories do people searching Remote Utilization Management Nurse jobs look for? The top searched job categories for Remote Utilization Management Nurse jobs are:
Remote Utilization Management Nurse jobs near you
Utilization Management Supervisor

Utilization Management Supervisor

Franciscan Health

Remote

Full-time

Posted 12 days ago

Franciscan Health rating

6.9

Company rating: 6.9 out of 10

Based on 257 frontline employees who took The Breakroom Quiz

452nd of 869 rated healthcare providers

Job description

Work From Home
Work From Home Work From Home, Indiana 46544
The Supervisor Utilization Management is responsible for the direct supervision of the daily operations of the Centralized Utilization Management department in order to assure that utilization management needs are addressed. This position ensures appropriate staffing levels, ongoing educational opportunities, and employee satisfaction to maintain operational commitment. The Supervisor maintains and enhances relationships with internal and external customers and peers across the continuum in order to facilitate excellent outcomes for patients and Franciscan.
WHO WE ARE
With 11 ministries and access points across Indiana, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve.
WHAT YOU CAN EXPECT
  • Maintain inter- and intra-departmental communications, special projects, programs, policies, and procedures as well as care management services.
  • Participate and educate team in performance improvement initiatives. Implement processes to satisfaction with those we are privileged to serve.
  • Coordinate and maintain compliance with HFAP, state and federal agencies pertaining to Utilization/Denial management activities.
  • Supervise direct reports and manage the performance of individuals through ongoing coaching, feedback, and development to motivate, engage and drive a high performing team.
  • Make decisions for direct reports in assigned function and performs people management activities, such as, performance evaluations, disciplinary actions, staff planning, and interviews.
  • Supervise and maintain Utilization Management operations in collaboration with the Manager and Director, including ensuring appropriate utilization and denial management.

QUALIFICATIONS
  • Bachelor's Degree in Nursing required
  • Active Indiana Registered Nurse (RN) license required
  • 5 years of Nursing/Patient Care required
  • 2 years of Utilization or Case Management experience preferred

TRAVEL IS REQUIRED:
Up to 20%
JOB RANGE:
Supervisor Utilization Management: $67,683.20 - $105,768.00
INCENTIVE:
Not Applicable
EQUAL OPPORTUNITY EMPLOYER
It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law.
Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights.
Franciscan Alliance is committed to equal employment opportunity.
Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on the benefit section of our career site, jobs.franciscanhealth.org.

What Franciscan Health employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply