ZipRecruiter

Log In

2

Remote Utilization Management Nurse Jobs (NOW HIRING)

Oak St. Health

Utilization Management Nurse Consultant

$32.01 - $68.55/hr

Registered Nurse (RN) - Utilization Management Join a dynamic healthcare team and make an impact on patient care from wherever you work. We are seeking an experienced Registered Nurse (RN) to support ...

Oak St. Health

Utilization Management Nurse Consultant

$26.01 - $56.14/hr

Registered Nurse (RN) - Utilization Management (24/7 Operations) Step away from bedside care and make a system-wide impact. Join our Utilization Management team and help ensure members receive the ...

Oak St. Health

Utilization Management Nurse Consultant

$26.01 - $68.55/hr

Prior authorization utilization experience preferred * Outpatient Clinical experience * Knowledge of Medicare/Medicaid * Managed care experience Education: * Associates Degree in Nursing required

Oak St. Health

Utilization Management Nurse Consultant

$26.01 - $68.55/hr

Prior authorization utilization experience preferred * Outpatient Clinical experience * Knowledge of Medicare/Medicaid * Managed care experience Education: * Associates Degree in Nursing required

Oak St. Health

Utilization Management Nurse Consultant

$26.01 - $68.55/hr

Prior authorization utilization experience preferred * Outpatient Clinical experience * Knowledge of Medicare/Medicaid * Managed care experience Education: * Associates Degree in Nursing required

Oak St. Health

Utilization Management Nurse Consultant

$26.01 - $68.55/hr

Prior authorization utilization experience preferred * Outpatient Clinical experience * Knowledge of Medicare/Medicaid * Managed care experience Education: * Associates Degree in Nursing required

Oak St. Health

Utilization Management Nurse Consultant

$26.01 - $68.55/hr

Prior authorization utilization experience preferred * Outpatient Clinical experience * Knowledge of Medicare/Medicaid * Managed care experience Education: * Associates Degree in Nursing required

Oak St. Health

Utilization Management Nurse Consultant

$32.01 - $68.55/hr

... N licensure in state of residence Utilization Management is a 24/7 operation and work schedules will include weekends, holidays, and evening hours Preferred Qualifications 2+ years of clinical ...

Oak St. Health

Utilization Management Nurse Consultant

$26.01 - $68.55/hr

Prior authorization utilization experience preferred * Outpatient Clinical experience * Knowledge of Medicare/Medicaid * Managed care experience Education: * Associates Degree in Nursing required

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 ...

Dignity Health Management Services

$57.37 - $85.33/hr

As a remote employee, we will provide you with the equipment needed to work from home, including a ... Bachelors of Nursing (BSN) preferred * Previous inpatient Utilization Management (UM) experience ...

previous pagenext page

Showing results 21-40

All JobsUtilization Management Nurse 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 Aug 10, 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?

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
Infographic showing various Remote Utilization Management Nurse job openings in the United States as of August 2026, with employment types broken down into 2% As Needed, 86% Full Time, 6% Part Time, and 6% Contract. Highlights an 100% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

Utilization Management Nurse Consultant

Oak St. Health

Remote

$32.01 - $68.55/hr

Other

Re-posted 12 days ago

Job description

Registered Nurse (RN) – Utilization Management

Join a dynamic healthcare team and make an impact on patient care from wherever you work.

We are seeking an experienced Registered Nurse (RN) to support our 24/7 Utilization Management operations. In this role, you will use your clinical expertise to review cases, assess medical necessity, coordinate care, and help ensure members receive appropriate, high-quality healthcare services.

What You'll Do
  • Review clinical information and apply evidence-based criteria to support coverage determinations and care recommendations.
  • Collaborate with providers, care teams, and internal partners to coordinate treatment and services.
  • Identify opportunities to improve healthcare quality, outcomes, and benefit utilization.
  • Refer members to appropriate programs and services that support their overall health needs.
  • Serve as a clinical resource for utilization and benefit management questions.
What We're Looking For Required Qualifications
  • Active, unrestricted RN license in your state of residence.
  • 2+ years of RN experience in an adult acute care or critical care setting.
  • Associate Degree in Nursing.
  • Strong communication, multitasking, and computer navigation skills.
  • Ability to work a designated schedule of 11:00 AM – 8:00 PM ET, including weekends, holidays, and evening hours based on business needs.
Preferred Qualifications
  • BSN preferred.
  • Clinical experience in Med-Surg or a specialty area.
  • Managed Care and/or Utilization Management experience.
  • Candidates located in the Eastern Time Zone preferred.
Why Join Us?
  • Apply your clinical expertise in a collaborative, fast-paced environment.
  • Help improve healthcare outcomes for members across the continuum of care.
  • Work with a mission-driven team focused on quality, efficiency, and patient-centered care.

Ready to leverage your nursing experience in a rewarding Utilization Management role? Apply today.

Anticipated Weekly Hours: 40

Time Type: Full time

Pay Range: $32.01 - $68.55

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families.

Apply