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Remote Utilization Management Jobs in Florida (NOW HIRING)

Actalent

Utilization Management Rn - Remote

Miami, FL · Remote

$35 - $39/hr

Qualifications: * 3+ years of utilization management, concurrent review, prior authorization ... remote position. Application Deadline This position is anticipated to close on May 27, 2026. About ...

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Pharmacy Careers

Appeals Pharmacist (Remote)

Hollywood, FL · On-site +1

$52.25 - $63.75/hr

Prior managed care or utilization management experience preferred - retail and hospital pharmacists ... Many roles offer hybrid or fully remote options. * Rewards: Competitive salary, comprehensive ...

Pharmacy Careers

Appeals Pharmacist (Remote)

Miami, FL · On-site +1

$54.75 - $66.75/hr

Prior managed care or utilization management experience preferred - retail and hospital pharmacists ... Many roles offer hybrid or fully remote options. * Rewards: Competitive salary, comprehensive ...

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$15

$31

$51

How much do remote utilization management jobs pay per hour?

As of May 28, 2026, the average hourly pay for remote utilization management in Florida is $31.60, according to ZipRecruiter salary data. Most workers in this role earn between $24.95 and $36.30 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Remote Utilization Management Nurse, and why are they important?

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 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 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.

What are the most commonly searched types of Utilization Management jobs in Florida? The most popular types of Utilization Management jobs in Florida are:
What are popular job titles related to Remote Utilization Management jobs in Florida? For Remote Utilization Management jobs in Florida, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Management jobs in Florida look for? The top searched job categories for Remote Utilization Management jobs in Florida are:
What cities in Florida are hiring for Remote Utilization Management jobs? Cities in Florida with the most Remote Utilization Management job openings:
Remote Utilization Management jobs near you
Infographic showing various Remote Utilization Management job openings in Florida as of May 2026, with employment types broken down into 3% As Needed, 49% Full Time, 43% Part Time, and 5% Contract. Highlights an 89% Physical, and 11% Remote job distribution, with an average salary of $65,722 per year, or $31.6 per hour.
Utilization Management Rn - Remote

Utilization Management Rn - Remote

Actalent

Miami, FL • Remote

$35 - $39/hr

Other

Medical, Dental, Vision, Life, Retirement, PTO

This job post has expired today. Applications are no longer accepted.

Job description

Urgent Hiring for "Remote Clinical Review Nurses"
Job Description:

  • Review approximately 20 cases a day for medical necessity.
  • Advocate for and protect members from unnecessary hospital admissions.
  • Follow established procedures and processes to complete authorizations.
  • Collaborate with a team of nurses to assist each other and complete cases.
Qualifications:
  • 3+ years of utilization management, concurrent review, prior authorization, utilization review, case management, and discharge planning is must
  • Active RN Compact License is Must

If you are Interested , Kindly give a call : (726) 216-6069
Job Type & Location
This is a Contract position based out of Miami, FL.
Pay and Benefits
The pay range for this position is $35.00 - $39.00/hr.
Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:
• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)
Workplace Type
This is a fully remote position.
Application Deadline
This position is anticipated to close on May 27, 2026.
About Actalent
Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.
The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.
San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.
Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.
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About Actalent

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Actalent connects passion with purpose. Our scalable talent solutions and services capabilities drive value and results and provide the expertise to help our customers achieve more. Every day, our experts around the globe are making an impact. We're supporting critical initiatives in engineering and sciences that advance how companies serve the world. Actalent promotes consultant care and engagement through experiences that enable continuous development. Our people are the difference. Actalent is an operating company of Allegis Group, the global leader in talent solutions.

Company size

5,001 - 10,000 Employees

Headquarters location

Hanover, MD, US

Year founded

1983

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