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Remote Utilization Management Jobs in Florida (NOW HIRING)

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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All JobsRemote Utilization Management JobsRemote Utilization Management Jobs in Florida

Remote Utilization Management information

See Florida salary details

$15

$31

$51

How much do remote utilization management jobs pay per hour?

As of Jun 24, 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.

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 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.

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 June 2026, with employment types broken down into 67% Full Time, and 33% Contract. Highlights an 100% Remote job distribution, with an average salary of $65,722 per year, or $31.6 per hour.

Utilization Management Physician needed in Daytona Beach, FL (Remote)

HealthPlus Staffing

Daytona Beach, FL • Remote

Full-time

Medical, Retirement, PTO

Posted 14 days ago

Job description

Utilization Management Physician (UMP)

Remote | Full-Time | Florida

Compensation: $240,000 base + bonus
Schedule: 40 hours/week
Work Model: Remote (on-site meetings in Daytona Beach, FL)

Overview
Seeking an experienced Utilization Management Physician to perform medical necessity reviews, peer-to-peer discussions, and clinical determinations using evidence-based criteria.

Responsibilities

  • Review pre-auths, concurrent reviews, claims, and appeals

  • Make medical necessity determinations using MCG/InterQual/CMS criteria

  • Conduct peer-to-peer reviews and support UM staff

  • Participate in committees and provider education as needed

Requirements

  • MD or DO with active, unrestricted Florida license

  • 3+ years UM Physician experience

  • 3–7 years clinical experience

  • Managed care experience required

  • Available via phone, email, and Teams

Benefits

  • Bonus opportunity

  • 401(k)

  • Health benefits

  • Malpractice coverage

  • PTO + CME

  • Licenses, fees, travel, and relocation reimbursed

About Us:

HealthPlus Staffing is National Leader in the Healthcare Staffing Industry. We partner up with top facilities nationwide with the focus of finding them highly qualified candidates.

Our Promise:

  • We will put you in front of the decision makers.
  • We will provide feedback on your application.
  • We will work on your behalf to obtain as much info as you need to make a well-informed decision.

If interested in this position, please submit an application or call us at 561-291-7787 to speak with one of our highly experienced consultants. We look forward to finding your next position!

The HealthPlus Team.