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Remote Utilization Management Jobs in Florida (NOW HIRING)

Sunshine State Health Plan

Medical Director

Miami, FL · On-site +1

$236K - $449K/yr

Provides medical leadership of all for utilization management, cost containment, and medical ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...

Sunshine State Health Plan

Medical Director

Hialeah, FL · On-site +1

$236K - $449K/yr

Provides medical leadership of all for utilization management, cost containment, and medical ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...

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Remote Utilization Management information

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$15

$31

$51

How much do remote utilization management jobs pay per hour?

As of Sep 8, 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 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 are the key skills and qualifications needed to thrive in remote utilization management?

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 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 August 2026, with employment types broken down into 1% As Needed, 86% Full Time, 11% Part Time, and 2% Contract. Highlights an 88% Physical, 3% Hybrid, and 9% Remote job distribution, with an average salary of $65,722 per year, or $31.6 per hour.

Licensed Physician Reviewer - Urologist , PRN (remote)

ChenMed, LLC

Miami, FL • On-site, Remote

$204K - $292K/yr

Part-time

Re-posted 17 days ago

ChenMed rating

8.4

Company rating: 8.4 out of 10

Based on 40 frontline employees who took The Breakroom Quiz

1st of 247 rated social care providers

Job description

We're unique. You should be, too.
We're changing lives every day. For both our patients and our team members. Are you innovative and entrepreneurial minded? Is your work ethic and ambition off the charts? Do you inspire others with your kindness and joy?
We're different than most primary care providers. We're rapidly expanding and we need great people to join our team.
The Physician Reviewer is the primary physician reviewer for Utilization Management (UM) cases in our organization. Other duties include advising other physician reviewers and attending daily calls with health plan teams and our local teams assisting with this function and coordinating care for our patients. The position will also participate in Process and Quality improvement in our developing area of Delegated Utilization Management.
  • Provides Delegated UM by covering the specified territories as assigned:
    • Establish 2-3 cases a day for each market covered (up to 6 markets); ensures attendance on all health plan and local calls; calls in for the weekly Primary Care Provider (PCP) and Skilled Nursing Facility (SNF) meetings covering the assigned territories.
  • Advises other physician reviewers.
  • Other duties as assigned and modified by manager.
  • Excellent analytical and deductive reasoning skills
  • Good judgement and problem-solving skills
  • Professional and effective communication skills
  • Strong organizational skills
  • Written and verbal fluency in English
  • Proficient in the use of Microsoft Office products such as Outlook, Excel, Word and PowerPoint

EDUCATION AND EXPERIENCE CRITERIA:
  • Graduate from accredited Medical School with a valid, unrestricted license is required
  • Completion of Internal Medicine or Family Practice residency
  • Board Certification in residency area - Urology
  • Two (2) years' experience in Hospital medicine preferred
  • At least one (1) year of utilization review experience preferred

PAY RANGE:
$204,761 - $292,515 Salary
The posted pay range represents the base hourly rate or base annual full-time salary for this position. Final compensation will depend on a variety of factors including but not limited to experience, education, geographic location, and other relevant factors. This position may also be eligible for a bonuses or commissions.
EMPLOYEE BENEFITS
https://chenmed.makeityoursource.com/helpful-documents
We're ChenMed and we're transforming healthcare for seniors and changing America's healthcare for the better. Family-owned and physician-led, our unique approach allows us to improve the health and well-being of the populations we serve. We're growing rapidly as we seek to rescue more and more seniors from inadequate health care.
ChenMed is changing lives for the people we serve and the people we hire. With great compensation, comprehensive benefits, career development and advancement opportunities and so much more, our employees enjoy great work-life balance and opportunities to grow. Join our team who make a difference in people's lives every single day.
Current employees, if you want to apply to our internal career site, please click HERE
Current Contingent Worker please see job aid HERE to apply
#LI-Remote

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About ChenMed

Sourced by ZipRecruiter

We're expanding healthcare equity across America. We're already in 15 states with 100+ medical centers. As a rapidly growing, physician-led organization, we have one central focus: rescue any and every senior from a healthcare system that has failed them. Our family of brands include Chen Senior Medical Center, JenCare Senior Medical Center, and Dedicated Senior Medical Center. Recently named a 2021 Best Places To Work and one of the only healthcare companies recognized in Fortune's 2020 "Change The World" list, ChenMed prides itself on creating a culture that enables career growth and promotes inclusion for all.

Industry

Health care and social assistance

Company size

5,001 - 10,000 Employees

Headquarters location

Miami, FL, US

Year founded

1985

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