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Remote Utilization Management Jobs (NOW HIRING)

Intus, Inc

Utilization Management Manager

The Utilization Management (UM) Manager is fully accountable for the performance of the UM nurse ... This is a fully remote role based in the United States. Sponsorship : This position is not eligible ...

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How much do remote utilization management jobs pay per hour?

As of Aug 3, 2026, the average hourly pay for remote utilization management 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.

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.

More about Remote Utilization Management jobs
What cities are hiring for Remote Utilization Management jobs? Cities with the most Remote Utilization Management job openings:
What are the most commonly searched types of Utilization Management jobs? The most popular types of Utilization Management jobs are:
What states have the most Remote Utilization Management jobs? States with the most job openings for Remote Utilization Management jobs include:
What job categories do people searching Remote Utilization Management jobs look for? The top searched job categories for Remote Utilization Management jobs are:
Remote Utilization Management jobs near you
Infographic showing various Remote Utilization Management job openings in the United States as of July 2026, with employment types broken down into 84% Full Time, 13% Part Time, 1% Temporary, and 2% Contract. Highlights an 93% Physical, 2% Hybrid, and 5% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

Supervisor, Utilization Management (RN)

Centene

Kansas City, MO • On-site, Remote

$75K - $135K/yr

Full-time

Medical, Retirement, PTO

Posted 14 days ago

Centene rating

8.4

Company rating: 8.4 out of 10

Based on 401 frontline employees who took The Breakroom Quiz

26th of 887 rated healthcare providers

Job description

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose: Supervises Prior Authorization, Concurrent Review, and/or Retrospective Review Clinical Review team to ensure appropriate care to members. Supervises day-to-day activities of utilization management team.
  • Monitors and tracks UM resources to ensure adherence to performance, compliance, quality, and efficiency standards
  • Collaborates with utilization management team to resolve complex care member issues
  • Maintains knowledge of regulations, accreditation standards, and industry best practices related to utilization management
  • Works with utilization management team and senior management to identify opportunities for process and quality improvements within utilization management
  • Educates and provides resources for utilization management team on key initiatives and to facilitate on-going communication between utilization management team, members, and providers
  • Monitors prior authorization, concurrent review, and/or retrospective clinical review nurses and ensures compliance with applicable guidelines, policies, and procedures
  • Works with the senior management to develop and implement UM policies, procedures, and guidelines that ensure appropriate and effective utilization of healthcare services
  • Evaluates utilization management team performance and provides feedback regarding performance, goals, and career milestones
  • Provides coaching and guidance to utilization management team to ensure adherence to quality and performance standards
  • Assists with onboarding, hiring, and training utilization management team members
  • Leads and champions change within scope of responsibility
  • Performs other duties as assigned
  • Complies with all policies and standards

Education/Experience: Requires Graduate of an Accredited School Nursing or Bachelor's degree and 4+ years of related experience.
Knowledge of utilization management principles preferred.
License/Certification:

  • RN - Registered Nurse - State Licensure and/or Compact State Licensure required
  • CA RN LICENSE REQUIRED
Pay Range: $75,300.00 - $135,400.00 per year

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.


Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

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