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Remote Utilization Review Manager Jobs (NOW HIRING)

Emory Healthcare

Utilization Review Specialist

Atlanta, GA · Remote

$47.40 - $54.95/hr

... Management Plan and the UR Department's processes. 4. Ensures that all InterQual reviews are ... Work Type: This position is a remote position outside traditional office, often from home or ...

Dane Street, LLC

Utilization Review Physician

Ability to manage short-TAT and urgent cases efficiently * Clear, audit-ready documentation ... Remote work from home * Full-time, Monday-Friday * Availability for occasional weekends and holiday ...

Bracane Co

Utilization Review Nurse

Plano, TX · Remote

This position is responsible for performing initial, concurrent review activities; discharge care ... Utilization management experience LOCATION: REMOTE in Texas ( Richardson area ? Dallas/Collin ...

Oscar Health

Utilization Review Nurse

Tempe, AZ · Remote

$35 - $45.94/hr

This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois ... Previous experience conducting concurrent or inpatient reviews for a managed care plan This is an ...

Mindful Health

Utilization Review Specialist

$25 - $30/hr

Utilization Review Specialist Mindful Health is a fast-growing company with the goal of providing ... Proven time management skills with the ability to meet deadlines consistently * Proficiency in ...

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Remote Utilization Review Manager information

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$39K

$91K

$167.5K

How much do remote utilization review manager jobs pay per year?

As of Jun 21, 2026, the average yearly pay for remote utilization review manager in the United States is $91,011.00, according to ZipRecruiter salary data. Most workers in this role earn between $59,500.00 and $109,500.00 per year, depending on experience, location, and employer.

What are some common challenges faced by a Remote Utilization Review Manager, and how can they be addressed?

A Remote Utilization Review Manager often encounters challenges such as maintaining effective communication with clinical teams, ensuring timely and accurate reviews, and staying updated with changing regulations and payer requirements. To address these, it's important to leverage secure collaborative platforms, establish clear workflows, and participate in ongoing training. Building strong relationships with team members and regularly reviewing protocols also help in overcoming remote work hurdles and ensuring compliance and efficiency.

What is the difference between Remote Utilization Review Manager vs Remote Utilization Review Nurse?

AspectRemote Utilization Review ManagerRemote Utilization Review Nurse
CredentialsTypically requires a nursing license, certifications like URAC or AAPC, and management experienceLicensed Registered Nurse (RN) with utilization review certification often preferred
Work EnvironmentOversees review teams, manages processes, and ensures compliance remotelyPerforms case reviews, assesses medical necessity, and documents findings remotely
Employer & Industry UsageHealth insurance companies, third-party administrators, healthcare organizations

The Remote Utilization Review Manager focuses on overseeing review teams and managing processes, while the Remote Utilization Review Nurse conducts case assessments and medical necessity reviews. Both roles require nursing credentials and are integral to healthcare utilization management, but differ in responsibilities and leadership levels.

What is a Remote Utilization Review Manager?

A Remote Utilization Review Manager is a healthcare professional responsible for overseeing the review of medical services and determining the necessity, appropriateness, and efficiency of those services from a remote location. They ensure that healthcare providers comply with guidelines and that patients receive appropriate care without unnecessary procedures. These managers work with clinical teams, insurance companies, and regulatory agencies to optimize patient outcomes and manage healthcare costs. Working remotely allows them to perform these duties using digital health records and telecommunication tools.

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

To thrive as a Remote Utilization Review Manager, you need expertise in healthcare management, case review, and regulatory compliance, typically supported by a nursing degree (RN or BSN) and relevant certifications such as CCM or URAC. Familiarity with utilization management software, electronic health records (EHRs), and payer systems is essential. Strong analytical thinking, attention to detail, and excellent communication skills help navigate complex cases and collaborate with clinical teams and insurers. These skills ensure effective resource utilization, regulatory adherence, and optimal patient outcomes in a remote healthcare environment.
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Remote Utilization Review Manager jobs near you
Travel Utilization Review RN - $2,130 per week

Travel Utilization Review RN - $2,130 per week

Vivian Health

Apple Valley, CA • Remote

$2.1K/wk

Other

Medical, Dental, Life, Retirement

Posted 2 days ago

Job description

American Consultants is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Apple Valley, California.

Job Description & Requirements
  • Specialty: Utilization Review
  • Discipline: RN
  • Start Date: 07/13/2026
  • Duration: 13 weeks
  • 40 hours per week
  • Shift: 8 hours, days
  • Employment Type: Travel
Job Opportunity – Registered Nurse, Utilization Review – Apple Valley, CA 92307

Start Date: July 13, 2026

Location: Apple Valley, California

Schedule: Day shift, 5x8-hour shifts (08:00 - 16:30). Minimum of 4 weekend shifts required within a 6-week period. Patient ratio 1:35-45. Remote utilization review position.

Highlights:
  • Remote utilization review opportunity with an acute care facility
  • 13-week assignment with competitive compensation and travel support
  • Work with Epic charting system and InterQual criteria
  • 40 hours of paid orientation provided
  • Business attire dress code for a professional environment
  • Serve diverse patient populations including neonates, adolescents, adults, and geriatrics
Requirements:
  • Active California RN license (pending licenses accepted if active by start date)
  • Minimum 3 years of acute medical Care Manager/Utilization Management experience in a hospital setting (health plan or medical group experience does not qualify)
  • Recent proficiency with Epic charting system within the last 6-12 months (required)
  • Experience with InterQual criteria (required)
  • Seasoned travel nursing experience required
  • Experience managing patient ratios of 35-45
  • Knowledge of Medicare regulations including CC44s, ABNs, HINNs, and MCSNs
  • Experience with HMOs, IPAs, and California Medi-Cal programs preferred
  • Proficiency in concurrent review, pre-certification, prior authorization, and appeals/denials processes
Why Join Us?

This remote utilization review position offers an excellent opportunity for experienced case management nurses seeking a structured day shift schedule in a professional acute care setting. You'll receive comprehensive orientation, competitive travel compensation, and the flexibility to work from home while supporting multiple facilities. The role provides up to 7 days of requested time off and requires commitment to 3 of 5 major holidays, ensuring work-life balance within a supportive travel nursing framework.

American Consultants Job ID #18533836. Pay package is based on 8 hour shifts and 40.0 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: RN:Case Manager,07:00:00-15:00:00

About American Consultants

Since 1989, American Consultants has been the leader in national healthcare staffing and consulting services. We have successfully placed thousands of healthcare professionals in executive, clinical, laboratory, financial, consulting, and HIT roles across the country. We specialize in Healthcare Search and Staffing, IT Staffing and Solutions, and Executive Search and Interim Services. American Consultants takes a consultative approach to help our clients solve their talent acquisition and HIT challenges. We are truly the healthcare people.

Why Vivian Health?

Be sure to apply via Vivian Health to increase your chances of landing your perfect job. Just complete your Vivian Health profileonce, and get access to thousands of opportunities across the country. Then keep up to date with your job application process and conversations with our easy to use app.

Benefits
  • Medical benefits
  • Dental benefits
  • Life insurance
  • Weekly pay
  • License and certification reimbursement
  • Holiday Pay
  • 401k retirement plan
  • Referral bonus

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