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Remote Utilization Review Nurse Practitioner Jobs in Boca Raton, FL

Guardian Recovery

UR COORDINATOR

Delray Beach, FL · On-site +1

$60K - $70K/yr

The Utilization Review Coordinator (UR Coordinator) is responsible to perform the process of ... Master's degree from an accredited college or university in social work, mental health, nursing, or ...

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All JobsUtilization Review Nurse Practitioner JobsRemote Utilization Review Nurse Practitioner JobsRemote Utilization Review Nurse Practitioner Jobs in Boca Raton, FL

Remote Utilization Review Nurse Practitioner information

See Boca Raton, FL salary details

$67.4K

$127.5K

$199.8K

How much do remote utilization review nurse practitioner jobs pay per year?

As of Aug 17, 2026, the average yearly pay for remote utilization review nurse practitioner in Boca Raton, FL is $127,512.00, according to ZipRecruiter salary data. Most workers in this role earn between $105,300.00 and $144,700.00 per year, depending on experience, location, and employer.

What is the difference between Remote Utilization Review Nurse Practitioner vs Telehealth Nurse Practitioner?

AspectRemote Utilization Review Nurse PractitionerTelehealth Nurse Practitioner
CertificationsNP license, possibly certification in utilization reviewNP license, general telehealth certifications
Work EnvironmentReviewing medical records, insurance data remotelyProviding patient care via telehealth platforms
Employer & IndustryInsurance companies, healthcare organizationsHospitals, clinics, telehealth companies

The main difference is that Remote Utilization Review Nurse Practitioners focus on reviewing medical necessity and insurance claims remotely, while Telehealth Nurse Practitioners provide direct patient care via telehealth platforms. Both roles require NP licensure, but their daily tasks and work environments differ significantly.

What is a remote utilization review nurse practitioner?

A Remote Utilization Review Nurse Practitioner is a licensed advanced practice nurse who evaluates the necessity, efficiency, and appropriateness of healthcare services, treatments, and hospital admissions, typically from a remote or home-based setting. They review patient medical records to ensure care meets established guidelines and insurance requirements, helping to control costs and ensure quality care. Their role often involves collaborating with physicians, insurance companies, and healthcare facilities to determine coverage and recommend alternative treatments when necessary. Working remotely, they rely heavily on electronic health records and telecommunication tools to perform their duties.

How does a remote utilization review nurse practitioner typically collaborate with healthcare teams while working offsite?

Remote Utilization Review Nurse Practitioners frequently collaborate with interdisciplinary teams through virtual meetings, secure messaging platforms, and electronic health record (EHR) systems. They work closely with physicians, case managers, and insurance representatives to review patient care plans, ensure medical necessity, and support appropriate resource utilization. Despite working remotely, maintaining clear communication and timely documentation is essential for seamless coordination and decision-making. Many organizations provide robust digital tools and regular team check-ins to facilitate collaboration and support remote staff.

What are the key skills and qualifications needed to thrive as a remote utilization review nurse practitioner, and why are they important?

To thrive as a Remote Utilization Review Nurse Practitioner, you need an advanced nursing degree (NP), active state licensure, and strong knowledge of clinical guidelines and insurance criteria. Familiarity with utilization management software, electronic health records (EHRs), and relevant certifications such as CCM (Certified Case Manager) are often required. Critical thinking, strong communication, and a detail-oriented approach set top performers apart in this remote role. These skills ensure accurate, compliant, and efficient review of patient care while supporting healthcare cost management and patient advocacy.

What are popular job titles related to Remote Utilization Review Nurse Practitioner jobs in Boca Raton, FL?

For Remote Utilization Review Nurse Practitioner jobs in Boca Raton, FL, the most frequently searched job titles are:

What job categories do people searching Remote Utilization Review Nurse Practitioner jobs in Boca Raton, FL look for?

The top searched job categories for Remote Utilization Review Nurse Practitioner jobs in Boca Raton, FL are:

What cities near Boca Raton, FL are hiring for Remote Utilization Review Nurse Practitioner jobs?

Cities near Boca Raton, FL with the most Remote Utilization Review Nurse Practitioner job openings:

Remote Utilization Review Nurse Practitioner jobs near you

Utilization Review RN (Remote)

HealthPlus Staffing

Fort Lauderdale, FL • Remote

$80K - $100K/yr

Full-time

Re-posted 4 days ago

Job description

Quick Job Details:

Setting: Fully Remote – Utilization Review
Schedule: Full-Time, Monday–Friday
Hours: Standard business hours
Patient Volume: N/A
Job Requirements:

  • Active RN license with Multi-State/Compact license required
  • Minimum 2 years of Utilization Review experience
  • Minimum 3 years of clinical nursing experience (acute care/hospital preferred)
  • Strong understanding of medical necessity, utilization management, healthcare reimbursement, and clinical documentation improvement
  • Excellent communication, analytical, and critical thinking skills
  • Ability to work independently in a remote environment

Responsibilities:

  • Conduct admission, continued stay, and observation reviews
  • Apply medical necessity criteria to determine appropriate level of care
  • Review cases for Physician Advisor escalation when appropriate
  • Collaborate with physicians, case managers, and insurance payers
  • Support denial prevention, documentation improvement, and revenue cycle initiatives
  • Ensure compliance with payer guidelines and regulatory requirements
  • Analyze clinical and financial data to identify quality improvement opportunities

Compensation: Competitive; based on experience

Benefits: Comprehensive benefits package

About Us:

HealthPlus Staffing is a national leader in the healthcare staffing industry. We partner with top healthcare organizations nationwide to connect highly qualified professionals with outstanding career opportunities.

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 information as possible to help you make a well-informed decision.

If you're interested in this opportunity, please submit an application or call 561-291-7787 to speak with one of our experienced consultants. We look forward to helping you find your next opportunity!

The HealthPlus Team