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Remote Utilization Review Nurse Practitioner Jobs in Rochester, MI

Belle, LLC

Nurse Practitioner: Remote Urgent Care

Detroit, MI · Remote

$109K - $151K/yr

... (NP) to provide remote telehealth support for Medicare beneficiaries enrolled in our Chronic Care ... Evaluate symptoms, review medical histories, and determine appropriate interventions. * Determine ...

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All JobsUtilization Review Nurse Practitioner JobsRemote Utilization Review Nurse Practitioner JobsRemote Utilization Review Nurse Practitioner Jobs in Rochester, MI

Remote Utilization Review Nurse Practitioner information

See Rochester, MI salary details

$65.4K

$123.7K

$193.8K

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

As of Aug 11, 2026, the average yearly pay for remote utilization review nurse practitioner in Rochester, MI is $123,680.00, according to ZipRecruiter salary data. Most workers in this role earn between $102,200.00 and $140,400.00 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 cities near Rochester, MI are hiring for Remote Utilization Review Nurse Practitioner jobs? Cities near Rochester, MI with the most Remote Utilization Review Nurse Practitioner job openings:
Remote Utilization Review Nurse Practitioner jobs near you

Coordinator-Utilization Review(Clinical Coding)/Full Time/Remote

Corporate Services

Troy, MI • Remote

Full-time

Re-posted 15 days ago

Job description

In this position you will be reviewing patient charts to determine if pre-elective surgical cases should be boarded as inpatient instead of outpatient.  You will also review the CPTs that were boarded for meeting inpatient on the CMS inpatient list and the InterQual inpatient list based on payer criteria used.

Hours are Monday - Friday from 830am until 5pm with no weekends

EDUCATION AND EXPERIENCE: 

  • RHIT, RHIA, or related coding certification required. 
  • Minimum 3-5 years of clinical experience preferred. 
  • Previous utilization management or case management experience preferred. 

CERTIFICATIONS/LICENSURES REQUIRED:

  •  RHIT, RHIA, or related coding certification required.
Additional Information
  • Organization: Corporate Services
  • Department: Central Utilization Mgt
  • Shift: Day Job
  • Union Code: Not Applicable

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