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Remote Utilization Review Nurse Practitioner Jobs

Dane Street

PRN Utilization Review Nurse Reviewer

The Utilization Management Nurse Reviewer plays a crucial role in healthcare systems by ensuring ... Apple equipment and a media stipend are provided for remote workspace. ABOUT DANE STREET: A fast ...

Personify Health

Utilization Review Nurse - RN

$35 - $43/hr

Current, unrestricted RN license in the United States or a U.S. territory (compact license accepted ... Utilization review/utilization management experience preferred Technical Skills: * Proficiency with ...

Personify Health

Utilization Review Nurse - RN

$35 - $43/hr

Current, unrestricted RN license in the United States or a U.S. territory (compact license accepted ... Utilization review/utilization management experience preferred Technical Skills: * Proficiency with ...

Personify Health

Utilization Review Nurse - RN

$35 - $43/hr

Current, unrestricted RN license in the United States or a U.S. territory (compact license accepted ... Utilization review/utilization management experience preferred Technical Skills: * Proficiency with ...

Gateway Rehab

Utilization Review Liaison - REMOTE

Registered Nurse (RN) with current Pennsylvania licensure. * Previous experience with utilization ... Remote. * Prolonged periods of sitting and working on a computer. * Minimal physical demands.

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Remote Utilization Review Nurse Practitioner information

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$71K

$134.4K

$210.5K

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

As of Sep 12, 2026, the average yearly pay for remote utilization review nurse practitioner in the United States is $134,369.00, according to ZipRecruiter salary data. Most workers in this role earn between $111,000.00 and $152,500.00 per year, depending on experience, location, and employer.

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 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.

More about Remote Utilization Review Nurse Practitioner jobs

What cities are hiring for Remote Utilization Review Nurse Practitioner jobs?

Cities with the most Remote Utilization Review Nurse Practitioner job openings:

What states have the most Remote Utilization Review Nurse Practitioner jobs?

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What are popular job titles related to Remote Utilization Review Nurse Practitioner jobs?

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

Remote Utilization Review Nurse Practitioner jobs near you
Infographic showing various Remote Utilization Review Nurse Practitioner job openings in the United States as of September 2026, with employment types broken down into 50% Full Time, and 50% Contract. Highlights an 100% Remote job distribution, with an average salary of $134,369 per year, or $64.6 per hour.

Utilization Review Nurse - Remote - Contract

Chicago, IL • Remote

HireOps Staffing, LLC
51 - 200 employees
Learn more about HireOps Staffing, LLCexternal

$41/hr

Full-time

Re-posted 7 days ago

Job description

Remote position, however, candidates must reside in the State of TX or State of IL

This position is a contract for about 9 months.

Pay:  $41/hour

RN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and appropriateness of the treatment plan. This Position Is Responsible For Performing Accurate And Timely Medical Review Of Claims Suspended For Medical Necessity, Contract Interpretation, Pricing; And To Initiate And/Or Respond To Correspondence From Providers Or Members Concerning Medical Determinations.
Knowledge of accreditation, i.e. URAC, NCQA standards and health insurance legislation. Awareness of claims processes and claims processing systems. PC proficiency to include Microsoft Word and Excel and health insurance databases. Verbal and written communication skills with ability to communicate to physicians, members and providers and compose and explain document findings. Organizational skills and prioritization skills. :Registered Nurse (RN) with unrestricted license in state. 3 years clinical experience.

Needs to be able to navigate MCG and Medical policies with the reviews.