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Remote Utilization Review Nurse Practitioner Jobs

Astrana Health, Inc.

UM Review Nurse

Monterey Park, CA · On-site +1

$34 - $47/hr

... Utilization Review Nurse to assist our Health Services Department. In this position, you will ... This is a remote position for CA-licensed nurses. Candidates must live in California. We are ...

Astrana Health, Inc.

UM Review Nurse

$34 - $47/hr

... Utilization Review Nurse to assist our Health Services Department. In this position, you will ... This is a remote position for CA-licensed nurses. Candidates must live in California. We are ...

Astrana Health

UM Review Nurse

$34 - $47/hr

This is a remote position for CA-licensed nurses. Candidates must live in California. We are ... Utilization Management experience in a fast-paced setting. Our Values: * Put Patients First

iMPROve Health

Contingent UR/LTSS Registered Nurse

... Utilization Review / Long-Term Services & Supports (UR/LTSS) Review Nurse . This fully remote ... position supports Michigan Medicaid programs by conducting Nursing Facility Level of Care (LOC ...

Enterprise Engineering

Be Seen First

Concurrent Utilization Review (UR) Nurse

OR · Remote

$30 - $38/hr

Concurrent Utilization Review (UR) Nurse Remote Opportunity Contract to Hire Must be licenses in California The Concurrent Utilization Review (UR) Nurse is responsible for conducting real-time ...

Medica

Utilization Management RN III

$70K - $120K/yr

Medica's Utilization Review Nurses are responsible for reviewing and documenting prior ... Active, unrestricted RN license required This position is a Remote role. To be eligible for ...

Astrana Health

UM Review Nurse

Monterey Park, CA · Remote

$34 - $47/hr

Astrana Health is looking for a CA-licensed Utilization Review Nurse to assist our Health Services ... This is a remote position for CA-licensed nurses. Candidates must live in California. We are ...

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All JobsUtilization Review Nurse Practitioner JobsRemote Utilization Review Nurse Practitioner Jobs

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 Aug 9, 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 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.
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? States with the most job openings for Remote Utilization Review Nurse Practitioner jobs include:
What job categories do people searching Remote Utilization Review Nurse Practitioner jobs look for? The top searched job categories for Remote Utilization Review Nurse Practitioner jobs 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 August 2026, with employment types broken down into 1% As Needed, 83% Full Time, 13% Part Time, and 3% Contract. Highlights an 91% Physical, 2% Hybrid, and 7% Remote job distribution, with an average salary of $134,369 per year, or $64.6 per hour.

Utilization Review Specialist

Banyan Treatment Centers - Texas

Pompano Beach, FL • Remote

$45K - $65K/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 11 days ago

Job description

Utilization Review Specialist | Remote | Full-Time
$50,000 – $65,000 Annually | Weekdays (Weekend Availability as Needed)

Banyan Treatment Centers is seeking an experienced and detail-driven Utilization Review Specialist to join our corporate team. In this remote role, you'll manage a caseload of 50–75 patients, conducting admission and continuing-stay reviews, coordinating authorizations, and serving as a key liaison between Banyan's clinical operations and the managed care organizations that fund patient treatment. Your work directly protects patient access to care and keeps the business running.

This is a high-volume, relationship-driven role for someone who thrives on precision, knows how to navigate managed care, and understands the stakes on both sides of the authorization process.

About Banyan Treatment Centers

Banyan Treatment Centers is a leading national provider of intensive treatment for individuals facing substance use and mental health disorders. Backed by TPG, one of the nation’s largest private equity investors, Banyan is rapidly expanding access to high-quality, compassionate care.

Why Join Our Team?

  • Mission-driven work with real business impact — your authorizations directly determine whether patients stay in treatment. Few roles sit closer to the intersection of clinical care and organizational sustainability.
  • Nationally recognized organization — Joint Commission–accredited, with 18 locations and telehealth services nationwide, and the infrastructure to support your work at scale.
  • Remote flexibility — work from anywhere while collaborating with clinical, billing, and operations teams across the country.
  • Collaborative environment — partner closely with clinical, operational, and billing teams to resolve outstanding case issues, support discharge planning, and ensure timely reimbursement.
  • Room to grow — join a rapidly expanding organization where UR professionals have visibility across the enterprise and opportunities to advance.
  • Comprehensive benefits including medical, dental, and vision insurance; whole and term life insurance; short- and long-term disability; 401(k) with employer match; paid time off and holidays; wellness incentives; and employee assistance and referral programs.

Key Responsibilities

  • Manage a caseload of 50–75 patients, authorizing 15–25 cases daily and ensuring timely utilization reviews and appropriate level of care determinations
  • Conduct admission and continuing-stay reviews to assess medical necessity and ensure compliance with treatment standards
  • Verify insurance benefits, coordinate authorizations, and communicate effectively with external case managers and managed care organizations
  • Establish and maintain contracts with managed care companies and request rate increases when appropriate
  • Collaborate with clinical and billing departments to support discharge planning, documentation, and timely reimbursement
  • Identify and address over- and underutilization trends
  • Assist in resolving outstanding case issues with insurers

Qualifications

Required:

  • High school diploma or equivalent
  • Minimum one year of utilization review experience in a psychiatric or chemical dependency setting
  • Strong organizational, documentation, and communication skills
  • Ability to manage high caseloads with accuracy and efficiency
  • Comfortable working independently in a remote environment

Preferred:

  • Graduate degree in a health or behavioral health related field
  • Clinical licensure (LCSW, LMHC, LPC, RN, or equivalent) — valued but not required
  • Experience working with managed care organizations, insurance authorization, and level of care criteria
  • Familiarity with Joint Commission standards and behavioral health regulatory requirements

Apply Now

If you're experienced in utilization review, thrive in a fast-paced and high-volume environment, and want your work to matter beyond the spreadsheet, we'd like to meet you. Apply today to join the Banyan Treatment Centers corporate team.

Banyan Treatment Centers is an equal opportunity employer.

Apply