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Remote Utilization Review Nurse Practitioner Jobs

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 ...

CommonSpirit Health

Utilization Review RN

The Utilization Review RN is responsible for the review of medical records for appropriate ... This position is open to remote/out of state candidates residing in only these states: Alabama ...

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

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 ...

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 ...

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 ...

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 ...

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All JobsUtilization Review Nurse Practitioner JobsRemote Utilization Review Nurse Practitioner Jobs

Remote Utilization Review Nurse Practitioner information

See salary details

$71K

$134.4K

$210.5K

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

As of Aug 8, 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.

UM Review Nurse

Astrana Health, Inc.

Remote

$34 - $47/hr

Other

Re-posted 16 days ago

Job description

UM Review Nurse
Department: HS - UM
Employment Type: Full Time
Location: 600 City Parkway West 10th Floor, Orange, CA 92868
Reporting To: Brenda Fresnares
Compensation: $34.00 - $47.00 / hour
Description
Astrana Health is looking for a CA-licensed Utilization Review Nurse to assist our Health Services Department. In this position, you will utilize your clinical judgement to approve or deny outpatient medical services for patients based on Medical Necessity Criteria, respective to various Health Plans.
This is a remote position for CA-licensed nurses. Candidates must live in California.
We are seeking nurses with at least one year of outpatient Utilization Management experience in a fast-paced setting.
Our Values:
  • Put Patients First
  • Empower Entrepreneurial Provider and Care Teams
  • Operate with Integrity & Excellence
  • Be Innovative
  • Work As One Team
What You'll Do
  • Complete prior authorization/retrospective review of elective inpatient admissions, outpatient procedures, post-homecare services, and durable medical equipment
  • Refer cases to Medical Directors as needed/appropriate
  • Maintain knowledge of state and federal regulations and accreditation standards
  • Comply with internal policies and procedures
  • Perform any other job duties as requested
Qualifications
  • Active and unrestricted LVN license in CA.
  • At least 1 years of outpatient UM experience
  • Experience with Microsoft applications such as Word, Excel, and Outlook
You'll be Great for this Role If:
  • At least two (2) years of health plan, IPA or MSO experience
  • Strong interpersonal skills
  • Ability to collaborate with co-workers, senior leadership, and other management
  • Experience educating and training staff
Environmental Job Requirements and Working Conditions
  • This is a remote position. Our office is located at 1600 Corporate Center Drive in Monterey Park, CA. Candidates who live within a 30 mile radius of the office may be expected to work hybrid.
  • The schedule is M-F 8 A - 5 P.
  • The national target pay range for this role is $34.00 - $47.00 per hour. Actual compensation will be based on job level, geographic location (current or future), experience, and other job-related factors.

Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based on race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided based on qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation.
Additional Information:
The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.

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