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Remote Utilization Review Nurse Jobs in Colorado

BreatheSuite Inc

Remote Nurse Practitioner

Denver, CO · On-site +1

Remote Nurse Practitioner Classification: 1099 Independent Contractor Work Structure: Fully Remote ... review * Develop and manage individualized care plans for patients with chronic lung conditions

BreatheSuite Inc

Remote Nurse Practitioner

Denver, CO · Remote

Job Title:Remote Nurse Practitioner Classification: 1099 Independent Contractor Work Structure ... review * Develop and manage individualized care plans for patients with chronic lung conditions

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Remote Utilization Review Nurse information

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$22

$44

$72

How much do remote utilization review nurse jobs pay per hour?

As of Aug 23, 2026, the average hourly pay for remote utilization review nurse in Colorado is $44.46, according to ZipRecruiter salary data. Most workers in this role earn between $35.14 and $51.06 per hour, depending on experience, location, and employer.

What is a remote utilization review nurse?

A Remote Utilization Review Nurse is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services and treatments, typically from a remote location such as their home. They review patient medical records, apply clinical guidelines, and collaborate with providers and insurance companies to ensure patients receive appropriate care while managing healthcare costs. This role often involves making coverage determinations, conducting pre-authorizations, and participating in appeals processes. Remote Utilization Review Nurses play a critical role in improving patient outcomes and resource allocation within the healthcare system.

What does a remote utilization review nurse do?

As a remote utilization nurse, your duties are to work from home or a remote location to review patient medical records and prepare a range of paperwork for different types of actions a hospital or health care provider can take. Your responsibilities are to determine patient coverage, carry out denial of service authorizations, and negotiate different treatment options and hospital stay length for patients. You rely on your knowledge of treatment options and diseases to determine the level of appropriate care for a patient. Because you telecommute, you also need good technical skills.

What are the key skills and qualifications needed to thrive as a remote utilization review nurse?

To thrive as a Remote Utilization Review Nurse, you need a current RN license, clinical experience, and a solid understanding of medical necessity criteria and healthcare regulations. Familiarity with utilization management software, EHR systems, and certifications like CCM or URAC are highly valued. Strong analytical thinking, attention to detail, and effective communication skills enable success in evaluating clinical documentation and collaborating with providers remotely. These skills and qualifications are essential to ensure efficient, compliant care decisions that optimize patient outcomes and resource use.

How does a remote utilization review nurse collaborate with physicians and other healthcare team members while working remotely?

As a Remote Utilization Review Nurse, collaboration with physicians, case managers, and other healthcare professionals is primarily conducted through secure digital platforms such as email, video conferencing, and electronic health record systems. Effective communication is essential to discuss patient care plans, clarify medical necessity, and ensure compliance with utilization policies. Nurses in this role often participate in virtual meetings or case conferences to present findings and recommendations. Building strong working relationships remotely requires proactive communication, responsiveness, and familiarity with digital collaboration tools.

What is the difference between Remote Utilization Review Nurse vs Remote Case Manager?

AspectRemote Utilization Review NurseRemote Case Manager
CertificationsRN license, possibly CCM or UR certificationsRN license, CCM or case management certifications
Work EnvironmentHealthcare facilities, insurance companies, telehealthInsurance companies, healthcare organizations, telehealth
Job FocusReview medical necessity, approve or deny servicesCoordinate patient care, arrange services, discharge planning

Remote Utilization Review Nurses primarily evaluate medical necessity for services, while Remote Case Managers coordinate patient care and discharge planning. Both roles require nursing credentials and work in healthcare or insurance settings, but their core responsibilities differ. Understanding these distinctions helps job seekers find the best fit for their skills and career goals.

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Remote Utilization Review Nurse jobs near you
Infographic showing various Remote Utilization Review Nurse job openings in Colorado as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 13% Part Time, 1% Temporary, 2% Contract, and 1% Nights. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $92,477 per year, or $44.5 per hour.

Remote Utilization Manager - Inpatient

AllHealth Network

Littleton, CO • Remote

$75K - $83K/yr

Full-time

Posted 17 days ago

Job description

Join Our Team as a Utilization Review Manager (RN or Social Worker)

Are you a compassionate nurse or social worker looking to make a real difference in behavioral health? AllHealth Network is seeking a dedicated Utilization Review Specialist to help ensure clients receive the care they need while collaborating with a team that values your expertise and commitment.

Why AllHealth Network?

  • Work in a supportive, interdisciplinary environment that values your professional judgment
  • Enjoy opportunities for ongoing learning, growth, and advancement
  • Make a tangible impact on client outcomes and community well-being
  • Be part of a mission-driven organization dedicated to high-quality, client-centered care

What You'll Do:

  • Advocate for clients by communicating clinical information to secure timely and appropriate care authorizations
  • Lead utilization reviews for clients in our Acute Treatment and Crisis Stabilization Units
  • Collaborate with nurses, social workers, case managers, and other healthcare professionals
  • Ensure quality care by coordinating with payers, treatment teams, and billing staff
  • Maintain accurate records and use your problem-solving skills to navigate challenging cases

What We’re Looking For:

  • Registered Nurse (BSN/RN) or Master’s in a human services field
  • Clinical license (LPC, LCSW) required 
  • Minimum 2 years’ experience in behavioral health utilization management, care coordination, or case management
  • Strong communication, organization, and advocacy skills
  • Experience with insurance processes, electronic records, and multidisciplinary teamwork

Ready to take your career to the next level with a team that cares as much as you do? Apply today and help us transform lives—one client at a time.

$75,000 - $83,000 annually 

AllHealth Network also provides a 10% compensation differential for individuals who are bilingual in English and Spanish (language proficiency testing required). 

The base salary range represents the low and high end of the AllHealth Network hiring range for this position. Actual salaries will vary and may be above or below the range based on various factors including but not limited to experience, education, training, merit, and the ability to embody the AllHealth Network mission and values.  The range listed is just one component of AllHealth Networks’ total compensation package for employees. Other rewards may include short-term and long-term incentives as well as a generous benefits package detailed below.

Apply