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Remote Utilization Review Nurse Jobs in Foley, AL

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Remote Utilization Review Nurse information

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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 Foley, AL is $36.19, according to ZipRecruiter salary data. Most workers in this role earn between $28.61 and $41.54 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.

What are popular job titles related to Remote Utilization Review Nurse jobs in Foley, AL?

For Remote Utilization Review Nurse jobs in Foley, AL, the most frequently searched job titles are:

What job categories do people searching Remote Utilization Review Nurse jobs in Foley, AL look for?

The top searched job categories for Remote Utilization Review Nurse jobs in Foley, AL are:

What cities near Foley, AL are hiring for Remote Utilization Review Nurse jobs?

Cities near Foley, AL with the most Remote Utilization Review Nurse job openings:

Infographic showing various Remote Utilization Review Nurse job openings in Foley, AL as of August 2026, with employment types broken down into 1% As Needed, 74% Full Time, 21% Part Time, 3% Contract, and 1% Nights. Highlights an 88% Physical, 3% Hybrid, and 9% Remote job distribution, with an average salary of $75,265 per year, or $36.2 per hour.

Registered Staff Nurse (RN) - Med/Surg/Neurology- 11th Floor - Providence Hospital

USA Health

Mobile, AL • Remote

Part-time

Re-posted 9 days ago


USA Health rating

6.2

Company rating: 6.2 out of 10

Based on 30 frontline employees who took The Breakroom Quiz

698th of 893 rated healthcare providers


Job description

Overview

USA Health is Transforming Medicine along the Gulf Coast to care for the unique needs of our community.
USA Health is changing how medical care, education and research impact the health of people who live in Mobile and the surrounding area. Our team of doctors, advanced care providers, nurses, therapists and researchers provide the region's most advanced medicine at multiple facilities, campuses, clinics and classrooms. We offer patients convenient access to innovative treatments and advancements that improve the health and overall wellbeing of our community.


Responsibilities

Practices family centered nursing according to policies and Nurse Practice Act; serves as Charge Nurse when assigned; supervises, plans, evaluates, and coordinates patient care provided by other licensed and non-licensed staff; demonstrates CPR according to American Heart Association standards; abides by and enforces all compliance requirements and policies and performs these responsibilities in an ethical manner consistent with the organization’s values; adheres to hospital policies including confidentiality; serves as preceptor for new employees and nursing students; utilizes the nursing process to: assess patients; plan individual care; identify expected outcomes; implement and evaluate nursing interventions for patients and families; performs therapeutic procedures and assists with diagnostic procedures required for the care of the patient; administers medications including controlled substances by all routes; administers blood and blood products; responds appropriately to emergency patient situations; performs basic life support and management of arrest situations; starts IVs; performs activities of daily living; when performing skilled procedures the RN can state the purpose, rationale, precautions and observations related to that procedure; utilizes proper body mechanics when: moving, positioning and transferring patients without assistance or with assistance when needed for patient safety; moves equipment that is necessary to perform essential functions; provides patient education by planning, coordinating and delegating, as appropriate, the educational needs of each patient; utilizes a personal computer or terminal to access the Clinical Information System; communicates and uses appropriate customer relation skills with physicians, patients, families and healthcare team in person and via telephone; responds to overhead pages; completes pain assessment tool, discharge forms, and MAR; supervises, evaluates and finalizes the patient care record; completes all mandatory unit, educational and hospital requirements; utilizes cost effective practices in performing all aspects of job; adheres to current Infection Control and Safety Standards; demonstrates the ability to provide competent patient care to the applicable patient population(s) based on the area of clinical care to include stroke patients when necessary; utilizes and cares for all types of CVL’s including PICC/Midlines; maintains current knowledge base of all unit policies and procedures, equipment location and supplies; identifies, organizes and directs activities to utilize resources, personnel, and materials to meet the needs of the patient and nursing staff; communicates with the Nurse Manager and Nurse Administrator, on an ongoing basis, regarding: changes in the unit status, patient related issues, Quality Management issues, and other events as they evolve; acts as first line in problem resolution with other departments and any complaints; assists with shift duty assignments; verifies that emergency equipment is functional; ensures that narcotic counts is complete and accurate; participates in Performance Improvement activities as assigned; accesses and accurately maintains electronic and paper medical records; regular and prompt attendance; ability to work schedule as defined and overtime as required; related duties as required.

Employees must be in a regular position, working 20 hours or more per week (.50 FTE or greater) to qualify for benefits.


Additional Information

Employees must be in a regular position, working 20 hours or more per week (.50 FTE or greater) to qualify for benefits.


Qualifications

Current Alabama RN license or current Multi-State RN License in accordance with Nurse Licensure Compact (NLC) for Alabama.  Note:  USA Health abides by the NLC requirements and guidelines for the state of Alabama.


Equal Employment Opportunity/Affirmative Action Employer

The University of South Alabama is an Equal Opportunity Employer and does not discriminate on the basis of race, color, national origin, sex, pregnancy, sexual orientation, gender identity, gender expression, religion, age, genetic information, disability, protected veteran status or any other applicable legally protected basis. 

EO Employer – minorities/females/veterans/disabilities/sexual orientation/gender identity.

Qualifications:

Current Alabama RN license or current Multi-State RN License in accordance with Nurse Licensure Compact (NLC) for Alabama.  Note:  USA Health abides by the NLC requirements and guidelines for the state of Alabama.

Education:UNAVAILABLEEmployment Type: PART_TIME

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