ZipRecruiter

Log In

2

Remote Utilization Review Nurse Jobs in Springville, UT

firsthand Health

Remote Triage Nurse

Provo, UT · On-site +1

$80K/yr

... are utilization. Together with our health plan partners, we are changing the way our society ... Such requests will be subject to review and approval by the Company, and exemptions will be granted ...

firsthand Health

Remote Triage Nurse

Provo, UT · Remote

The Triage Nurse is a remote Registered Nurse who provides telephone and electronic triage support to firsthand individuals and staff, while also supporting outpatient care coordination. This is ...

Vital Care

Supervising Physician - Telehealth

Lehi, UT · Remote

... nurse practitioners and physician assistants. Lead providers perform daily consultation reviews and ... This is an ideal opportunity for physicians seeking flexible, remote clinical collaboration work ...

micro1 AI

Clinical Pharmacy Technicians

Provo, UT · Remote

$70 - $80/hr

Remote micro1 is engaging Pharmacovigilance Experts to contribute their advanced drug safety ... Author and review evaluation tasks based on DSURs, PSURs/PBRERs, and associated safety data and ...

micro1 AI

Pharmacovigilance Expert

Provo, UT · Remote

$70 - $80/hr

Remote micro1 is engaging Pharmacovigilance Experts to contribute their advanced drug safety ... Author and review evaluation tasks based on DSURs, PSURs/PBRERs, and associated safety data and ...

Scribe-X

Remote Medical Scribe

Provo, UT · Remote

$14 - $17/hr

Anyone looking to begin a career in medicine (MD, DO, PA, NP, or RN) should consider becoming a ... Review completed charts with the provider between patients or at the completion of shift * Update ...

IQVIA

Clinical Trial Psych Rater

American Fork, UT · Remote

$62K - $156K/yr

Remote/Virtual Hours: Estimated 10-16 hours per month Role: Clinical Specialist About IQVIA IQVIA ... This position involves reviewing scales administered by raters to confirm standardized assessment ...

Canals

Customer Success Manager

Lehi, UT · Remote

Facilitate regular business reviews to demonstrate ROI and align on future goals. * Contribute to ... Demonstrated success driving product adoption, utilization and training end users. * Proven ...

All JobsUtilization Review Nurse JobsRemote Utilization Review Nurse JobsRemote Utilization Review Nurse Jobs in Springville, UT

Remote Utilization Review Nurse information

See Springville, UT salary details

$19

$39

$64

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

As of Aug 26, 2026, the average hourly pay for remote utilization review nurse in Springville, UT is $39.32, according to ZipRecruiter salary data. Most workers in this role earn between $31.06 and $45.14 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.

More about Remote Utilization Review Nurse jobs

What cities near Springville, UT are hiring for Remote Utilization Review Nurse jobs?

Cities near Springville, UT with the most Remote Utilization Review Nurse job openings:

Remote Utilization Review Nurse jobs near you
Infographic showing various Remote Utilization Review Nurse job openings in Springville, UT as of August 2026, with employment types broken down into 1% Internship, 1% As Needed, 78% Full Time, 17% Part Time, 1% Temporary, and 2% Contract. Highlights an 87% Physical, 2% Hybrid, and 11% Remote job distribution, with an average salary of $81,793 per year, or $39.3 per hour.

Behavioral Health Utilization Management Specialist

Draper, UT • On-site, Remote

Row Partners
See more jobs at Row Partnersexternal

$60K - $70K/yr

Full-time

Medical, Dental, Vision, PTO

Re-posted 12 days ago

Job description

Behavioral Health Utilization Management Specialist

Location: Utah (Hybrid & Remote Options Available)

Job Type: Full-time

Department: Behavioral Health / Utilization Management

Who We Are

At Row Partners, we’re more than a healthcare support organization — we’re a passionate team dedicated to empowering behavioral health facilities and their patients. We believe that compassionate, accessible, and high-quality care starts with the right people on our team.

Our Behavioral Health division is growing, and we’re looking for a Behavioral Health Utilization Management Specialist who shares our commitment to improving access, ensuring appropriate care, and supporting patient success stories every day.

If you’re driven by purpose, thrive in a collaborative environment, and want your work to make a real difference, this role is for you.

The Role

As a Behavioral Health Utilization Management Specialist, you will be the bridge between clinical care and insurance coverage — ensuring patients receive the right services, at the right time, for the right reasons. Your expertise will help providers, patients, and payers work together toward the shared goal of better behavioral health outcomes.

What You’ll Do

  • Champion patient care by reviewing medical records and clinical documentation to determine medical necessity and appropriateness of behavioral health services.
  • Collaborate and connect with clinicians, medical staff, and insurance providers to make sure patients get timely access to the services they need.
  • Conduct clinical reviews for inpatient, outpatient, and residential behavioral health services.
  • Ensure quality of care by reviewing treatment plans, discharge plans, and progress toward goals.
  • Support evidence-based treatment by applying clinical criteria and guidelines to approve and recommend necessary care.
  • Stay ahead of industry standards, insurance requirements, and treatment protocols.
  • Advocate for patients by facilitating communication and resolving barriers between providers, patients, and payers.
  • Document with precision for utilization reviews, audits, and compliance needs.

What You Bring

Proven Success

  • A history of professional growth, creative problem-solving, and a commitment to excellence.
  • Integrity, accountability, and a collaborative spirit that uplifts your team and patients alike.

Preferred Experience

  • 2+ years in utilization management, case management, or behavioral health services
  • Familiarity with mental health and substance use disorder diagnoses.
  • Understanding of insurance coding, billing, and behavioral health authorization procedures.

Preferred Skills

  • Strong knowledge of Behavioral Health diagnosis, Treatments, and evidence-based practices.
  • Comfort with utilization management tools (ASAM, MCG, InterQual).
  • Excellent communication and relationship-building skills.
  • Ability to multitask in a fast-paced environment.
  • EHR system proficiency.

(If you don’t have all the experience listed, but have the passion and potential to succeed, we’re willing to train the right candidate.)

Work Location

  • Based in Sandy, Utah — remote work available for those living more than 50 miles from the office.

Why You’ll Love Working With Us

  • Competitive salary & comprehensive benefits (health, dental, vision).
  • Paid time off, sick leave, and paid holidays.
  • Opportunities for growth, training, and continuing education.
  • Supportive, team-first culture where your contributions matter.
  • The chance to impact lives and improve care outcomes every single day.

If you’re ready to use your skills to make a lasting difference in behavioral health care, we’d love to hear from you. Apply today and join a team thats shaping the future of patient care.