ZipRecruiter

Log In

2

Remote Utilization Review Rn Jobs in Birmingham, AL

Varsity Tutors

NCLEX-RN Tutor

Birmingham, AL · Remote

$18 - $40/hr

Adapts instruction using UWorld, Kaplan, or ATI practice question banks, content review materials, and test-taking strategy workshops to support BSN and ADN graduates preparing for registered nurse ...

Oshi Health

Registered Dietitian

Birmingham, AL · Remote

$75K - $80K/yr

Collaborate with a multidisciplinary team of GI physicians, NP/PAs, and psychologists to ensure a ... Remote-first flexibility -- work from home anywhere within our accepted states * Growth:

Transform9

Senior Customer Success Manager

Birmingham, AL · On-site +1

Run quarterly business reviews with practice leadership using their own metrics: answer rates, hold ... Channel structured client feedback to product Location Remote (US) with approximately 25% travel to ...

Transform9

Senior Customer Success Manager

Birmingham, AL · On-site +1

Run quarterly business reviews with practice leadership using their own metrics: answer rates, hold ... Channel structured client feedback to product Location Remote (US) with approximately 25% travel to ...

Varsity Tutors

NCLEX-PN Tutor

Birmingham, AL · Remote

$18 - $40/hr

... RN scope questions, pharmacology calculations, and managing anxiety with the adaptive testing format. Adapts instruction using NCLEX-PN specific practice question banks, content review focused on ...

next page

Showing results 1-20

All JobsUtilization Review Rn JobsRemote Utilization Review Rn JobsRemote Utilization Review Rn Jobs in Birmingham, AL

Remote Utilization Review Rn information

See Birmingham, AL salary details

$20

$39

$64

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

As of Sep 7, 2026, the average hourly pay for remote utilization review rn in Birmingham, AL is $39.63, according to ZipRecruiter salary data. Most workers in this role earn between $31.30 and $45.53 per hour, depending on experience, location, and employer.

What is a remote utilization review RN?

A Remote Utilization Review RN is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services provided to patients, typically working from a remote location. They review medical records, apply clinical guidelines, and collaborate with healthcare providers to ensure patients receive the right care at the right time. Their work helps manage healthcare costs and improves patient outcomes by preventing unnecessary treatments or hospital stays. Remote Utilization Review RNs often work for insurance companies, hospitals, or healthcare organizations, and use secure digital platforms to conduct their reviews.

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

To excel as a Remote Utilization Review RN, you need a valid RN license, strong clinical judgment, and knowledge of utilization management principles. Familiarity with electronic medical records (EMR), utilization management software, and guidelines such as InterQual or MCG is typically required. Outstanding attention to detail, critical thinking, and effective communication skills help you collaborate with healthcare teams and advocate for appropriate patient care. These competencies are crucial for ensuring medical necessity, regulatory compliance, and optimal resource use in a remote setting.

What are some common challenges remote utilization review RNs face when working from home, and how can they be addressed?

Remote Utilization Review RNs often encounter challenges such as maintaining clear communication with interdisciplinary teams, managing time efficiently, and staying updated on changing payer guidelines. To address these challenges, it's important to establish consistent check-ins with team members via video or chat platforms, use digital tools to organize and prioritize caseloads, and participate in ongoing training sessions provided by employers. Adhering to a structured daily routine and leveraging available technology can help ensure productivity and high-quality reviews while working remotely.

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

AspectRemote Utilization Review RnRemote Case Manager Rn
CertificationsRN license, Utilization Review certification (e.g., URAC)RN license, Case Management certification (e.g., CCM)
Work EnvironmentReviewing medical records, insurance policies, telehealth platformsCoordinating patient care, discharge planning, telehealth
Employer & IndustryInsurance companies, healthcare organizationsHospitals, insurance providers, healthcare agencies

Remote Utilization Review Rns primarily focus on evaluating medical necessity for insurance coverage, while Remote Case Manager Rns coordinate patient care and discharge planning. Both roles require RN licensure and involve telehealth work, but they serve different functions within healthcare and insurance industries.

What are popular job titles related to Remote Utilization Review Rn jobs in Birmingham, AL?

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

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

The top searched job categories for Remote Utilization Review Rn jobs in Birmingham, AL are:

What cities near Birmingham, AL are hiring for Remote Utilization Review Rn jobs?

Cities near Birmingham, AL with the most Remote Utilization Review Rn job openings:

Remote Utilization Review Rn jobs near you
Infographic showing various Remote Utilization Review Rn job openings in Birmingham, AL as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 14% Part Time, 1% Temporary, and 3% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $82,423 per year, or $39.6 per hour.

Utilization Review Specialist

ADDICTION AND MENTAL HEALTH SERVICES, LLC

Birmingham, AL • Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 5 days ago

Job description

About Company:

We’re officially a Great Place To Work®! We’ve always believed that supporting our team is just as important as supporting our patients. Now, we’re proud to share that we’ve earned Great Place To Work® Certification - based entirely on feedback from our own employees.

Read more here: https://ow.ly/YQ1C50WuRH1

This certification reflects the culture we’ve worked hard to build - one rooted in trust, inclusion, and purpose-driven leadership.

At Bradford Health Services, we are committed to providing exceptional care to our patients while fostering a supportive and rewarding workplace for our employees. We believe that taking care of our team allows them to take better care of others, which is why we offer a comprehensive benefits package designed to support their well-being.

Our benefits include:

  • Medical Coverage – Three new BCBSAL medical plans with better rates, improved co-pays, and enhanced prescription benefits.

  • Expanded Coverage – Options for domestic partners and a wider network of in-network providers.

  • Mental Health Support – Improved access to services and a new Employee Assistance Program (EAP) featuring digital wellness tools like Cognitive Behavioral Therapy (CBT) modules and wellness coaching.

  • Voluntary Coverages – Pet insurance, home and auto insurance, family legal services, and more.

  • Student Loan Repayment – Available for nurses and therapists.

  • Retirement Benefits – 401(k) plan through Voya to help employees plan for the future.

  • Generous PTO – A robust paid time off policy to support work-life balance.

  • Voluntary Benefits for Part-Time Employees – Dental, vision, life, accident insurance, and telehealth options for those working 20 hours or more per week.

At Bradford Health Services, we don’t just invest in our patients—we invest in our people.



About the Role:

The Utilization Review Specialist plays a critical role in ensuring that healthcare services provided to patients are medically necessary, efficient, and compliant with regulatory standards. This position involves thorough evaluation of patient records, treatment plans, and clinical data to determine the appropriateness of care and resource utilization. The specialist collaborates closely with healthcare providers, insurance companies, and case managers to facilitate timely approvals and optimize patient outcomes. By applying clinical knowledge and analytical skills, the role helps to control healthcare costs while maintaining high-quality patient care. Ultimately, the Utilization Review Specialist contributes to the integrity and sustainability of healthcare delivery systems across the United States.

Minimum Qualifications:

  • Bachelor’s degree in Nursing, Health Administration, or a related healthcare field.
  • At least 2 years of experience in utilization review, case management, or clinical healthcare roles.
  • Strong knowledge of medical terminology, clinical procedures, and healthcare regulations.
  • Familiarity with insurance authorization processes and utilization management guidelines.
  • Excellent communication and analytical skills with attention to detail.

Preferred Qualifications:

  • Registered Nurse (RN) license or relevant clinical certification.
  • Experience working with electronic health record (EHR) systems and utilization review software.
  • Certification in Utilization Review (e.g., Certified Professional in Utilization Review or Certified Case Manager).
  • Knowledge of specific payer policies and healthcare reimbursement models.
  • Advanced training in healthcare compliance and quality assurance.

Responsibilities:

  • Review and analyze medical records, treatment plans, and clinical documentation to assess the necessity and appropriateness of healthcare services.
  • Coordinate with healthcare providers, insurance representatives, and case managers to obtain additional information and clarify treatment details.
  • Make informed decisions regarding authorization, continuation, or denial of services based on clinical guidelines, policies, and regulatory requirements.
  • Document findings and decisions accurately in electronic health record systems and prepare detailed reports for internal and external stakeholders.
  • Stay current with healthcare regulations, insurance policies, and clinical best practices to ensure compliance and effective utilization management.

Skills:

The Utilization Review Specialist uses clinical expertise and analytical skills daily to evaluate patient care plans and determine medical necessity. Strong communication skills are essential for collaborating effectively with healthcare providers and insurance representatives to gather information and explain decisions. Attention to detail ensures accurate documentation and compliance with regulatory standards. Proficiency with electronic health records and utilization management software facilitates efficient case review and reporting. Additionally, staying informed about healthcare policies and clinical guidelines enables the specialist to make well-informed, ethical decisions that balance patient care quality with cost containment.

Apply