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Remote Utilization Review Rn Jobs in Boca Raton, FL

Guardian Recovery

UR COORDINATOR

Delray Beach, FL · On-site +1

$60K - $75K/yr

The Utilization Review Coordinator (UR Coordinator) is responsible to perform the process of ... Master's degree from an accredited college or university in social work, mental health, nursing, or ...

Varsity Tutors

NCLEX-RN Tutor

Sunrise, FL · 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 ...

Varsity Tutors

NCLEX-RN Tutor

Miramar, FL · 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 ...

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All JobsUtilization Review Rn JobsRemote Utilization Review Rn JobsRemote Utilization Review Rn Jobs in Boca Raton, FL

Remote Utilization Review Rn information

See Boca Raton, FL salary details

$20

$40

$65

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

As of Jul 26, 2026, the average hourly pay for remote utilization review rn in Boca Raton, FL is $40.12, according to ZipRecruiter salary data. Most workers in this role earn between $31.73 and $46.06 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Remote Utilization Review RN, and why are they important?

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 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 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 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 are popular job titles related to Remote Utilization Review Rn jobs in Boca Raton, FL? For Remote Utilization Review Rn jobs in Boca Raton, FL, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review Rn jobs in Boca Raton, FL look for? The top searched job categories for Remote Utilization Review Rn jobs in Boca Raton, FL are:
What cities near Boca Raton, FL are hiring for Remote Utilization Review Rn jobs? Cities near Boca Raton, FL 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 Boca Raton, FL as of July 2026, with employment types broken down into 72% Full Time, 12% Part Time, and 16% Contract. Highlights an 42% Physical, 4% Hybrid, and 54% Remote job distribution, with an average salary of $83,458 per year, or $40.1 per hour.
Utilization Review RN (Remote)

Utilization Review RN (Remote)

HealthPlus Staffing

Fort Lauderdale, FL • Remote

$80K - $100K/yr

Full-time

Posted 13 days ago

Job description

Quick Job Details:

Setting: Fully Remote – Utilization Review
Schedule: Full-Time, Monday–Friday
Hours: Standard business hours
Patient Volume: N/A
Job Requirements:

  • Active RN license with Multi-State/Compact license required
  • Minimum 2 years of Utilization Review experience
  • Minimum 3 years of clinical nursing experience (acute care/hospital preferred)
  • Strong understanding of medical necessity, utilization management, healthcare reimbursement, and clinical documentation improvement
  • Excellent communication, analytical, and critical thinking skills
  • Ability to work independently in a remote environment

Responsibilities:

  • Conduct admission, continued stay, and observation reviews
  • Apply medical necessity criteria to determine appropriate level of care
  • Review cases for Physician Advisor escalation when appropriate
  • Collaborate with physicians, case managers, and insurance payers
  • Support denial prevention, documentation improvement, and revenue cycle initiatives
  • Ensure compliance with payer guidelines and regulatory requirements
  • Analyze clinical and financial data to identify quality improvement opportunities

Compensation: Competitive; based on experience

Benefits: Comprehensive benefits package

About Us:

HealthPlus Staffing is a national leader in the healthcare staffing industry. We partner with top healthcare organizations nationwide to connect highly qualified professionals with outstanding career opportunities.

Our Promise:

  • We will put you in front of the decision makers.
  • We will provide feedback on your application.
  • We will work on your behalf to obtain as much information as possible to help you make a well-informed decision.

If you're interested in this opportunity, please submit an application or call 561-291-7787 to speak with one of our experienced consultants. We look forward to helping you find your next opportunity!

The HealthPlus Team