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Remote Utilization Review Rn Jobs in Miami, FL (NOW HIRING)

Sanitas

Palliative Medical Director (68386)

Doral, FL · On-site +1

... management, utilization review and quality assurance. * Collaborates in the development and ... Provides professional oversight for advanced practice nurses (ARNP) and/or physician assistants ...

IQVIA

Flex Nurse Educator

Miami, FL · Remote

Deliver remote patient education, including medication administration training and adherence ... Active RN license in good standing (compact multi-state preferred); may be required to obtain ...

IQVIA

Flex Nurse Educator - Miami, FL

Miami, FL · Remote

Deliver remote patient education, including medication administration training and adherence ... Active RN license in good standing (compact multi-state preferred); may be required to obtain ...

York Risk Services

RN Field Case Manager

Miami, FL · On-site +1

$74K - $94K/yr

... remote work environment that allows face to face interaction with injured workers and medical ... RN licensure required. Valid driver's license required. High speed internet required. Employment ...

Sedgwick

RN Field Case Manager

Miami, FL · On-site +1

$74K - $94K/yr

... remote work environment that allows face to face interaction with injured workers and medical ... RN licensure required. Valid driver's license required. High speed internet required. Employment ...

Scribe-X

Remote Medical Scribe

Fort Lauderdale, FL · 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 ...

Scribe-X

Remote Medical Scribe

Miami, FL · 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 ...

Scribe-X

Remote Medical Scribe

Hialeah, FL · 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 ...

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Remote Utilization Review Rn information

See Miami, FL salary details

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

As of Sep 6, 2026, the average hourly pay for remote utilization review rn in Miami, FL is $40.44, according to ZipRecruiter salary data. Most workers in this role earn between $31.97 and $46.44 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 Miami, FL?

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

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

The top searched job categories for Remote Utilization Review Rn jobs in Miami, FL are:

What cities near Miami, FL are hiring for Remote Utilization Review Rn jobs?

Cities near Miami, 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 Miami, FL as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution, with an average salary of $84,116 per year, or $40.4 per hour.

Palliative Medical Director (68386)

Sanitas

Doral, FL • On-site, Remote

Full-time

Re-posted 8 days ago

Key responsibilities

  • Oversees the coordination and oversight of all medical care and quality of services provided at the center level.

  • Provides leadership for activities related to the delivery of medical care and clinical services, including quality assurance and policy development.

  • Performs direct patient care within the clinic scope of practice.

Job description

Job Summary
The Medical Director is responsible for the coordination and oversight of all medical care and quality of services provided at the center level. They ensure proper functioning of day-to-day operations of the facility, in coordination with clinic staff, to provide consistent quality of care to patients. This role also provides delivery of medical services to patients of the center. The Medical Director oversees the activities of group providers, analyzes results and provides feedback.
Essential Job Functions
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
  • Provides leadership for several activities related to the delivery of medical care and clinical services such as cost management, utilization review and quality assurance.
  • Collaborates in the development and periodic review of written clinical policies, guidelines and protocols for the functioning of the clinic and responsibilities of the clinicians.
  • Supervises risk coding, HEDIS quality metric completion by group providers and provides feedback.
  • Participates in the recruitment and selection process for medical providers and other clinic staff.
  • Plans, assigns, and directs work; assesses and appraises providers performance.
  • Assumes responsibility for quality of medical services rendered to patients by monitoring quality and appropriateness of care.
  • Provides guidance and leadership for performance guidelines.
  • Oversee clinical peer review.
  • Provides supervision of continuing professional education, in-service training and orientation of new medical staff.
  • Provides key input to the development of care delivery policies and procedures.
  • Oversees documentation and care planning.
  • Performs periodic review of practice management functions.
  • Address emergency issues.
  • Assures a high standard of medical care by reviewing results of patient satisfaction surveys; reviews and handles clinical patient complaints.
  • Maintains OSHA, ACHA, emergency preparedness, infection control and regulatory compliance for the clinic.
  • Supports provider education, in-service training and orientation of new medical staff.
  • Provides professional oversight for advanced practice nurses (ARNP) and/or physician assistants (PAs) with collaboration agreements.
  • Handles provider behavior and impairment issues.
  • Analyzes, manages and develops improvement plans for adverse events as well as patient complaints/issues that arise from medical care.
  • Leads physician governance committees to include Medical Records Quality Committee, Infection Diseases Committee, and Adverse Events Committee.
  • Participate and lead in future development projects for the organization.
  • Deliver direct patient care within the clinic scope of practice.
  • Perform other duties as assigned by the executive team.

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