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Remote Utilization Review Rn Jobs in Mobile, AL (NOW HIRING)

Pharmacy Careers

Appeals Pharmacist (Remote)

Mobile, AL · On-site +1

$48.75 - $59.50/hr

Collaborate with physicians, nurses, and medical directors during case reviews. * Track, document ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...

DataAnnotation

Registered Nurse

Mobile, AL · Remote

$40 - $60/hr

MDs, PAs, and Nurses. Benefits ... This a full-time or part-time REMOTE position * You'll be able to choose which projects you want to ...

DataAnnotation

RN

Mobile, AL · Remote

$40 - $60/hr

MDs, PAs, and Nurses. Benefits ... This a full-time or part-time REMOTE position * You'll be able to choose which projects you want to ...

ZOLL Medical

Patient Service Representative

Daphne, AL · Remote

$15.25 - $19.25/hr

Preferred Candidates include (not limited to): RN, EMT, Paramedic, EMS, Firefighter, PA, LPN, MA ... All candidates reviewed on an individual basis. Summary Description: The Cardiac Management ...

ZOLL LifeVest

Patient Service Representative

Foley, AL · Remote

$15 - $19/hr

Preferred Candidates include (not limited to): RN, EMT, Paramedic, EMS, Firefighter, PA, LPN, MA ... All candidates reviewed on an individual basis. Summary Description: The Cardiac Management ...

ZOLL Medical

Patient Service Representative

Foley, AL · Remote

$15 - $19/hr

Preferred Candidates include (not limited to): RN, EMT, Paramedic, EMS, Firefighter, PA, LPN, MA ... All candidates reviewed on an individual basis. Summary Description: The Cardiac Management ...

Outokumpu

Legal Counsel - USA & Canada

Calvert, AL · On-site +1

If remote from Atlanta or anywhere else, monthly travel to Calvert, Alabama for 2-3 day stay ... Draft, review, and negotiate a wide range of procurement and buy-side agreements, including ...

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Remote Utilization Review Rn information

See Mobile, AL salary details

$21

$41

$68

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

As of May 29, 2026, the average hourly pay for remote utilization review rn in Mobile, AL is $41.96, according to ZipRecruiter salary data. Most workers in this role earn between $33.17 and $48.17 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 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 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 popular job titles related to Remote Utilization Review Rn jobs in Mobile, AL? For Remote Utilization Review Rn jobs in Mobile, AL, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review Rn jobs in Mobile, AL look for? The top searched job categories for Remote Utilization Review Rn jobs in Mobile, AL are:
What cities near Mobile, AL are hiring for Remote Utilization Review Rn jobs? Cities near Mobile, AL with the most Remote Utilization Review Rn job openings:
Remote Utilization Review Rn jobs near you

Remote Prior Authorization Pharmacist

Pharmacy Careers

Mobile, AL • Remote

$49.75 - $59.75/hr

Other

Posted 5 days ago

Job description

Remote Prior Authorization Pharmacist - Work From Home in Managed Care
A confidential managed care organization is seeking a motivated Remote Prior Authorization Pharmacist to evaluate prescription requests, ensure medical necessity, and improve patient access to safe and effective therapies. This work-from-home position is ideal for pharmacists who want to transition out of retail or hospital settings while building expertise in managed care.
Key Responsibilities

  • Review prior authorization requests for accuracy, appropriateness, and clinical necessity.
  • Apply plan criteria, evidence-based guidelines, and regulatory standards to determinations.
  • Communicate approval/denial decisions clearly to providers and patients.
  • Collaborate with physicians, nurses, and medical directors on complex cases.
  • Document outcomes in compliance with health plan policies and CMS/state regulations.
  • Support process improvements to streamline workflow and turnaround times.


What You'll Bring

  • Education: Doctor of Pharmacy (PharmD) or Bachelor of Pharmacy degree.
  • Licensure: Active and unrestricted pharmacist license in the U.S.
  • Experience: Prior authorization, utilization management, or managed care preferred - retail or hospital pharmacists with strong clinical judgment are encouraged to apply.
  • Skills: Excellent clinical review, documentation, and communication skills.

Why This Role?

  • Flexibility: 100% remote work from home with flexible scheduling options.
  • Impact: Directly influence patient access to safe and cost-effective medications.
  • Growth: Build specialized skills in utilization management and managed care.
  • Rewards: Competitive compensation, benefits, and career advancement opportunities.


About Us
We are a confidential healthcare partner working with health plans and PBMs across the U.S.. Our pharmacists ensure patients receive the right therapy at the right time while maintaining compliance with all regulations.
Apply Today
Take the next step in your career with our Remote Prior Authorization Pharmacist opportunity - and enjoy the benefits of working from home while shaping the future of managed care.

Apply