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Remote Utilization Review Rn Jobs in Spring Hill, FL

Liberty Dental Plan Careers

Senior Staff Dentist

Tampa, FL · Remote

$175K - $185K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Conduct retrospective utilization reviews and support provider behavior change initiatives ... Remote role with collaboration across national teams * High-impact role shaping clinical standards ...

LIBERTY DENTAL

Senior Staff Dentist

Tampa, FL · On-site +1

$175K - $185K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Conduct retrospective utilization reviews and support provider behavior change initiatives ... Remote role with collaboration across national teams * High-impact role shaping clinical standards ...

Belle, LLC

Nurse Practitioner: Remote Urgent Care

Tampa, FL · Remote

$104K - $144K/yr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

As these issues arise, a team of remote nurses coordinate care with other healthcare providers ... Evaluate symptoms, review medical histories, and determine appropriate interventions. * Determine ...

Scribe-X

Remote Medical Scribe

Tampa, FL · Remote

$14 - $17/hr

  • Medical

  • PTO

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 ...

Elevance Health

Utilization Management Rep I (contract)

Tampa, FL · Remote

$35K - $40K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Refers cases requiring clinical review to a Nurse reviewer. * Responsible for the identification ... The position is remote. The training will be onsite in the Tampa office for 1-2 weeks. * 5411 Sky ...

Oshi Health

Registered Dietitian

Tampa, FL · 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:

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Showing results 21-40

All JobsUtilization Review Rn JobsRemote Utilization Review Rn JobsRemote Utilization Review Rn Jobs in Spring Hill, FL

Remote Utilization Review Rn information

See Spring Hill, FL salary details

$18

$35

$58

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

As of Aug 17, 2026, the average hourly pay for remote utilization review rn in Spring Hill, FL is $35.87, according to ZipRecruiter salary data. Most workers in this role earn between $28.37 and $41.20 per hour, depending on experience, location, and employer.

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 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 Spring Hill, FL?

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

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

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

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

Cities near Spring Hill, 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 Spring Hill, 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 $74,613 per year, or $35.9 per hour.

Behavioral Health Care Advocate - UM - Remote

UnitedHealth Group

Tampa, FL • On-site, Remote

$60K - $107K/yr

Full-time

Retirement

Re-posted 24 days ago

UnitedHealth Group rating

7.6

Company rating: 7.6 out of 10

Based on 146 frontline employees who took The Breakroom Quiz

189th of 887 rated healthcare providers

Job description

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
The Optum family of businesses, is seeking a Behavioral Health Care Advocate to join our team. As a member of the Optum Behavioral Care team, you'll be an integral part of our vision to make healthcare better for everyone.
At OptumHealth, you will perform within an innovative culture that's focused on transformational change in the health care system. You will leverage your skills across a diverse and multi-faceted business. And you will make contributions that will have an impact that's greater than you've ever imagined.
The Strategic Outpatient Engagement & Management (STEM) Care Advocate will complete telephonic clinical reviews directly with Providers to ensure members are getting the most effective and efficient care promoting best practices in the Outpatient psychotherapy and community-based treatment setting.
This position is inbound-queue based, and is fully remote, with a Monday-Friday, 10:30am - 7:00pm CST schedule
You'll enjoy the flexibility to work remotely* from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
  • Focus on outpatient commercial, Medicaid and Medicare behavioral health services
  • Conducting outpatient reviews to determine appropriate care
  • Assessing if member care meets coverage guidelines
  • Shaping member treatment in partnership with providers to ensure best practices
  • Administering benefits and reviewing treatment plans

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
  • Active, unrestricted, Independent Level Clinician in Psychology, Social Work, Counseling or Marriage or Family Counseling with 2+ years of experience in behavioral health
  • Active, unrestricted independent licensure in state of residence
  • 2+ years of experience in a behavioral health setting
  • Outpatient psychotherapy and community-based treatment experience
  • Proven MS Office proficiency (Word, Excel, Outlook, Internet)
  • Distraction-free space in home to use as a home office
  • Access to high-speed internet (DSL or Cable)

Preferred Qualifications:
  • 2+ years of demonstrated experience (post licensure) in a related mental health environment including outpatient services
  • Experience working with EMRs (electronic medical records)
  • Experience in managed care
  • Experience conducting clinical review to determine appropriate levels of care
  • Demonstrated telephonic/office-based experience
  • Telephone queue experience
  • Utilization review/management experience

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

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