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

HandsOn Global Management

Be Seen First

UM Review Nurse

Tampa, FL · Remote

$36 - $40/hr

Performs prospective, concurrent, and retrospective inpatient and/or outpatient utilization reviews ... Licensed RN or LPN required. * Minimum of two to three years varied clinical experience required.

paradigm

Clinical Navigator

Tampa, FL · Remote

$61K - $84K/yr

Experience with DME, utilization review, EMRs, care management platforms, and Microsoft Office ... Qualifications: * RN required. * 3-5 years Workers' compensation and/or complex case management ...

paradigm

Clinical Navigator

Tampa, FL · Remote

$61K - $84K/yr

Experience with DME, utilization review, EMRs, care management platforms, and Microsoft Office ... Qualifications: * RN required. * 3-5 years Workers' compensation and/or complex case management ...

NTT DATA Services

BPO Senior Manager

Tampa, FL · Remote

$93K/yr

... reviewers supporting the appeals and utilization management process. This role ensures all appeal ... Active Registered Nurse (RN) license required. (Not encumbered only) * Florida State-required RN ...

NTT DATA Services

BPO Senior Manager

Tampa, FL · Remote

$93K/yr

... reviewers supporting the appeals and utilization management process. This role ensures all appeal ... Active Registered Nurse (RN) license required. (Not encumbered only) * Florida State-required RN ...

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Remote Utilization Review Rn information

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

As of Sep 3, 2026, the average hourly pay for remote utilization review rn in Tampa, FL is $39.96, according to ZipRecruiter salary data. Most workers in this role earn between $31.59 and $45.87 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 Tampa, FL?

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

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

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

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

Cities near Tampa, 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 Tampa, FL as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 14% Part Time, 3% Contract, and 1% Nights. Highlights an 86% Physical, 2% Hybrid, and 12% Remote job distribution, with an average salary of $83,111 per year, or $40 per hour.

UM Review Nurse

HandsOn Global Management

Tampa, FL • Remote

$36 - $40/hr

Full-time

Medical, PTO

Posted 17 days ago

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Job description

PURPOSE AND SCOPE:

The UM Nurse Reviewer is responsible for the medical necessity review of outpatient services that

require prior authorization, and /or management of concurrent inpatient admissions. The medical

necessity review process includes assessment and interpretation of plan specific benefits, medical

criteria, and clinical documentation.

PRINCIPAL RESPONSIBILITIES AND DUTIES

• Performs prospective, concurrent, and retrospective inpatient and/or outpatient utilization reviews

(UR) using evidence-based guidelines, policies and nationally recognized clinical criteria, and internal

policies and procedures.

• Evaluates severity of illness and intensity of service of member’s needs at time of inpatient

admission utilizing approved criteria.

• Triage and prioritize cases and other assigned duties to meet CMS turnaround time standards.

• Prepare and escalate cases to MDs for review when appropriate.

• Demonstrates effective communication methods and skills, using lines of authority appropriately.

• Establishes a relationship with providers to determine/provide needed services to member.

• Maintains accurate record of UR activities.

• Regular attendance is required as employee works as part of a team & requires interaction with

medical staff and clients.

• Adheres to quality standards and confidentiality policies and procedures.

• Ensures compliance with all state and federal regulations and guidelines in day-to-day activities.

• Adapts to changes in policies, procedures, new techniques, and additional responsibilities.


CUSTOMER SERVICE:

• Responsible for driving the HealthOps culture through values and customer service standards.

• Accountable for outstanding customer service to all external and internal contacts.

• Develops and maintains positive relationships through effective and timely communication.

• Takes initiative and action to respond, resolve and follow up regarding customer service issues with all

customers in a timely manner.


EDUCATION, EXPERIENCE AND REQUIRED SKILLS:

• Licensed RN or LPN required.

• Minimum of two to three years varied clinical experience required.

• Managed care experience preferred.

• An equivalent combination of education, training, and experience.

• Ability to read and interpret documents and calculate figures and amounts.

• Excellent oral and written communication skills including good grammar, voice and diction.

• Proficient in MS Office with basic computer and keyboarding skills.

• Excellent customer service skills (friendly, courteous and helpful).

• InterQual experience helpful.

Company Description

HandsOn Global Management (“HGM”) is a hybrid family office / PE fund / technology incubator focused on building innovative companies and driving synergies within our portfolio. We specialize in technology platforms, analytics and business process services.

Headquartered in Santa Monica, CA, HandsOn Global Management (“HGM”) manages a number of funds and investments in partnership with some of the world’s largest investment banks, private equity groups and global financial institutions. Over the last decade, HGM has completed several acquisitions, integrated them and taken some public. Companies acquired and controlled by HGM employ over 17,000 people in the Americas, EMEA, and Asia, and have over 50% of the Fortune 100® as customers.

HGM’s main focus is on acquiring synergetic assets in U.S. and emerging markets, which yield above-market returns. To achieve this goal, HGM invests in companies with strong fundamentals and significant performance improvement potential, where the HGM team can apply their hands-on approach to managing portfolio companies, as well as their investment discipline and technology to increase the overall value proposition of each portfolio company.