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Remote Utilization Review Social Worker Jobs (NOW HIRING)

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Concurrent Utilization Review (UR) Nurse

OR · Remote

$30 - $38/hr

Concurrent Utilization Review (UR) Nurse Remote Opportunity Contract to Hire Must be licenses in ... social workers, and care teams to facilitate seamless care transitions. · Participate in ...

Bracane Co

Utilization Review Nurse

Plano, TX · Remote

***REMOTE - Candidates must be based in Texas: Austin area - Travis/Williamson Counties or Richardson ... ** RN working in the insurance or managed care industry using medically accepted criteria to ...

Oscar Health

Utilization Review Nurse

Miami, FL · Remote

$35 - $45.94/hr

You will report into the Supervisor, Utilization Review. Work Location ... This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois;

Oscar Health

Utilization Review Nurse

Dallas, TX · Remote

$35 - $45.94/hr

You will report into the Supervisor, Utilization Review. Work Location ... This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois;

Oscar Health

Utilization Review Nurse

Atlanta, GA · Remote

$35 - $45.94/hr

You will report into the Supervisor, Utilization Review. Work Location ... This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois;

Oscar Health

Utilization Review Nurse

Tempe, AZ · Remote

$35 - $45.94/hr

You will report into the Supervisor, Utilization Review. Work Location ... This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois;

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Remote Utilization Review Social Worker information

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How much do remote utilization review social worker jobs pay per hour?

As of Jul 31, 2026, the average hourly pay for remote utilization review social worker in the United States is $42.28, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 per hour, depending on experience, location, and employer.

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

To thrive as a Remote Utilization Review Social Worker, you need a background in social work (often a MSW and relevant licensure), knowledge of medical terminology, and experience in patient care coordination. Familiarity with utilization management software, electronic health records (EHRs), and certification such as ACM or CCM is typically required. Strong analytical thinking, communication skills, and the ability to work independently are vital soft skills for this position. These skills ensure effective patient advocacy, compliance with regulations, and optimal resource utilization in a remote healthcare environment.

How does a Remote Utilization Review Social Worker typically collaborate with interdisciplinary teams while working off-site?

Remote Utilization Review Social Workers regularly communicate with physicians, nurses, case managers, and insurance representatives through virtual meetings, secure emails, and electronic health record systems. Despite working remotely, they play a key role in ensuring appropriate patient care by reviewing cases, discussing treatment plans, and advocating for necessary services. Collaboration often involves scheduled case conferences and prompt responses to queries, requiring strong organizational and digital communication skills. Building effective working relationships remotely is crucial for delivering coordinated, patient-centered care.

What does a Remote Utilization Review Social Worker do?

A Remote Utilization Review Social Worker evaluates patient care plans and medical records to ensure that healthcare services are medically necessary, appropriate, and cost-effective. Working remotely, they collaborate with healthcare providers, insurance companies, and patients to review treatment plans and make recommendations on care approvals or alternatives. Their goal is to help manage healthcare costs while ensuring patients receive the care they need, often working within hospitals, insurance companies, or third-party review organizations.
More about Remote Utilization Review Social Worker jobs
What cities are hiring for Remote Utilization Review Social Worker jobs? Cities with the most Remote Utilization Review Social Worker job openings:
What are the most commonly searched types of Utilization Review Social Worker jobs? The most popular types of Utilization Review Social Worker jobs are:
What states have the most Remote Utilization Review Social Worker jobs? States with the most job openings for Remote Utilization Review Social Worker jobs include:
What job categories do people searching Remote Utilization Review Social Worker jobs look for? The top searched job categories for Remote Utilization Review Social Worker jobs are:
Remote Utilization Review Social Worker jobs near you
Infographic showing various Remote Utilization Review Social Worker job openings in the United States as of July 2026, with employment types broken down into 70% Full Time, 16% Part Time, 7% Temporary, and 7% Contract. Highlights an 100% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

Utilization Review RN (Remote)

HealthPlus Staffing

Fort Lauderdale, FL • Remote

$80K - $100K/yr

Full-time

Posted 17 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