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Remote Utilization Review Social Worker Jobs in Boca Raton, FL

Headway

Licensed Clinical Social Worker

Hollywood, FL · On-site +1

$121.74/hr

Licensed Clinical Social Worker (LCSW) Licensed Clinical Social Worker (LCSW) Up to $121.74/hour Fully Remote or In-Person Flexible Schedule Pay & Flexibility * Hourly Rate: Up to $121.74 per hour.

Guardian Recovery

UR COORDINATOR

Delray Beach, FL · On-site +1

$60K - $70K/yr

The Utilization Review Coordinator (UR Coordinator) is responsible to perform the process of ... Master's degree from an accredited college or university in social work, mental health, nursing, or ...

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All JobsUtilization Review Social Worker JobsRemote Utilization Review Social Worker JobsRemote Utilization Review Social Worker Jobs in Boca Raton, FL

Remote Utilization Review Social Worker information

See Boca Raton, FL salary details

$20

$40

$65

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

As of Sep 1, 2026, the average hourly pay for remote utilization review social worker in Boca Raton, FL is $40.12, according to ZipRecruiter salary data. Most workers in this role earn between $31.73 and $46.06 per hour, depending on experience, location, and employer.

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.

What are the key skills and qualifications needed to thrive as a remote utilization review social worker?

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.

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For Remote Utilization Review Social Worker jobs in Boca Raton, FL, the most frequently searched job titles are:

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Remote Utilization Review Social Worker jobs near you
Infographic showing various Remote Utilization Review Social Worker job openings in Boca Raton, FL as of August 2026, with employment types broken down into 68% Full Time, 21% Part Time, and 11% Contract. Highlights an 100% Remote job distribution, with an average salary of $83,458 per year, or $40.1 per hour.

Remote Registered Nurse - Utilization Review - RRNUR 26-10215

Compu-Vision - Healthcare

Fort Lauderdale, FL • Remote

$1.9K/wk

Full-time

This job post has expired today. Applications are no longer accepted.

Job description

Remote Registered Nurse – Utilization Review

Location: Fort Myers, FL 33916
Work Arrangement: Remote
Duration: Contract - 13 Weeks
Schedule: Monday–Friday, 8:00 AM–4:30 PM
Weekend: Every 5th weekend rotation
Radius Requirement: 50-mile radius rule applies — travelers only

Position Overview

We are seeking an experienced Registered Nurse – Utilization Review for a remote Utilization Management position. The ideal candidate will have strong provider-side Utilization Management experience, along with hands-on experience using Dragonfly and Epic.

This role requires an experienced RN who can independently perform utilization review activities in a remote environment and effectively collaborate with providers and healthcare teams.

Key Responsibilities
  • Perform Utilization Review and Utilization Management activities in a provider-side healthcare environment.
  • Review clinical documentation to determine medical necessity and appropriate levels of care.
  • Apply established clinical criteria, policies, and guidelines to utilization decisions.
  • Collaborate with providers, physicians, case management teams, and other healthcare professionals.
  • Review patient records and clinical information using Epic EMR.
  • Utilize Dragonfly for utilization management activities.
  • Identify potential gaps in care and escalate issues appropriately.
  • Maintain accurate and timely documentation of utilization review activities.
  • Communicate effectively with clinical and administrative teams.
  • Support organizational quality, compliance, and utilization management objectives.
  • Float to sister campuses when required.
Required Qualifications
  • Active Registered Nurse (RN) license.
  • Minimum 2 years of relevant experience.
  • Provider-side Utilization Management experience required.
    • Payer-only Utilization Management experience does not qualify.
  • Dragonfly experience required.
  • Epic EMR experience required.
  • CCM or CMCN certification required.
  • Strong clinical assessment, analytical, and documentation skills.
  • Comfortable working independently in a remote environment.
  • Strong computer skills and ability to work effectively with remote technology.
  • Must have access to a personal computer/laptop; equipment is not provided.
  • Prior travel nursing experience highly preferred.
  • Degree accreditation verification required, or 5 years of qualifying experience.
Additional Requirements
  • Must be willing to participate in an every 5th weekend rotation.
  • Must meet the 50-mile radius rule and qualify as a traveler.
  • Floating to sister campuses may be required.
  • Must be comfortable working remotely with minimal supervision.
  • Excellent communication and organizational skills required.