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Remote Utilization Review Social Worker Jobs (NOW HIRING)

Mindful Health

Utilization Review Specialist

$25 - $30/hr

We seek enthusiastic individuals passionate about helping clients and value working in a team ... Coordinate with Social Services to support timely discharge planning * Prepare and present monthly ...

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;

Winston Medical Staffing

Be Seen First

Utilization Review Nurse

Newark, NJ · Remote

$38 - $40/hr

Position is 100% remote but will have to go to Newark, NJ to pick up equipment and short ... working knowledge of operations of utilization, case and/or disease management processes ...

Umpqua Health

Utilization Review Nurse

Roseburg, OR · Remote

$85K - $105K/yr

UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR ... Working with a variety of personalities, maintaining a consistent and fair communication style.

Umpqua Health

Utilization Review Nurse

Roseburg, OR · On-site +1

$85K - $105K/yr

UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR ... Working with a variety of personalities, maintaining a consistent and fair communication style.

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

As of Jul 13, 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 69% Full Time, 14% Part Time, 3% Temporary, and 14% Contract. Highlights an 100% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.
Utilization Review Specialist

Utilization Review Specialist

Mindful Health

Remote

$25 - $30/hr

Full-time

Medical, Dental, Vision, Life, PTO

Re-posted 17 days ago

Job description

Utilization Review Specialist
Mindful Health is a fast-growing company with the goal of providing an intentionally different approach to mental health and well-being. We are a combination of bricks and mortar locations and virtual service offerings across the state of Texas to create a high-end client experience.
Mindful Health creates an atmosphere that supports and values our clients and team members. Our commitment is to cultivate a place that provides intentional and exceptional care for our clients and a warm and nurturing environment for our team so we can make a lasting impact in our communities. We believe that health encompasses the whole person, mind, and body, and our clinical programming is built around this belief. We work to empower clients to live fuller and healthier lives. We maintain these same beliefs in developing and supporting our Mindful Health team. We seek enthusiastic individuals passionate about helping clients and value working in a team environment. Please visit our website for more information about our services, locations and team at www.mindful.health.
Job Summary:
Utilization Review Specialist: Responsible for ensuring adherence to Mindful Health’s utilization review plan by evaluating the efficiency, effectiveness, and medical necessity of outpatient services, including admissions and extended treatment. *Must reside in Texas*
Duties/Responsibilities:
  • Establish processes to verify the medical necessity and appropriateness of outpatient admissions
  • Conduct concurrent reviews to ensure extended stays are justified and properly documented
  • Track patient lengths of stay and continued-stay days
  • Refer non-compliant cases to the Physician Advisor for further evaluation
  • Collaborate with the Utilization Review Committee to identify and resolve review-related issues
  • Flag quality-of-care concerns and escalating them to the Quality Assurance Committee
  • Coordinate with Social Services to support timely discharge planning
  • Prepare and present monthly utilization reports and key metrics
Required Skills:
  • Strong verbal and written communication abilities
  • Exceptional organizational skills and keen attention to detail
  • Proven time management skills with the ability to meet deadlines consistently
  • Proficiency in Microsoft Office Suite and related software applications
Education and Experience:
  • Associate's or Bachelor’s degree in a healthcare related field preferred
  • 1–2 years of experience in utilization review
  • Active CPR certification
Physical Requirements:
  • Ability to sit at a desk and work on a computer for extended periods
  • Capable of lifting, holding, pushing, and pulling up to 15 pounds
  • Proficient in typing, navigating, and viewing monitors for prolonged durations
  • Visual acuity to view monitors with close vision, color perception, depth perception, and focus adjustment
  • Effective verbal and written communication skills to engage with patients, team members, and customers
  • Ability to read, write, and comprehend information through active listening
  • Consistent performance of essential job functions in accordance with ADA, FMLA, and applicable federal, state, and local regulations, including meeting productivity standards
  • Reliable and punctual attendance aligned with workplace standards
  • Flexibility to work at multiple locations during a scheduled work week
  • Mobility to move throughout the office or client sites to assist patients as needed
Mindful Health offers:
  • A healthy amp; positive atmosphere where everyone is valued.
  • Schedule: Monday-Friday, 8AM-5PM CST
  • Salary: $25.00 - $30.00 / hr

Benefits:
  • 120 hours (15 days) of paid time off annually
  • 9 paid holidays
  • 40 hours (5 days) of sick leave
  • 24 hours (3 days) of bereavement leave per occurrence
  • Comprehensive medical and supplemental health insurance, including vision, dental, life insurance, amp; both short- and long-term disability
  • Opportunities for professional development and continued education

The job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee. Duties, responsibilities, and activities may change, or new ones may be assigned at any time with or without notice. Employee signature below indicates the employee’s understanding of the requirements, essential functions, and duties of the position.

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