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Remote Utilization Review Social Worker Jobs (NOW HIRING)

UK St Claire

Utilization Review Nurse

Morehead, KY · On-site +1

We strive to foster the talent and potential of our employees and prioritize safe working ... Supports utilization review processes by planning, analyzing data, and setting goals to ensure ...

Centene

Utilization Review Clinician - Behavioral Health

OR · On-site +1

$27.02 - $48.55/hr

License/Certification: * LCSW- License Clinical Social Worker required or * LMHC-Licensed Mental ... remote. Hours are Monday-Friday 8:00 am-5:00 pm PST. Must be licensed in state of WA. Pay Range ...

TEEMA Group

REMOTE RN - Quality Review

Phoenix, AZ · Remote

$42 - $43.50/hr

Active, unrestricted license as a Registered Nurse (RN) or Licensed Clinical Social Worker (LCSW) * ... Experience in clinical quality, utilization review, or case review * Familiarity with federal or ...

TEEMA

Clinical Quality Reviewer - REMOTE

$41 - $44/hr

CLINICAL QUALITY REVIEWER (RN or LCSW) Job ID: 87049 Location: USA- Remote in approved states ... Review medical records to identify potential quality, safety, and utilization concerns * Conduct ...

TEEMA Group

Clinical Quality Review Nurse

Phoenix, AZ · Remote

$41 - $44/hr

CLINICAL QUALITY REVIEWER (RN or LCSW) Location: USA- Remote in approved states Overview: TEEMA is ... Review medical records to identify potential quality, safety, and utilization concerns * Conduct ...

TEEMA Group

Clinical Quality Reviewer - REMOTE

Phoenix, AZ · Remote

$40 - $42/hr

Review medical records to identify potential quality, safety, and utilization concerns * Conduct ... Active, unrestricted license as a Registered Nurse (RN) or Licensed Clinical Social Worker (LCSW) * ...

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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 15, 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.
Physician Reviewer - Orthopedic Spine Surgery (Utilization Review)

Physician Reviewer - Orthopedic Spine Surgery (Utilization Review)

Dane Street, LLC

New York, NY • Remote

Contractor

Posted 6 days ago

Job description

Dane Street, a nationally recognized Independent Review Organization (IRO), is expanding its panel of Physician Reviewers. We are currently seeking Board-Certified Orthopedic Spine Surgeons with an active New York medical license and Workers' Compensation Board Certification to conduct Utilization Reviews.

This is a fully remote, non-clinical role offering supplemental income with flexible scheduling. Physicians provide objective, evidence-based opinions on the medical necessity of treatment requests and appeals. No patient contact, no treatment, and no doctor-patient relationship is established.

Key Responsibilities:

  • Review medical records to determine the medical necessity of services
  • Utilize state-specific workers' compensation guidelines and nationally recognized criteria
  • Submit clear, concise, and well-supported determinations
  • Complete reviews within required timeframes (typically 1-5 business days)
  • Participate in peer-to-peer calls as needed (coordinated by Dane Street)
  • Complete addenda when new information is provided

Role Highlights:

  • Independent contractor (1099) status
  • Average case takes 15 minutes or less
  • Flat rate per case - consistent, supplemental income
  • Fully remote - work from anywhere
  • You control volume and availability
  • No direct patient interaction or treatment
  • Chronological, pre-organized medical records provided
  • User-friendly portal and streamlined case management
  • Full onboarding and ongoing support included

Requirements:

  • Board Certification in Orthopedic Surgery (Spine focus preferred)
  • Active, unrestricted New York medical license
  • Workers' Compensation Board Certification (New York)
  • Active clinical practice

About Dane Street:
Dane Street is a national leader in Utilization Review and Independent Medical Review services. We partner with highly qualified, actively practicing physicians to ensure high-quality, evidence-based clinical decisions that support better outcomes across the healthcare system.

Apply today to join our Physician Review Panel and start earning on your schedule.

Apply