Fort Lauderdale, FL · Remote
$80K - $100K/yr
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
New
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Fort Lauderdale, FL · Remote
$80K - $100K/yr
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
New
Fort Lauderdale, FL · On-site +1
$30K - $40K/yr
Remote Preferred Residence: Candidates residing in Florida, Tennessee, Texas, Virginia, South ... Conduct utilization reviews for admissions and continued stays to establish medical necessity and ...
New
Fort Lauderdale, FL · On-site +1
$30K - $40K/yr
Remote Preferred Residence: Candidates residing in Florida, Tennessee, Texas, Virginia, South ... Conduct utilization reviews for admissions and continued stays to establish medical necessity and ...
New
The Manager, Utilization Review is responsible for overseeing the daily operations of the ... HBiz complies with all applicable employment laws for remote and multi-state hiring and provides ...
The Manager, Utilization Review is responsible for overseeing the daily operations of the ... HBiz complies with all applicable employment laws for remote and multi-state hiring and provides ...
We are currently seeking Board-Certified physicians in DERMATOLOGY to conduct independent Utilization Reviews . This is a flexible, fully remote opportunity requiring just 1-2 hours per week -with no ...
We are currently seeking Board-Certified physicians in DERMATOLOGY to conduct independent Utilization Reviews . This is a flexible, fully remote opportunity requiring just 1-2 hours per week -with no ...
We are currently seeking Board-Certified physicians in Rheumatology to conduct independent Utilization Reviews . This is a flexible, fully remote opportunity requiring just 1-2 hours per week -with ...
We are currently seeking Board-Certified physicians in Rheumatology to conduct independent Utilization Reviews . This is a flexible, fully remote opportunity requiring just 1-2 hours per week -with ...
We are currently seeking Board-Certified physicians in RADIOLOGY to conduct independent Utilization Reviews . This is a flexible remote opportunity requiring just 1-2 hours per week -with no minimum ...
We are currently seeking Board-Certified physicians in RADIOLOGY to conduct independent Utilization Reviews . This is a flexible remote opportunity requiring just 1-2 hours per week -with no minimum ...
Miami, FL · On-site +1
Minimum 7 years of relevant experience (5 years of case management/utilization review experience) Knowledge, Skills and Attitudes: • Ability to communicate effectively in both oral and written form ...
Miami, FL · On-site +1
Minimum 7 years of relevant experience (5 years of case management/utilization review experience) Knowledge, Skills and Attitudes: • Ability to communicate effectively in both oral and written form ...
In collaboration with Utilization Management leadership, develop and maintain effective working relationships with contracted providers involved in remote utilization review and physician advisory ...
In collaboration with Utilization Management leadership, develop and maintain effective working relationships with contracted providers involved in remote utilization review and physician advisory ...
Delray Beach, FL · On-site +1
$60K - $75K/yr
The Utilization Review Coordinator (UR Coordinator) is responsible to perform the process of utilization review to ensure appropriate reimbursement by third party payers. This includes managing ...
Delray Beach, FL · On-site +1
$60K - $75K/yr
The Utilization Review Coordinator (UR Coordinator) is responsible to perform the process of utilization review to ensure appropriate reimbursement by third party payers. This includes managing ...
Utilization Management Physician (UMP) Remote | Full-Time | Florida Compensation: $240,000 base ... Responsibilities * Review pre-auths, concurrent reviews, claims, and appeals * Make medical ...
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Utilization Management Physician (UMP) Remote | Full-Time | Florida Compensation: $240,000 base ... Responsibilities * Review pre-auths, concurrent reviews, claims, and appeals * Make medical ...
Miami, FL · On-site +1
$204K - $292K/yr
At least one (1) year of utilization review experience preferred PAY RANGE: $204,761 - $292,515 ... Remote
Miami, FL · On-site +1
$204K - $292K/yr
At least one (1) year of utilization review experience preferred PAY RANGE: $204,761 - $292,515 ... Remote
... work remote. The incumbent conducts initial, concurrent and retrospective chart reviews for ... The Utilization Review Case Manager coordinates with the healthcare team for optimal and efficient ...
... work remote. The incumbent conducts initial, concurrent and retrospective chart reviews for ... The Utilization Review Case Manager coordinates with the healthcare team for optimal and efficient ...
... work remote. The incumbent conducts initial, concurrent and retrospective chart reviews for ... The Utilization Review Case Manager coordinates with the healthcare team for optimal and efficient ...
... work remote. The incumbent conducts initial, concurrent and retrospective chart reviews for ... The Utilization Review Case Manager coordinates with the healthcare team for optimal and efficient ...
... work remote. The incumbent conducts initial, concurrent and retrospective chart reviews for ... The Utilization Review Case Manager coordinates with the healthcare team for optimal and efficient ...
... work remote. The incumbent conducts initial, concurrent and retrospective chart reviews for ... The Utilization Review Case Manager coordinates with the healthcare team for optimal and efficient ...
... work remote. The incumbent conducts initial, concurrent and retrospective chart reviews for ... The Utilization Review Case Manager coordinates with the healthcare team for optimal and efficient ...
... work remote. The incumbent conducts initial, concurrent and retrospective chart reviews for ... The Utilization Review Case Manager coordinates with the healthcare team for optimal and efficient ...
Sarasota, FL · Remote
$40/hr
Utilization/Medical record review and chart abstraction * Current standards of medical practice ... Remote Work, Prolonged Sitting, Screen Exposure This is not designed to cover or contain a ...
Sarasota, FL · Remote
$40/hr
Utilization/Medical record review and chart abstraction * Current standards of medical practice ... Remote Work, Prolonged Sitting, Screen Exposure This is not designed to cover or contain a ...
Orlando, FL · Remote
$40/hr
Utilization/Medical record review and chart abstraction * Current standards of medical practice ... Remote Work, Prolonged Sitting, Screen Exposure This is not designed to cover or contain a ...
Orlando, FL · Remote
$40/hr
Utilization/Medical record review and chart abstraction * Current standards of medical practice ... Remote Work, Prolonged Sitting, Screen Exposure This is not designed to cover or contain a ...
Tampa, FL · Remote
$40/hr
Utilization/Medical record review and chart abstraction * Current standards of medical practice ... Remote Work, Prolonged Sitting, Screen Exposure This is not designed to cover or contain a ...
Tampa, FL · Remote
$40/hr
Utilization/Medical record review and chart abstraction * Current standards of medical practice ... Remote Work, Prolonged Sitting, Screen Exposure This is not designed to cover or contain a ...
Plantation, FL · On-site +1
$25.75 - $33.25/hr
Experience with utilization management systems or clinical decision-making tools such as Medical ... Effectively work independently and as a team, in a remote setting. Required and Preferred ...
Plantation, FL · On-site +1
$25.75 - $33.25/hr
Experience with utilization management systems or clinical decision-making tools such as Medical ... Effectively work independently and as a team, in a remote setting. Required and Preferred ...
Plantation, FL · On-site +1
$25.75 - $33.25/hr
Experience with utilization management systems or clinical decision-making tools such as Medical ... Effectively work independently and as a team, in a remote setting. Required and Preferred ...
Plantation, FL · On-site +1
$25.75 - $33.25/hr
Experience with utilization management systems or clinical decision-making tools such as Medical ... Effectively work independently and as a team, in a remote setting. Required and Preferred ...
$15.99 - $19.22
2% of jobs
$19.22 - $22.45
9% of jobs
$24.67 is the 25th percentile. Wages below this are outliers.
$22.45 - $25.69
21% of jobs
The median wage is $28.31 / hr.
$25.69 - $28.92
23% of jobs
$28.92 - $32.16
13% of jobs
$34.67 is the 75th percentile. Wages above this are outliers.
$32.16 - $35.39
10% of jobs
$35.39 - $38.62
8% of jobs
$38.62 - $41.86
5% of jobs
$41.86 - $45.09
5% of jobs
$45.09 - $48.32
2% of jobs
$48.32 - $51.56
2% of jobs
$15
$31
$51
To thrive as a Remote Utilization Review professional, you need a solid foundation in clinical knowledge, critical thinking, and an active RN or LPN license, often supported by experience in case management or prior authorization. Familiarity with medical coding (ICD-10, CPT), electronic health records (EHRs), and utilization management software is typically required, along with URAC or related certifications. Excellent communication, attention to detail, and strong organizational skills help you efficiently manage cases and coordinate with providers and payers. These skills ensure accurate assessments of medical necessity, compliance with regulations, and effective remote collaboration with healthcare teams.
A typical day for a Remote Utilization Review professional involves reviewing patient medical records, evaluating the necessity of proposed treatments against established guidelines, and collaborating with healthcare providers to gather additional information when needed. You will spend much of your time analyzing documentation, submitting recommendations, and ensuring that care authorization decisions align with payer policies and clinical best practices. Communication with case managers, physicians, and insurance representatives is frequent and essential. The work is generally independent and deadline-driven but requires strong teamwork and responsiveness through virtual meetings, emails, and calls.
A Remote Utilization Review job involves assessing medical records and treatment plans to ensure they meet insurance guidelines and medical necessity criteria. Professionals in this role, often nurses or healthcare specialists, work remotely to review patient care for cost-effectiveness and compliance with policies. They collaborate with healthcare providers, insurance companies, and case managers to approve or deny services based on established guidelines. This position requires strong analytical skills, knowledge of medical policies, and attention to detail.
$80K - $100K/yr
Full-time
Posted 2 days ago
New
Quick Job Details:
Setting: Fully Remote – Utilization Review
Schedule: Full-Time, Monday–Friday
Hours: Standard business hours
Patient Volume: N/A
Job Requirements:
Responsibilities:
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:
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
Sourced by ZipRecruiter
Recruiting and staffing services
11 - 50 Employees
Boynton Beach, FL, US
2019
