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Remote Utilization Review Jobs in Miramar, FL (NOW HIRING)

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;

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Remote Utilization Review information

See Miramar, FL salary details

$19

$39

$63

How much do remote utilization review jobs pay per hour?

As of Aug 29, 2026, the average hourly pay for remote utilization review in Miramar, FL is $39.19, according to ZipRecruiter salary data. Most workers in this role earn between $30.96 and $45.00 per hour, depending on experience, location, and employer.

What is a remote utilization review?

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.

What does a remote utilization review do?

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.

What are the key skills and qualifications needed to thrive in remote utilization review?

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.

What are the most commonly searched types of Utilization Review jobs in Miramar, FL?

The most popular types of Utilization Review jobs in Miramar, FL are:

What are popular job titles related to Remote Utilization Review jobs in Miramar, FL?

For Remote Utilization Review jobs in Miramar, FL, the most frequently searched job titles are:

What job categories do people searching Remote Utilization Review jobs in Miramar, FL look for?

The top searched job categories for Remote Utilization Review jobs in Miramar, FL are:

What cities near Miramar, FL are hiring for Remote Utilization Review jobs?

Cities near Miramar, FL with the most Remote Utilization Review job openings:

Remote Utilization Review jobs near you
Infographic showing various Remote Utilization Review job openings in Miramar, FL as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution, with an average salary of $81,506 per year, or $39.2 per hour.

Utilization Review RN (Remote)

HealthPlus Staffing

Fort Lauderdale, FL • Remote

Full-time

Re-posted 16 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