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Remote Utilization Review Jobs in Phoenix, AZ (NOW HIRING)

Banner Health

RN, Case Manager

Phoenix, AZ · Remote

After completing training, it is a remote position with a work schedule of Monday - Friday 8am ... MINIMUM QUALIFICATIONS Must possess knowledge of case management or utilization review as normally ...

Intend Inc d.b.a. Tangelo

Be Seen First

Remote Member Services Contractor

Phoenix, AZ · Remote

$24 - $27/hr

... utilization. * Documentation Support : Contribute to external knowledge bases and FAQs to ensure ... Review system data and provide independent operational insights to streamline the member experience ...

Lincare

Medical Nutrition Spc - Remote

Phoenix, AZ · Remote

$29.25 - $39.25/hr

Conducts nutritional assessments by reviewing medical records, physician orders, and laboratory ... for utilization in patient care applications * Verifies enteral and oral nutrition orders for ...

TEKsystems

REMOTE- Inpatient Coder

Phoenix, AZ · Remote

$22 - $28/hr

Review emergency department medical records and accurately assign ICD-10-CM diagnosis codes, CPT ... including utilization of the ACEP E/M tool. * Analyze clinical documentation from physicians ...

Gastro Care Partners

SCHEDULING COORDINATOR

Foster, OK · On-site +1

$22 - $26/hr

Fully Remote Compensation: Pay $22.00-$26.00 DOE (Depending on Experience) Benefits: This position ... Review schedules to identify coverage gaps, conflicts, capacity constraints, and access concerns.

Banner Health

RN Medical Management

Phoenix, AZ · Remote

... reviews. Ideal candidates have experience in prior authorization or utilization management ... THIS IS A REMOTE POSITION Monday-Friday 8:00AM- 5:00PM AZ TIME WITH ROTATING WEEKENDS EVERY 8 th ...

StateServ Medical LLC

Account Manager - Remote

Mesa, AZ · Remote

$65K - $75K/yr

Partner with Clinical Managers to promote appropriate medication utilization, patient care outcomes, and cost management initiatives. * Lead recurring business reviews by preparing meeting agendas ...

StateServ

Account Manager - Remote

Mesa, AZ · On-site +1

$65K - $75K/yr

Partner with Clinical Managers to promote appropriate medication utilization, patient care outcomes, and cost management initiatives. * Lead recurring business reviews by preparing meeting agendas ...

StateServ

Account Manager - Remote

Mesa, AZ · On-site +1

$65K - $75K/yr

Partner with Clinical Managers to promote appropriate medication utilization, patient care outcomes, and cost management initiatives. * Lead recurring business reviews by preparing meeting agendas ...

StateServ Medical LLC

Account Manager - Remote

Mesa, AZ · Remote

$65K - $75K/yr

Partner with Clinical Managers to promote appropriate medication utilization, patient care outcomes, and cost management initiatives. * Lead recurring business reviews by preparing meeting agendas ...

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Remote Utilization Review information

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How much do remote utilization review jobs pay per hour?

As of Sep 5, 2026, the average hourly pay for remote utilization review in Phoenix, AZ is $41.98, according to ZipRecruiter salary data. Most workers in this role earn between $33.17 and $48.22 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 Phoenix, AZ?

The most popular types of Utilization Review jobs in Phoenix, AZ are:

What are popular job titles related to Remote Utilization Review jobs in Phoenix, AZ?

For Remote Utilization Review jobs in Phoenix, AZ, the most frequently searched job titles are:

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Remote Utilization Review jobs near you
Infographic showing various Remote Utilization Review job openings in Phoenix, AZ as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution, with an average salary of $87,323 per year, or $42 per hour.

Inpatient Care Management Nurse RN - Remote PST MST or CST

UnitedHealth Group

Phoenix, AZ • On-site, Remote

$60K - $107K/yr

Full-time

Retirement

Posted 7 days ago

UnitedHealth Group rating

7.6

Company rating: 7.6 out of 10

Based on 146 frontline employees who took The Breakroom Quiz

191st of 898 rated healthcare providers

Job description

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
As an Inpatient Care Management Nurse, you will be responsible for ensuring proper utilization of our health services. This means you will be tasked with assessing and interpreting member needs and identifying solutions that will help our members live healthier lives. This is an inspiring job at a truly inspired organization.
What makes your nursing career greater with UnitedHealth Group? You can improve the health of others and help heal the health care system. You will work within an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you'll open doors for yourself that simply do not exist in any other organization, anywhere.
You'll enjoy the flexibility to work remotely * from the Pacific, Mountain, or Central Time Zone regions within the U.S. as you take on some tough challenges.
Primary Responsibilities:
  • Perform initial and concurrent review of inpatient cases applying evidenced-based criteria (i.e. MCG/Interqual criteria)
  • Discuss cases with facility healthcare professionals to obtain plans-of-care
  • Collaborate with Optum Enterprise Clinical Services Medical Directors on performing utilization management
  • Participation in discussions with the Clinical Services team to improve the progression of care to the most appropriate level
  • Consult with the Medical Director, as needed, for complex cases and make appropriate referrals to downstream partners
  • Apply clinical expertise when discussing case with internal and external Case Managers and Physicians
  • Identify delays in care or services and manage with MD
  • Follow all Standard Operating Procedures in end to end management of cases
  • Obtain clinical information to assess and expedite alternate levels of care
  • Facilitate timely and appropriate care and effective discharge planning
  • Participate in team meetings, education, discussions, and related activities
  • Maintain compliance with Federal, State and accreditation organizations
  • Identify opportunities for improved communication or processes
  • Participate in audit activities and meetings

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
  • Current, unrestricted RN license in state of Residence
  • 3+ years of clinical nursing experience practicing clinically (Acute Inpatient, SNF/AIR/LTAC, Emergency Department, Urgent Care, Doctor's Office, School Nurse)
  • Experience in acute, long term care, acute rehabilitation, or skilled nursing facilities
  • Proficiency in computer skills - Windows, IM, Excel (Microsoft Suite), Outlook, clinical platforms
  • Designated workspace and access to install secure high-speed internet via cable/DSL in home

Preferred Qualifications:
  • Bachelor's degree
  • Compact license
  • Managed Care experience
  • 1+ years of experience involving utilization review and evidence-based guidelines (i.e. MCG, InterQual Guidelines)
  • Experience performing discharge planning
  • Ability to work independently
  • Demonstrated effective verbal and written communication skills

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

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